Does BadgerCare Cover Home Birth in Wisconsin? 2026 Coverage Since the 2017 Licensed Midwife Medicaid Expansion
Yes. BadgerCare Plus (Wisconsin's Medicaid program) covers home birth attended by Medicaid-enrolled Licensed Midwives, effective for dates of service on and after January 1, 2017. [1] Wisconsin's Licensed Midwife credential is open to midwives holding either the NARM CPM credential or the CNM credential. [2] The coverage policy pays fee-for-service; HMO members must use providers in their HMO's network, and each HMO decides whether to contract with licensed midwives, so confirm your plan type before hiring. [1]
Wisconsin made a major Medicaid policy shift in January 2017 when Licensed Midwives became enrollable Medicaid providers under a provision of the 2015-17 state budget. [1] BadgerCare Plus now covers LM-attended home birth when the midwife is Medicaid-enrolled. [1] But the structure has a quirk worth understanding: the ForwardHealth coverage policy is fee-for-service, and most members are enrolled in HMOs. A licensed midwife can serve HMO members only if she contracts with that HMO directly, and HMOs have discretion over which providers they contract with. [1]
On this page
Sources cited (4)
- ForwardHealth Update 2016-51
- Wis. Admin. Code SPS 181.01
- ForwardHealth Licensed Midwife Handbook (2025)
- Social Security Act § 1905(a)(17)
Does BadgerCare cover home birth?
Yes. BadgerCare Plus has covered maternity care from Medicaid-enrolled Licensed Midwives for dates of service on and after January 1, 2017, based on a provision of the 2015-17 biennial budget (2015 Wisconsin Act 55). [1] Covered services include antepartum care, delivery, postpartum care, newborn care within the LM scope of practice, and supplies and materials for home delivery. [1]
The practical caveat: the ForwardHealth policy applies to members on a fee-for-service basis. Members enrolled in a BadgerCare Plus or Medicaid SSI HMO must get obstetric care from providers in the HMO's network, and a licensed midwife can join that network only by contracting with the HMO directly. HMOs are given discretion over which providers they contract with, so LM access varies by HMO and by year. [1] Ask your HMO directly whether any licensed midwife is in network before you count on coverage.
Which midwife credentials does BadgerCare cover?
Wisconsin runs two midwife credentials, and its Licensed Midwife license is unusually broad.
Wisconsin Licensed Midwives (LMs) are credentialed by the Wisconsin Department of Safety and Professional Services under Wis. Stat. 440.982. The license is open to midwives holding either a valid CPM credential from NARM or a valid CNM credential. [2] LMs are eligible Medicaid providers when enrolled with ForwardHealth. [1]
Nurse-midwives license separately through the Wisconsin Board of Nursing and were Medicaid providers before 2017. ForwardHealth notes that nurse-midwives already enrolled in Wisconsin Medicaid do not need a separate LM enrollment, because the covered services allowed for licensed midwives are also allowed for nurse-midwives. [1] CNM services also carry the federal § 1905(a)(17) mandatory benefit protection. [4]
Unlicensed lay midwives cannot bill Wisconsin Medicaid. Licensure, then ForwardHealth enrollment, is the path for any midwife wanting to practice and bill in Wisconsin. [1,2]
| CREDENTIAL | BADGERCARE COVERAGE | PRACTICE SETTING |
|---|---|---|
| WI Licensed Midwife (LM) | Yes when ForwardHealth-enrolled (since 2017) [1] | Birth center or home |
| Nurse-midwife (CNM) | Yes (federal mandate + state coverage) [1,4] | Hospital, birth center, home |
| LM with CPM credential | Yes (2017 state coverage) [1,2] | Birth center or home |
| FFS BadgerCare Plus | Covers enrolled LMs directly [1] | Most reliable for home birth |
| HMO BadgerCare Plus | Only if the LM contracts with your HMO [1] | Coverage varies by HMO |
How does Wisconsin Medicaid reimburse home birth midwives?
Wisconsin Medicaid reimburses Licensed Midwives through ForwardHealth, the state's Medicaid administration system. The November 2016 ForwardHealth Update added Licensed Midwives as an enrollable provider type, with license verification handled automatically against DSPS records. [1] Current policy lives in the Licensed Midwife service area of the ForwardHealth Online Handbook. [3]
For global obstetric care, ForwardHealth requires at least six antepartum visits, a vaginal delivery, and at least one postpartum visit before an LM bills the global CPT code; supplies and materials for home delivery are covered separately. [1] Each midwife decides whether to enroll as a Medicaid provider; not all LMs participate. Ask about enrollment and expected coverage in the first phone call.
The HMO rules are the structural quirk. A Medicaid-enrolled licensed midwife with no contract with your HMO is a non-network provider, and ForwardHealth policy states that Medicaid-enrolled non-network providers may not serve HMO members even as private-pay patients. [1] That makes your plan type the first thing to check, not the last.
"Wisconsin solved the credentialing question with an LM license open to CPMs and CNMs, and the coverage question with the 2017 ForwardHealth expansion. The remaining barrier is HMO contracting: each HMO decides whether any licensed midwife is in its network.
On the Wisconsin BadgerCare Plus structure
How do you find a Medicaid-accepting midwife in Wisconsin?
Wisconsin's Licensed Midwife community is concentrated in Madison, Milwaukee, Eau Claire, and the Fox Valley. The Wisconsin Guild of Midwives directory is the best starting point.
Determine if you're on FFS or HMO BadgerCare Plus
Your enrollment confirmation lists which type. The distinction matters significantly for home birth coverage in Wisconsin.
If HMO: ask whether any LM is in network
Each Wisconsin HMO decides individually whether to contract with licensed midwives. [1] Ask your HMO: "Is any licensed midwife in network for planned home birth?" If not, ask the HMO and ForwardHealth what your options are.
Search for Wisconsin Licensed Midwives by region
Home Birth Partners and the Wisconsin Guild of Midwives both maintain provider directories. Most LMs serve Madison, Milwaukee metro, Eau Claire, and Green Bay regions.
Confirm Medicaid enrollment by phone
Each Wisconsin LM decides individually whether to enroll as a Medicaid provider. Ask each midwife: "Are you currently enrolled with Wisconsin Medicaid as a Licensed Midwife provider, and accepting BadgerCare clients in 2026?"
What if your HMO BadgerCare plan won't cover an LM home birth?
Wisconsin's HMO structure creates a genuine coverage gap for home birth midwifery. Four things to know:
Ask about an HMO exemption or plan change. ForwardHealth handles enrollment questions at 800-362-3002. Exemptions are limited, but a different HMO in your service area may contract with a licensed midwife even if yours doesn't.
Use a freestanding birth center. Several Wisconsin birth centers staff LMs and CNMs and accept BadgerCare Plus. Confirm the birth center and its midwives are in your HMO's network before booking.
Hospital-based CNM care. Wisconsin HMOs contract with hospital-based CNMs. If home birth isn't workable under your specific HMO, hospital-based CNM-attended birth keeps midwifery-led care in network.
Know the private-pay limit before writing a check. ForwardHealth policy bars Medicaid-enrolled licensed midwives who are not in your HMO's network from serving HMO members as private-pay patients. [1] If you are considering paying out of pocket, raise this rule directly with the midwife and ForwardHealth before signing a contract.
For a full guide to home birth midwives in Wisconsin, including licensing, costs by region, and what to ask before hiring, see our Wisconsin home birth midwife guide.
Bottom line: BadgerCare Plus has covered home birth attended by Medicaid-enrolled Licensed Midwives since January 1, 2017, [1] and Wisconsin's LM license accepts both CPM and CNM credential holders. [2] The coverage pathway is fee-for-service; HMO members need a licensed midwife who contracts with their specific HMO, and HMOs have discretion over contracting. [1] Determine your plan type first, use the Wisconsin Guild of Midwives directory, and confirm both Medicaid enrollment and HMO network status with each practice before you sign.
- Wisconsin Department of Health Services, ForwardHealth. Licensed Midwives May Now Become Wisconsin Medicaid Providers. Update 2016-51, November 2016. View source
- Wisconsin Administrative Code § SPS 181.01. Licensure requirements for licensed midwives. View source
- Wisconsin Department of Health Services, ForwardHealth. Online Handbook: Licensed Midwife (archived August 1, 2025). View source
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
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