Form F-10139 Badgercare Plus Premium Information / Payment - Wisconsin

Form F-10139 Badgercare Plus Premium Information / Payment - Wisconsin

What Is Form F-10139?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F-10139?
A: Form F-10139 is a document related to Badgercare Plus Premium Information/Payment in Wisconsin.

Q: What is Badgercare Plus?
A: Badgercare Plus is a health care program in Wisconsin that provides benefits to eligible low-income individuals and families.

Q: What is Badgercare Plus Premium?
A: Badgercare Plus Premium is a specific type of Badgercare Plus plan that requires a monthly premium payment.

Q: What information does Form F-10139 include?
A: Form F-10139 includes information about the premium amount, payment due dates, and how to make payments for Badgercare Plus Premium.

Q: Who needs to fill out Form F-10139?
A: Individuals enrolled in Badgercare Plus Premium in Wisconsin may need to fill out Form F-10139.

Q: What happens if I don't make premium payments on time?
A: If premium payments for Badgercare Plus are not made on time, coverage may be suspended or terminated.

Q: Can I get assistance with premium payments?
A: Yes, Wisconsin offers a Premium Assistance program for individuals who need help paying their Badgercare Plus premiums.

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Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form F-10139 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-10139 Badgercare Plus Premium Information / Payment - Wisconsin

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