Family Planning Only Services

Information for current users

The purpose of this program is to provide contraceptive (birth control) services to eligible residents, and related reproductive health care that is part of regular birth control services.

Thanks to the Wisconsin Medicaid Family Planning Only Services (FPOS), you might qualify to receive these services at no cost to you.

• Who should consider this program?
• What services are included?
• Who can get these services?
• Who can I see?
• What documents are needed to apply?
• How do I apply?
• Who can I contact for more information?
• When can I receive services?
• Additional Resources
• What does the Forward card look like?

Who should consider this program?

Eligible residents who are at least 15 years of age wanting contraceptive and reproductive care services.

Overview: Wisconsin residents seeking contraception are now able to get confidential family planning health care services and supplies through the Family Planning Only Services. The goal of the FPOS is to stop unintended pregnancy and sexually transmitted diseases (STDs).

What services are included?

Birth control methods, supplies and family planning health care services which includes:

• Routine reproductive health exams including pap tests
• Birth control pills, patch, ring, or injection
• Condoms
• Natural family planning supplies
• Pregnancy testing and counseling
• STD testing and treatment
• Emergency contraception
• Education and information

Who can get these services?

Use the checklist below to see if you might qualify.

• I am at least 15 years old. Yes or No
• I am a U.S. citizen living in Wisconsin. Yes or No
• I do NOT receive any other Forward Health, BadgerCare Plus standard or benchmark programs. Yes or No
• I meet the income requirements.* Yes or No

*Monthly income limits:
One-person household $2,975
Two person household $4,011
Three person household $5,046

If you answered "yes" to all of the statements above, there is a good chance you may qualify for the Family Planning Only Services.

Who can I see?

Any Medicaid-certified provider can offer the FPOS services. If you are a current UWW student you may also receive services from:
University Health & Counseling Services
710 Starin Road
Whitewater, WI 53190
(262) 472-1300

What documents are needed to apply?

Family Planning Only Services requires the following information be provided with your application for enrollment or renewal:

1. PROOF OF IDENTITY (current Drivers License, Student ID, US Military ID, State ID)

2. PROOF OF CITIZENSHIP REQUIRED IF YOU WERE NOT BORN IN WISCONSIN you will also need ONE of the following for proof of U.S. Citizenship:*

• U.S. Passport
• Certified copy of U.S. Birth Certificate
• U.S. State Department Report of Birth Abroad
• Adoption papers showing U.S. birth
• U.S. Citizenship ID Card

*These forms of ID can take up to 3 months to obtain. Please do NOT apply to the program if you do not have acceptable documentation.

3. PAYROLL STUBS FOR THE FULL 30 DAYS PRIOR TO YOUR APPLICATION

1. • IF PAID WEEKLY, 4 STUBS
   • IF PAID BIWEEKLY, 2 STUBS
   • IF PAID BIMONTHLY, 2 STUBS
   • IF PAID MONTHLY, 1 STUB

• IF YOU ARE MARRIED, YOU MUST ALSO HAVE 30 DAYS OF PAY STUBS FOR YOUR SPOUSE
• IF YOU ARE UNABLE TO PROVIDE 30 DAYS OF PAY STUBS, YOU CAN HAVE YOUR EMPLOYER COMPLETE
  • AN EMPLOYER VERIFICATION FORM (Available at 2nd floor reception window)
  • A STATEMENT FROM YOUR EMPLOYER LISTING
    • EMPLOYMENT START DATE
    • NUMBER OF HOURS WORKED PER WEEK
    • RATE OF PAY OR SALARY

4. IF YOU ARE AN ALIEN CITIZEN, MUST RESIDE IN THE U.S. FOR 5 YEARS AND HAVE A "GREEN" CARD

How do I apply?

1. Call UHCS (262) 472-1300 for a Waiver application appointment.
2. Bring along the required documents (see above) or it will delay the processing of your application and date when you can begin receiving free services..

Who can I contact for more information?

For more information on the Family Planning Only Services call University Health and Counseling Services at (262) 472 1300 menu option 6

When can I receive services?

You are eligible for FPOS services after you receive your “About Your Benefits” letter and FORWARD HEALTH card in the mail. The letter will confirm your dates of eligibility in the program. Be aware that the approval process can take 6-8 weeks to complete. You will be responsible to pay for any services received until you are approved.

To receive FPOS services at UHCS, you must be currently enrolled at UWW, present your FORWARD HEALTH card at each FPOS appointment and maintain a current address and telephone number with UHCS.

Additional Resources

• Maternal and Child Health Hotline or 1-800-642-7837
• Wisconsin Department of Health and Family Services

Attention users of the Family Planning Only Services

In order to receive services at UHCS you must:

1. Be a currently enrolled student and present your student ID. - To remain a participant in the program you must reapply every year and receive a confirmation of eligibility.
2. Present your Forward/Forward Health card at each appointment. - Lost card? Call Recipient Services at 1-800-362-3002 for a replacement, mailed next business day.
3. Keep your address current. - When you have a change of address, fill out your Medicaid/BadgerCare Change Report that was sent to you via postal mail with your Notice of Decision.

If you show up for your Family Planning clinic appointment without your Forward/Forward Health card you will have to reschedule your appointment. You must bring your card to the rescheduled appointment before you may receive services to be paid for by the Family Planning Waiver Program (FPWP).

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The timing of receiving services is critical for your services to be paid for by the FPWP. Please note the time periods below.

If you have a current medical order for prescriptive contraception and are currently enrolled in the FPWP, you can receive: 3 months of prescriptive contraceptives (pills, patch or ring) every 78 days. A Depo injection every 90 days.

If you are currently enrolled in the FPOS, you can receive:

• Condoms as needed
• A routine annual exam every 365 days. You must wait 365 days but no longer than 390 days or you may run out of contraception.
• Pregnancy testing and counseling
• STD testing and treatment
• Emergency contraception
• Education and information

If other reproductive health issues arise, ask your provider about what other tests, treatments and medication may be paid for by the FPWP.

If you have questions call 262-472-1300 and press option 6 for billing and insurance.

The monthly limits for eligibility for FPOS are:

• One person household $3,122
• Two person household $4,227
• Three person household $5,332