Health Screenings and Assessments

Your health is important to us. We want to make sure you get the care you need. To best serve you, we'd like to learn more about your overall health and your health goals.

Please choose the correct option below to complete a health screening for yourself and/or any dependents enrolled in BadgerCare Plus or Medicaid SSI with either MHS Health Wisconsin or Network Health.

Here are some tips to help you get started.

Choose the health program that you are enrolled in (BadgerCare Plus or Medicaid SSI) and the age of the person who needs to complete the screening.

Then select the health plan that manages your health benefits. You will choose either MHS Health Wisconsin or Network Health. If you don't know your health plan, call us at 1-888-713-6180 (TTY: 711).

NOTE: Infants and Children enrolled in BadgerCare Plus or Medicaid SSI use the same form. Please be sure to complete the correct form based on their age.
Click the underlined text link to download the PDF so you can fill it out online. Forms are available in English and Spanish. Other languages or formats are available upon request at no cost. Call us at 1-888-713-6180 to request another language or alternative format.
Be sure to answer all the questions.
Save your completed form(s) for yourself and/or your dependents.
Email them to us by clicking on the buttons below.

BadgerCare Plus

You can also complete your health screening over the phone. Please call us Monday through Friday between 8 a.m. and 5 p.m. (CST). We can be reached at 1-833-236-5458 (TTY: 711).

Email your Health Assessment

Medicaid SSI

You can also complete your health screening over the phone. Please call us Monday through Friday between 8 a.m. and 5 p.m. (CST). We can be reached at 1-844-545-6326 (TTY: 711).

Email your Health Screening

Infants (Birth to 6 Months)

A yearly Health Risk Screening (HRS) should be completed for infants, birth to 6 months, with BadgerCare Plus or Medicaid SSI.

MHS Health members

Network Health members

Children (Ages 6 months - 17 years old)

A yearly Health Risk Screening (HRS) should be completed for children, ages 6 months thru 17 years, with BadgerCare Plus or Medicaid SSI.

MHS Health members

Network Health members

BadgerCare Plus Adults

A Health Needs Assessment (HNA) should be completed for adults, ages 18 and older, with BadgerCare Plus.

MHS Health members

Network Health members

Medicaid SSI members can earn a $25 reward for completing their HRS. Learn more about the My Health Pays rewards program.

Medicaid SSI Adults

A yearly Health Risk Screening (HRS) should be completed for all adult Medicaid SSI members, ages 18 and older. Infants and Children enrolled in Medicaid SSI should use the forms above.

MHS Health members

Network Health members

Important Note: If you are enrolled in Medicaid SSI, someone from our care team will call you after your screening is received.