BadgerCare Plus HMOs vs ForwardHealth FFS Credentialing
By George Ruan • October 9, 2026
Last updated: October 9, 2026.
Sections
- ForwardHealth enrollment and HMO participation are separate
- Current BadgerCare Plus HMOs, checked October 9, 2026
- Identify FFS versus HMO coverage for the service date
- Ask the HMO about the exact product and clinician
- Expect plan-specific authorization and claims procedures
- Track the two approvals separately
- Related Wisconsin Medicaid guides
- Frequently Asked Questions
ForwardHealth enrollment and HMO participation are separate
ForwardHealth provides state Medicaid enrollment resources. To join a BadgerCare Plus or Medicaid SSI HMO network, its HMO Providers page directs providers to the plan’s provider relations team. A state portal login does not establish an HMO contract.
ForwardHealth: enroll with an HMO network
Current BadgerCare Plus HMOs, checked October 9, 2026
The DHS member page currently lists the following plans. Availability varies by county; this is the BadgerCare Plus list, not a claim that every plan offers every Wisconsin Medicaid product or serves every county.
Anthem Blue Cross and Blue Shield
Chorus Community Health Plans
Dean Health Plan
Group Health Cooperative of Eau Claire
Group Health Cooperative of South Central Wisconsin
Independent Care Health Plan (iCare)
MercyCare Insurance Company
MHS Health Wisconsin
Molina Health Care
Network Health Plan
Quartz
Security Health Plan Wisconsin
UnitedHealthcare of Wisconsin
DHS BadgerCare Plus HMO list and counties
Identify FFS versus HMO coverage for the service date
The state’s EVS identifies program enrollment, managed care enrollment, and other insurance. Use that result to identify the member’s route before asking about participation or submitting a claim. A ForwardHealth card alone does not settle which payer handles the service.
ForwardHealth Online Handbook: Enrollment Verification
Ask the HMO about the exact product and clinician
Our suggested inquiry: identify the BadgerCare Plus product, billing organization, rendering clinician, service location, and intended start date. Ask the plan to confirm participation and the applicable credentialing or contracting process in writing. Use the plan’s provider relations route.
ForwardHealth: enroll with an HMO network
Expect plan-specific authorization and claims procedures
The Online Handbook explains that HMOs may set authorization, claims submission, and adjudication procedures that differ from fee-for-service procedures. Check the responsible plan’s provider guidance for the service rather than copying the FFS workflow.
ForwardHealth Online Handbook: managed care policies
Track the two approvals separately
Keep a small practice worksheet with a ForwardHealth enrollment row and a separate row for each HMO/product. Record evidence and dates for both. Leave unresolved participation questions visible instead of treating a portal login or submitted application as approval.
ForwardHealth: enroll with an HMO network
Related Wisconsin Medicaid guides
Frequently Asked Questions
Is Dean Health Plan a BadgerCare Plus HMO?
DHS’s current BadgerCare Plus list includes Dean Health Plan. Check the state’s county list and the plan’s provider relations team for the relevant product.
Are HMO prior authorization and claim procedures identical to FFS?
No. ForwardHealth explains that HMO procedures can differ; consult the member’s responsible plan.
How do I know whether the member has an HMO?
Check service-date enrollment through EVS and review managed care information alongside the benefit plan and other coverage.
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