The Family Planning Only Services
Program provides low to no-cost
sexual and reproductive health care
for people with limited income to
reduce unplanned pregnancies.
Who is eligible?
You may be able to enroll if you meet all of the following:
• You live in Wisconsin.
• You are a U.S. citizen or have a qualifying immigration status.
• You are of childbearing or reproductive age.
• You have income at or below $3,840.30 per month (eective February 1, 2024). Only
your own income is counted. Your assets are not counted.
• You are not enrolled in Wisconsin Medicaid or BadgerCare Plus. (You can be enrolled
in private health insurance while you are enrolled in the Family Planning Only
Services Program.)
If you are eligible for the Family Planning Only Services Program, you will be enrolled
for 12 months. Your coverage must be renewed yearly. About one month before your
coverage ends, you will get a letter with information about the renewal process.
What services are covered?
Benets include contraceptive services
and supplies, tests and treatments for
sexually transmitted diseases, and routine
preventive services related to family
planning.
Covered services must be related to a
family planning oce visit. For example,
Pap tests are only covered when they are
completed at a family planning oce visit
or with a referral from a family planning
provider.
Services that may be covered when
provided at an initial, yearly, or follow-up
family planning-related oce visit include:
• Contraceptive services and supplies, like
birth control pills and condoms.
• Natural family planning supplies.
• Pap tests.
• Routine preventive primary services
that are family planning-related.
• Tests and treatment for sexually
transmitted diseases (like chlamydia,
gonorrhea, herpes, and syphilis) and
certain other lab tests.
• Voluntary sterilizations for those aged
21 or older.
Family Planning Only
Services Program
Getting Services
After you enroll in the Family Planning
Only Services Program, you will get a
ForwardHealth member card in the mail.
If you used to be enrolled in the Family
Planning Only Services Program,
BadgerCare Plus, or Medicaid, you will not
automatically get a new ForwardHealth
card. You can use your old card if you still
have it. If needed, you can request a new
card through your ACCESS account (log in
at access.wi.gov) or call Member Services
at 800-362-3002.
You will need to show your ForwardHealth
card when you have a family planning-
related appointment or pick up a
prescription for contraceptive supplies at a
pharmacy.
Protecting your privacy
If you apply for or enroll in the Family
Planning Only Services Program, you can
have information sent to an address other
than your home address. If you are under
18:
• Your local agency will not contact your
parents or other caretakers.
• You will not be referred to a child
support agency.
How do I apply?
You can apply for the Family Planning
Only Services Program:
• Online at access.wi.gov.
• By phone.
• In person at your agency. Find
your agency at dhs.wisconsin.gov/
forwardhealth/imagency/index.htm.
• By completing a paper application
and mailing it to your local agency. To
get a paper application or ask for help
completing the application, go to dhs.
wisconsin.gov/forwardhealth/resources.
htm or call Member Services at 800-
362-3002.
More Information
For more information about the Family
Planning Only Services Program, you can:
• Visit dhs.wisconsin.gov/fpos/index.htm.
• Contact your local agency.
• Call Member Services at 800-362-3002.
P-02314 (02/2024)
Generally, you can start getting benets the rst of the month in which you apply and
meet all program rules. You may also be able to get temporary coverage (also known
as Express Enrollment) before your full application is complete and processed. Learn
more at dhs.wisconsin.gov/forwardhealth/express-enrollment.htm and check with your
provider for eligibility.
Nondiscrimination Notice: Discrimination is Against the Law – Health Care-Related Programs
The Wisconsin Department of Health Services complies with applicable Federal civil rights laws and does not discriminate on the basis
of race, color, national origin, age, disability, or sex. The Department of Health Services does not exclude people or treat them
differently because of race, color, national origin, age, disability, or sex.
The Department of Health Services:
• Provides free aids and services to people with disabilities to communicate effectively with us, such as:
o Qualified sign language interpreters.
o Written information in other formats (large print, audio, accessible electronic formats, other formats).
• Provides free language services to people whose primary language is not English, such as:
o Qualified interpreters.
o Information written in other languages.
If you need these services, contact the Department of Health Services civil rights coordinator at 844-201-6870.
If you believe that the Department of Health Services has failed to provide these services or discriminated in another way on the basis
of race, color, national origin, age, disability, or sex, you can file a grievance with: Department of Health Services, Attn: Civil Rights
Coordinator, 1 West Wilson Street, Room 651, PO Box 7850, Madison, WI 53707-7850, 844-201-6870, TTY: 711, fax: 608-267-1434,
or email to d[email protected]isconsin.gov. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance,
the Department of Health Services civil rights coordinator is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically
through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
