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 Medicaid BadgerCare Plus or SSI Medicaid with MHS Health Wisconsin or Network Health.
Here are some tips to help you get started.
- Choose your correct Medicaid health plan, 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 SSI Medicaid use the same form and should complete the form based on their age.
- Click the 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.
- 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).
SSI Medicaid
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).
Infants (Birth to 6 Months)
A yearly Health Risk Screening (HRS) should be completed for infants, birth to 6 months, with BadgerCare Plus or SSI Medicaid.
MHS Health Medicaid members
> MHS Health HRS Infant (English) (PDF)
> MHS Health HRS Infant (Spanish) (PDF)
Network Health Medicaid members
> Network Health HRS Infant (English) (PDF)
> Network Health HRS Infant (Spanish) PDF)
Children (Ages 6 months - 17)
A yearly Health Risk Screening (HRS) should be completed for children, ages 6 months thru 17 years, with BadgerCare Plus or SSI Medicaid.
MHS Health Medicaid members
> MHS Health HRS Child (English) (PDF)
> MHS Health HRS Child (Spanish) (PDF)
Network Health Medicaid members
> Network Health HRS Child (English) (PDF)
> Network Health HRS Child (Spanish) (PDF)
BadgerCare Plus Adults
A yearly Health Needs Assessment should be completed for adults, ages 18 and older, with BadgerCare Plus.
MHS Health plan Medicaid members
> MHS Health HNA Adult (English) (PDF)
> MHS Health HNA Adult (Spanish) (PDF)
Network Health plan Medicaid members
> Network Health HNA Adult (English) (PDF)
> Network Health HNA Adult (Spanish) (PDF)
SSI Medicaid members can earn a $25 reward for completing their HRS. Learn more about the My Health Pays rewards program.
SSI Medicaid Adults
A yearly Health Risk Screening (HRS) should be completed for all adult SSI Medicaid members, ages 18 and older. Infants and Children enrolled in SSI Medicaid should complete the age-related forms above.
MHS Health SSI Medicaid members
> MHS Health HRS SSI (English) (PDF)
> MHS Health HRS SSI (Spanish) (PDF)
Network Health SSI Medicaid members
> Network Health HRS SSI (English) (PDF)
> Network Health HRS SSI (Spanish) (PDF)
If you are enrolled in SSI Medicaid, someone from our care team will call you after your screening is received.