If you live in Wisconsin and need affordable health coverage, you may qualify for BadgerCare Plus, the state's Medicaid program. Wisconsin is unique among states that did not expand Medicaid under the Affordable Care Act because it still covers all adults with incomes up to 100% of the Federal Poverty Level (FPL). That means there is no coverage gap in Wisconsin, and nearly all low-income residents have a path to either Medicaid or subsidized Marketplace insurance.
This guide covers everything you need to know about Wisconsin Medicaid eligibility in 2026, including current income limits, who qualifies, how to apply, and what benefits you can expect.
Not sure if you qualify? Check your eligibility in minutes with our free screener.
What Is BadgerCare Plus?
BadgerCare Plus is Wisconsin's name for its Medicaid program, administered by the Department of Health Services (DHS). It provides health coverage to low-income children, pregnant women, parents, and adults under age 65. For seniors (65 and older) and people with disabilities, the program is simply called Medicaid and has different rules including asset limits.
BadgerCare Plus covers a wide range of medical services including doctor visits, hospital stays, prescription drugs, mental health services, preventive care, and more. Most members are enrolled in managed care plans (HMOs) where available.
Who Qualifies for BadgerCare Plus in 2026?
Eligibility depends on your age, household size, income, and immigration status. Here are the main categories:
- Adults ages 19 to 64: Household income at or below 100% FPL. This includes childless adults, which is unusual for a non-expansion state.
- Children ages 0 to 18: Household income at or below 306% FPL. Families with income between 201% and 306% FPL may need to pay small premiums.
- Pregnant women: Household income at or below 306% FPL. Coverage continues through 60 days postpartum.
- Parents and caretakers: Household income at or below 100% FPL, living with a dependent child.
To qualify, you must also be a Wisconsin resident and a U.S. citizen or qualified immigrant. Non-refugee adults must have been lawfully present for at least five years.
2026 BadgerCare Plus Income Limits
The following monthly income limits are effective February 1, 2026 through January 31, 2027. These figures come directly from the Wisconsin DHS.
Adults (100% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,330 |
| 2 | $1,803 |
| 3 | $2,277 |
| 4 | $2,750 |
| 5 | $3,223 |
| 6 | $3,697 |
| 7 | $4,170 |
| 8 | $4,643 |
| Each additional person | +$473 |
Children and Pregnant Women (306% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $4,070 |
| 2 | $5,518 |
| 3 | $6,967 |
| 4 | $8,415 |
| 5 | $9,863 |
| 6 | $11,312 |
| 7 | $12,760 |
| 8 | $14,209 |
| Each additional person | +$1,448 |
Children Premium Threshold (201% FPL)
Families with children whose income falls between 201% and 306% FPL may be required to pay monthly premiums. These premiums are capped at 5% of household income.
| Household Size | Premium Threshold |
|---|---|
| 1 | $2,673 |
| 2 | $3,625 |
| 3 | $4,576 |
| 4 | $5,528 |
| 5 | $6,479 |
| 6 | $7,430 |
| 7 | $8,382 |
| 8 | $9,333 |
| Each additional person | +$951 |
Important note: These income limits are based on Modified Adjusted Gross Income (MAGI). There is no asset test for BadgerCare Plus, so your savings, home, or vehicle values do not affect eligibility.
How to Apply for BadgerCare Plus: Step by Step
Applying for Wisconsin Medicaid is straightforward. You can apply online, by phone, or in person.
Step 1: Gather Your Documents
Before you start, have the following ready:
- Social Security numbers for all household members
- Proof of income (pay stubs, tax returns, or employer letters)
- Proof of Wisconsin residency (utility bill, lease, or mail with your address)
- Proof of citizenship or immigration status
- Date of birth for all household members
- Information about any current health insurance
Step 2: Apply Online Through ACCESS
The fastest way to apply is through Wisconsin's ACCESS portal at access.wisconsin.gov. ACCESS is the state's unified application system that lets you apply for BadgerCare Plus, FoodShare (SNAP), and other programs with a single application.
- Go to access.wisconsin.gov
- Create an account or log in
- Select "Apply for Benefits"
- Complete the application with your household and income information
- Upload supporting documents
- Submit your application
You can also start at HealthCare.gov during Open Enrollment. If the system determines you may qualify for Medicaid, it will refer you to the Wisconsin Medicaid agency.
Step 3: Apply by Phone or In Person (Alternative Methods)
- Phone: Call 1-800-362-3002 to apply over the phone or get help with your application
- In person: Visit your local county or tribal Income Maintenance agency. Find your local office at dhs.wisconsin.gov/forwardhealth/imagency
- Paper application: Download the application form from dhs.wisconsin.gov, complete it, and mail or deliver it to your local Income Maintenance agency
Step 4: Complete Your Interview
After submitting your application, you may be contacted for a phone interview. Answer promptly to avoid delays.
Step 5: Receive Your Determination
Wisconsin must process your application within 45 days (or 90 days for disability-related Medicaid). You will receive a notice by mail with the decision. If approved, you will get information about selecting a health plan and your coverage start date.
What BadgerCare Plus Covers
BadgerCare Plus provides comprehensive health coverage including:
- Doctor and specialist visits
- Hospital inpatient and outpatient care
- Emergency room services
- Prescription medications
- Mental health and substance abuse treatment
- Preventive care and screenings
- Lab tests and X-rays
- Maternity and newborn care
- Vision care for children
- Dental services (limited for adults)
- Transportation to medical appointments
Most BadgerCare Plus members pay no premiums and have minimal or no copays. Families with children in the 201% to 306% FPL range may have small premiums as noted above.
Wisconsin's Unique Medicaid Situation
Wisconsin stands out because it did not expand Medicaid under the ACA, yet it has no coverage gap. The state uses a Section 1115 waiver to cover childless adults up to 100% FPL. Adults earning above the poverty level can transition seamlessly to subsidized Marketplace plans through HealthCare.gov.
As of early 2025, nearly 198,000 non-disabled adults without minor children were enrolled in BadgerCare Plus. If Wisconsin were to fully expand Medicaid to 138% FPL, an estimated 89,700 additional residents could gain coverage with enhanced federal funding.
For now, if your income is above 100% FPL as an adult, you should explore Marketplace plans where you may qualify for premium tax credits and cost-sharing reductions.
Renewing Your Coverage
BadgerCare Plus coverage must be renewed annually. The DHS will send you a renewal packet before your coverage period ends. You can complete your renewal through ACCESS online, by phone, or by mail.
Key tips for renewal:
- Watch for your renewal notice and respond before the deadline
- Report any changes in income, household size, or address promptly through ACCESS
- Children have 12 months of continuous coverage regardless of premium payment
- If your coverage lapses, you can reapply at any time since Medicaid has no open enrollment period
Other Benefits You May Qualify For
If you qualify for BadgerCare Plus, you may also be eligible for other assistance programs in Wisconsin:
- FoodShare (SNAP): Food assistance for households up to 200% FPL
- WHEAP: Help paying heating and electric bills
- WIC: Nutrition support for pregnant women, infants, and children under 5
- Wisconsin Works (W-2): Cash assistance and employment services for families
You can apply for many of these programs through the same ACCESS portal. Check all the programs you may qualify for with our free screener.
For a full overview of available programs, visit Wisconsin Benefits Overview.
Frequently Asked Questions
Can I apply for BadgerCare Plus at any time?
Yes. Unlike Marketplace insurance, Medicaid does not have an open enrollment period. You can apply any time of the year.
How long does it take to get approved?
Wisconsin must process most applications within 45 days. Disability-related applications may take up to 90 days.
Is there an asset test for BadgerCare Plus?
No. BadgerCare Plus eligibility is based on income only. Your savings, home, vehicles, and other assets do not count. However, Medicaid for seniors and people with disabilities does have asset limits.
What if my income is just above the limit?
If your income is above 100% FPL as an adult, you likely qualify for subsidized health insurance through the Marketplace at HealthCare.gov. Wisconsin uses the federal marketplace, and premium tax credits can significantly reduce your costs.
Do I need to be a U.S. citizen?
You must be a U.S. citizen or a qualified immigrant. Non-refugee adults need to have been lawfully present in the U.S. for at least five years to qualify. Children and pregnant women who are lawfully present may qualify without the five-year waiting period.
Can I have BadgerCare Plus and employer insurance at the same time?
In some cases, yes. If your employer offers coverage but it is unaffordable, you may still qualify for BadgerCare Plus based on your income. Contact your local Income Maintenance agency to discuss your situation.
What is the phone number for BadgerCare Plus?
You can reach the BadgerCare Plus helpline at 1-800-362-3002. Representatives can help with applications, renewals, and general questions.
Take the Next Step
Figuring out whether you qualify for Wisconsin Medicaid does not have to be complicated. Use our free eligibility screener to check your potential benefits in just a few minutes. It covers BadgerCare Plus along with other federal and state programs you may be missing out on.
If you have questions or need help applying, call 1-800-362-3002 or visit access.wisconsin.gov to get started today.
