Wisconsin program
Help paying the work-plan premium (HIPP)
Wisconsin can pay work-plan premiums for eligible families who also have BadgerCare Plus.
What it is
Wisconsin can pay work-plan premiums for eligible families who also have BadgerCare Plus.
HIPP compares the cost of the employer plan and Medicaid's remaining coverage with Medicaid alone. Approval can reduce the family's payroll deduction while preserving the work plan's network. BadgerCare Plus enrollment comes first.
Eligibility rules
- Children, pregnant members, parents and caretakers on BadgerCare Plus can qualify. Adults without children are excluded.
- The state compares employer-plan and wraparound costs with direct Medicaid coverage. The current policy has no minimum employer-contribution test.
What you get
- Payment of the family's employer-plan premium when approved.
- Help with the plan's deductibles and coinsurance.
- Medicaid benefits for care the employer plan leaves out.
If you decide to apply
- Your social worker can help you decide whether to talk with the income maintenance agency about a HIPP referral and current form.
- Bring the family's premium amount, the employer plan's benefit summary and your child's ForwardHealth number.
Your income maintenance agency for a HIPP referral; agency referral: 800-362-3002 · Official page ↗
Good to know
Approval depends on the state's cost comparison. A parent cannot be penalized for not taking part.
Other details
- The premium-payment unit at the state's fiscal agent makes the cost comparison. A denial can be reviewed with the figures it used.
- The remaining Medicaid benefits use fee-for-service coverage.
- Your social worker can help the income maintenance agency make a HIPP referral and obtain the current form. Before changing either plan, the premium-payment unit needs to confirm whether existing employer enrollment is necessary, who receives the payment, how fee-for-service Medicaid would work and the expected decision date. The referral number is not a guarantee of approval or a direct HIPP payment line.
Federal background: Medicaid premium assistance.
Official sources
“Could HIPP pay our work-plan premium, what would change about our coverage, and could you help request a review if the benefits outweigh the drawbacks?”
Why I’m asking: I want to keep our treatment network while understanding whether the premium can be paid for us.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Ask for the referral and hand over the employer plan's premium and benefit summary.
Your social worker
The social worker or the agency worker makes the referral.
The care team
Records and letters when the application asks for them.
- Who decides
- The premium-payment unit at the state's fiscal agent, on a cost comparison.
- Ask your social worker
- “Our child is on BadgerCare Plus and we pay for a work plan. Can the agency refer us to the premium-payment programme and confirm the current form in writing?”
How to apply
First step: Ask your income maintenance agency to refer you to the premium-payment programme, and take the work plan's premium figure with you.
- Ask the agency to refer you to the premium-payment programme and to confirm the current form.
- Take the employer plan's premium figure and summary of benefits with you.
Official application / program page ↗
Where it starts: Ask your income maintenance agency to refer the household to the premium-payment programme and to confirm the current form in writing.
What to gather
- The monthly premium the family pays
- The plan's summary of benefits
- Your child's ForwardHealth number
How long: No decision deadline is published; ask the agency for a timescale when you are referred.
What a yes looks like
The family's share of the premium paid, with BadgerCare Plus behind the work plan.
What a no looks like, and the next move
The comparison came out against it. Ask which figures were used and whether a different plan option changes it.
Watch out
- The decision is a cost comparison, so a plan the state finds expensive is refused.
- The published policy is dated 2022; ask the agency to confirm the current form and phone line.
- Not taking part cannot be held against a parent.
Dates that change this
2022-08-01: The published policy carries a 2022 date and is still the one in the 2026 handbook. The current form, the direct phone line, the decision deadline and the payee were not published; ask the agency to confirm them in writing. (not yet confirmed against the final rule)
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
The state pays the family's share of the employer premium, plus coinsurance and deductibles, with Medicaid covering what the plan leaves out.
Covers: Payment of the family's share of the employer plan premium · Payment of coinsurance and deductibles under that plan · Fee-for-service cover for benefits the employer plan leaves out
Legal protection: Parents cannot be penalised for not co-operating with the programme
What it costs the family: None when it is approved.
The eligibility facts, as published
- Who
- children, pregnant members and parents or caretakers on BadgerCare Plus; not adults without children
- Test
- cost-effectiveness, comparing the employer plan and the wraparound against covering the member directly
- Employer contribution
- no minimum employer-contribution test in the current published policy
- Unknowns
- whether the employee must already be enrolled, and whether the child must be fee-for-service, were not published
The trap: The state decides on cost-effectiveness, comparing the employer plan plus the wraparound against covering the person directly. There is no minimum employer-contribution test in the current published policy. Parents cannot be penalised for not taking part.
Where I read this
- BadgerCare Plus Handbook 7.7 Health Insurance Premium Payment — Wisconsin Department of Health Services, read September 10, 2026