BadgerCare Plus Income Limits (Wisconsin Medicaid, 2026)

BadgerCare Plus is the Wisconsin Department of Health Services program that covers Medicaid and Children's Health Insurance Program (CHIP) benefits for low- and moderate-income Wisconsin residents. Roughly 1.3 million Wisconsinites are enrolled in BadgerCare Plus and related Medicaid programs as of 2026. The program dates to 1999, when Wisconsin created BadgerCare to help families transition off welfare. The 2008 BadgerCare Plus expansion merged Medicaid and CHIP into a single integrated coverage program, one of the first in the country to do so. The 2026 Federal Poverty Level, $15,960 for a single person and $33,000 for a family of four in the 48 contiguous states, anchors every income threshold in this guide.

Wisconsin occupies a unique position in the Medicaid landscape. The state chose not to adopt the Affordable Care Act's full Medicaid expansion to 138% FPL for adults, which means Wisconsin does not receive the enhanced 90% federal matching rate available to full expansion states. Instead, Wisconsin operates under a Section 1115 BadgerCare waiver that covers childless adults up to 100% FPL using the standard federal match. The practical result is that adults earning between 100% and 138% FPL (between $15,960 and $22,025 per year for a single person in 2026) are not covered by BadgerCare Plus but do qualify for subsidized ACA marketplace plans through healthcare.gov. This arrangement means Wisconsin avoids the traditional ACA coverage gap seen in states like Texas and Florida, where non-expansion leaves low-income adults with no coverage option at all. For children and pregnant women, however, BadgerCare Plus is exceptionally generous: 300% FPL, one of the broadest thresholds in the Midwest.

BadgerCare Plus income limits effective February 1, 2026 (updated annually each February when HHS publishes new Federal Poverty Level guidelines) differ significantly by coverage group. Adults ages 19-64 qualify up to 100% FPL, which equals $1,330 per month or $15,960 per year for a single adult. Children under age 19 and pregnant women qualify at 300% FPL, which equals $8,250 per month or $99,000 per year for a family of four. Wisconsin also covers aged, blind, and disabled (ABD) residents through the SSI-related Medicaid pathway, with an asset test of $2,000 for individuals. Starting in 2027, new federal work requirements from the One Big Beautiful Bill Act will require childless adult BadgerCare Plus members to document 80 hours per month of work or qualifying activity. The table and sections below detail each coverage group's income limit for 2026.

BadgerCare Plus (Wisconsin Medicaid) income limits by household size (2026)

The 2026 BadgerCare Plus (Wisconsin Medicaid) income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states, effective February 1, 2026. Adult column = BadgerCare Plus for adults ages 19-64 (100% FPL; Wisconsin is not a full expansion state). Children column = BadgerCare Plus for children under 19 (300% FPL; Wisconsin merged Medicaid and CHIP). Pregnancy column = BadgerCare Plus Prenatal Plan for pregnant women (300% FPL with 12 months of postpartum coverage). Adults earning 100-138% FPL do not qualify for BadgerCare Plus but do qualify for subsidized ACA marketplace plans. Add $5,680 of annual income per additional household member (adult column); add $17,040 per additional member (children and pregnancy columns).

BadgerCare Plus (Wisconsin Medicaid) eligibility requirements (non-income)

BadgerCare Plus eligibility in 2026 turns on four non-income tests in addition to the income limits above: Wisconsin residency, citizenship or qualifying immigration status, Social Security Number (or an application pending), and household composition. Asset tests apply only to aged, blind, and disabled (ABD) Medicaid categories, not to the MAGI-based BadgerCare Plus groups (adults, children, pregnant women). Wisconsin uses Modified Adjusted Gross Income (MAGI) rules, consistent with federal Medicaid law, for all non-ABD coverage groups.

• Wisconsin residency: You must live in Wisconsin with the intent to remain. There is no minimum residency duration; you can apply the day you arrive, but you must be physically present in the state. Homeless applicants with a Wisconsin address (shelter, encampment, or general-delivery post office) are considered residents.
• Citizenship and immigration status: U.S. citizens qualify without restriction. Most lawfully present immigrants (LPRs, asylees, refugees, Cuban/Haitian entrants, certain trafficking victims) qualify for full BadgerCare Plus. The federal 5-year bar applies to most newly-arrived lawful permanent residents for non-emergency Medicaid; Wisconsin does not use state funds to bridge this bar for adults (though it does cover children under separate authority in some instances). Undocumented immigrants do not qualify for BadgerCare Plus; emergency Medicaid covers emergency medical conditions only.
• Social Security Number: Every applicant must provide a Social Security Number or proof that an application for a SSN is pending. Individuals who are applying on behalf of others (for example, a parent applying for a child) need not have their own SSN if they are not seeking coverage for themselves.
• Age: BadgerCare Plus adults category covers ages 19-64. Children's BadgerCare Plus covers ages 0-18. Pregnant women apply through the BadgerCare Plus Prenatal Plan. Individuals age 65 or older are covered through Wisconsin Medicaid for the Elderly, Blind, and Disabled or through Medicare Savings Programs if they are Medicare beneficiaries.
• Asset test (ABD categories only): For aged, blind, and disabled Medicaid (not BadgerCare Plus MAGI groups), countable assets must not exceed $2,000 for an individual or $3,000 for a couple. Exempt assets include: one home (if the applicant or spouse lives there), one vehicle, household goods, personal effects, burial funds up to $1,500, and life insurance with face value under $1,500. For nursing home Medicaid, a 60-month look-back period applies to asset transfers.
• Employer-sponsored insurance (ESI) cost-effectiveness test: If a BadgerCare Plus member has access to employer-sponsored health insurance, Wisconsin conducts a cost-effectiveness test to determine whether it is more cost-effective for Medicaid to pay the employee's share of the ESI premium instead of providing full BadgerCare Plus coverage. This is known as the Health Insurance Premium Payment (HIPP) program and does not result in a denial of BadgerCare Plus; it changes how coverage is delivered.

What income counts for BadgerCare Plus (Wisconsin Medicaid)

BadgerCare Plus uses Modified Adjusted Gross Income (MAGI) rules for all non-ABD coverage groups: adults, children, and pregnant women. MAGI starts with your federal adjusted gross income (AGI) and adds back certain tax deductions. Wisconsin does not apply a separate 5% standard income disregard to the adult (100% FPL) threshold; however, children and pregnant women (300% FPL) do receive a 5% income disregard plus a 1% conversion factor, raising the effective tested threshold in the ForwardHealth system to approximately 306% FPL. Income is counted for all household members who are required to file a federal tax return or who choose to file, following IRS household composition rules for Medicaid.

Income sources included

• Wages, salaries, and tips (W-2 income): All gross earned income from employment, before any pre-tax payroll deductions, is counted as MAGI income for BadgerCare Plus.
• Self-employment net income: Net profit from a business or freelance work (gross revenue minus allowable business expenses) counts as MAGI income. Report the net Schedule C or Schedule F figure.
• Social Security retirement and SSDI benefits: Taxable Social Security retirement and Social Security Disability Insurance (SSDI) benefits count as MAGI income. Note: Supplemental Security Income (SSI) is NOT counted (see excluded list).
• Unemployment compensation: State and federal unemployment benefits count in full as MAGI income for BadgerCare Plus.
• Pensions and retirement distributions: Taxable distributions from 401(k), IRA, pension plans, and annuities count as MAGI income.
• Interest, dividends, and capital gains: Investment income, including interest from savings accounts, dividends from stocks, and net capital gains from the sale of assets, counts as MAGI income.
• Rental income and royalties: Net rental income (rent received minus allowable rental expenses) and royalty income count as MAGI income for BadgerCare Plus.
• Alimony (pre-2019 divorce decrees): Alimony received under divorce decrees finalized before January 1, 2019 (before the Tax Cuts and Jobs Act changed the federal tax treatment) counts as MAGI income. Alimony from decrees finalized after 2018 is not taxable and therefore not counted.

Income sources excluded

• Supplemental Security Income (SSI): SSI payments are not taxable and are specifically excluded from MAGI income for BadgerCare Plus. SSI recipients generally qualify for SSI-related Medicaid through a separate fast-track pathway without a separate MAGI income test.
• Child support received: Child support received by the custodial parent or household is not counted as income for BadgerCare Plus eligibility purposes.
• Veterans' benefits: VA disability compensation, pensions, and education benefits (GI Bill) are excluded from MAGI income and do not count toward the BadgerCare Plus income threshold.
• Workers' compensation: State workers' compensation payments received for a work-related injury or illness are excluded from MAGI income.
• TANF cash assistance: Temporary Assistance for Needy Families (Wisconsin Works / W-2 program) cash grants are not counted as MAGI income for BadgerCare Plus.
• Gifts, inheritances, and loan proceeds: Gifts received, inherited assets, and the proceeds of personal loans do not count as income under MAGI rules.

How to apply for BadgerCare Plus (Wisconsin Medicaid) in Wisconsin

BadgerCare Plus applications in Wisconsin go through ACCESS, the state's online benefits portal at access.wisconsin.gov, managed by the Wisconsin Department of Health Services (DHS). The same ACCESS application covers BadgerCare Plus, FoodShare (Wisconsin's SNAP program), Wisconsin Shares child care, and other benefit programs. You can also apply by phone through the Income Maintenance call center at 1-800-362-3002, by mail using form F-10182 (BadgerCare Plus Application Packet), or in person at your county or tribal Income Maintenance (IM) office. For pregnant women who need coverage quickly, the BadgerCare Plus Express Enrollment option at dhs.wisconsin.gov/forwardhealth/express-enrollment.htm provides faster processing.

1. 1. Gather your documents before starting the application. You will need: photo ID, Social Security Numbers for each person applying, proof of Wisconsin residency, proof of income for the past 30 days (pay stubs, employer letter, or last-year tax return if self-employed), and information about any health insurance you currently have through an employer.
2. 2. Go to access.wisconsin.gov and click 'Apply for Benefits.' Create an account or log in if you already have one. Complete all required sections of the online application, listing every household member, their income sources, and any current insurance coverage. The online form saves your progress so you can return if interrupted.
3. 3. Submit your application and note your confirmation number. Wisconsin DHS will send you a notice within 10 business days acknowledging receipt of your application and identifying any missing information or documentation they need.
4. 4. Respond promptly to any requests for additional information. Wisconsin IM workers may contact you by mail, phone, or through your ACCESS account. You typically have 10 days to respond. Failure to provide requested documentation is the most common reason applications are denied.
5. 5. Receive your eligibility determination notice. Most BadgerCare Plus applications are decided within 45 days. If approved, your BadgerCare Plus card and a notice of your coverage group, managed care plan, and effective date will arrive by mail. If denied, the notice will explain the reason and your appeal rights.
6. 6. If approved, choose a managed care organization (MCO). Most BadgerCare Plus members in Wisconsin receive coverage through a state-contracted managed care plan (such as Molina Healthcare, Quartz, or WPS Health Insurance), not fee-for-service Medicaid. You will receive enrollment materials and have a window to select your preferred MCO. If you do not choose, Wisconsin DHS will auto-assign you to an MCO in your region.

Official portal: ACCESS Wisconsin (access.wisconsin.gov)

Documents needed

• Photo ID: Wisconsin driver's license, state-issued ID card, passport, or military ID for the primary applicant.
• Social Security Numbers (SSNs) for every person applying for coverage. If a SSN has not been issued yet, provide proof that an application is pending.
• Proof of Wisconsin residency: utility bill, lease or mortgage statement, bank statement, or any government mail showing your Wisconsin address.
• Proof of U.S. citizenship or qualifying immigration status: birth certificate, U.S. passport, naturalization certificate, Permanent Resident Card (green card), Employment Authorization Document, or I-94 arrival record.
• Proof of income: last 30 days of pay stubs (or employer letter stating gross wages and hours). Self-employed applicants should provide the most recent federal tax return (Schedule C or Schedule F) or a signed self-employment income statement.
• Health insurance information: If you or a household member has employer-sponsored health insurance (ESI), bring the insurance card, policy number, and the employee premium amount. Wisconsin may determine it is more cost-effective for BadgerCare to pay the ESI premium instead.

Processing timeline: Standard BadgerCare Plus applications are decided within 45 days of submission. Applications for pregnant women are eligible for express enrollment and may be processed faster (within a few days) at dhs.wisconsin.gov/forwardhealth/express-enrollment.htm. Applications for aged, blind, or disabled Medicaid may take up to 90 days due to the medical determination process. If you have not received a decision within 45 days and have not been asked for additional information, contact the BadgerCare Plus helpline at 1-800-362-3002.

Common reasons applications get denied

• Income above the BadgerCare Plus threshold for your coverage group: adult income above 100% FPL ($15,960/year for one person in 2026), or children/pregnancy income above 300% FPL ($99,000/year for a family of four in 2026).
• Failure to provide requested documentation within the 10-day response window. This is the most common procedural reason for denial. If you receive a request for verification, respond within 10 days or contact your county IM office to request an extension.
• Not a Wisconsin resident: if you no longer live in Wisconsin or cannot demonstrate residency, you do not qualify for BadgerCare Plus. Apply in your current state of residence.
• Federal 5-year bar for newly-arrived lawful permanent residents: most LPRs who arrived within the past 5 years are not eligible for full BadgerCare Plus Medicaid (only emergency Medicaid). Some exceptions apply for refugees, asylees, Cuban/Haitian entrants, and special-immigrant visa holders.
• Starting March 2027: failure to meet the new federal 80-hour monthly work requirement for childless adults ages 19-64. Notices from Wisconsin DHS about this requirement will be sent in fall 2026. This requirement does not apply to adults with a dependent child under 19 living in their home, pregnant women, or individuals with a disability or serious medical condition.

Children's health coverage in Wisconsin: BadgerCare Plus covers most kids up to 300% FPL

Wisconsin merged its Medicaid and CHIP programs in 2008 under the BadgerCare Plus umbrella, so most children in Wisconsin do not apply separately for CHIP. Children under age 19 qualify for BadgerCare Plus up to 300% of the Federal Poverty Level, which equals $47,880 per year (or $3,990 per month) for a single-child household and $99,000 per year (or $8,250 per month) for a family of four in 2026. Children in households earning between 201% and 300% FPL may owe a small monthly premium capped at 5% of household income. The ForwardHealth system uses an effective threshold of 306% FPL (300% plus the federal 5% disregard and 1% conversion factor) when determining eligibility. Apply for children's BadgerCare Plus at access.wisconsin.gov, the same portal used for adult coverage.

Compare Medicaid and CHIP income limits for all 50 states

If you have Medicare and limited income: Wisconsin Medicare Savings Programs (2026)

Wisconsin runs three Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries. These programs pay some or all of your Medicare premiums, deductibles, and cost-sharing, and they automatically enroll you in the federal Extra Help (Low Income Subsidy) program for Medicare Part D prescription drug costs. The three Wisconsin MSPs for 2026 are: Qualified Medicare Beneficiary (QMB), which pays Medicare Part A and Part B premiums plus deductibles and cost-sharing, for individuals with income at or below 100% FPL and assets at or below $9,950 for an individual ($14,910 for a couple); Specified Low-Income Medicare Beneficiary (SLMB), which pays the Medicare Part B premium only, for individuals with income between 100% and 120% FPL; and SLMB Plus, which pays the Part B premium, for individuals with income between 120% and 135% FPL. For SLMB, a single person qualifies with income between $1,330 and $1,596 per month in 2026. Dual-eligible BadgerCare Plus members who also have Medicare may be automatically enrolled in a Dual Eligible Special Needs Plan (D-SNP) for coordinated coverage. Apply for Wisconsin MSPs through access.wisconsin.gov or by calling 1-800-362-3002.

Read the full Medicare eligibility guide

Frequently Asked Questions