Wisconsin has three managed care programs under the umbrella of ForwardHealth that serve specific subsets of the Medicaid population. Family Care is a voluntary program that provides MLTSS to dual eligibles and Medicaid EBD individuals ages 18 years and over. Family Care plans operate as prepaid inpatient health plans (PIHPs) because they provide a limited set of benefits on a capitated basis. Plans are available on a regional basis.The plans provide all home- and community-based waiver services, as well as some state plan benefits related to long-term care. All other services are provided on an FFS basis. There are five participating plans, and individuals have a choice of plan in their region.
This Wisconsin Medicaid Contract is for Care Wisconsin Health Plan, signed January 1, 2018.
For more information on Wisconsin’s Medicaid managed care programs, and to view other contracts, visit Wisconsin Medicaid Managed Care Contracts.