If you live in Wisconsin and need affordable health coverage, Medicaid could be the answer. Wisconsin's Medicaid program is called BadgerCare Plus, and it provides free or low-cost health insurance to eligible residents including adults, children, and pregnant women. Whether you are between jobs, working a low-wage position, or simply need help covering medical costs, this guide walks you through everything you need to know about applying for Medicaid in Wisconsin.
Not sure if you qualify? Check your eligibility in minutes with our free screener before you start the application process.
What Is BadgerCare Plus?
BadgerCare Plus is Wisconsin's version of Medicaid. It is administered by the Wisconsin Department of Health Services (DHS) and covers doctor visits, hospital stays, prescriptions, mental health services, dental care, vision care, and more.
Wisconsin is unique among states that have not formally expanded Medicaid under the Affordable Care Act (ACA). Despite not adopting the full ACA expansion, Wisconsin covers all adults with household income up to 100% of the Federal Poverty Level (FPL), including adults without dependent children. This means there is no "coverage gap" in Wisconsin, unlike most other non-expansion states.
For children and pregnant women, coverage extends much further, up to 306% of the FPL.
For more details on all available programs in the state, visit our Wisconsin Benefits Overview.
Who Is Eligible for BadgerCare Plus?
Eligibility depends on your age, household size, income, and residency status. Here are the main categories:
- Adults ages 19 to 64: Household income at or below 100% FPL
- Children ages 0 to 18: Household income at or below 306% FPL (premiums may apply above 201% FPL)
- Pregnant women: Household income at or below 306% FPL
- Parents and caretaker relatives: Household income at or below 100% FPL
Additional requirements:
- You must be a Wisconsin resident
- You must be a U.S. citizen or qualified immigrant (non-refugee/asylee adults must have been lawfully present for at least five years)
- There is no asset test for most BadgerCare Plus categories
BadgerCare Plus Income Limits (2026)
The following monthly income limits are effective February 1, 2026 through January 31, 2027. These amounts come directly from the Wisconsin Department of Health Services.
| Family Size | Adults (100% FPL) | Children Premium Threshold (201% FPL) | Children/Pregnant Women Limit (306% FPL) |
|---|---|---|---|
| 1 | $1,330 | $2,673 | $4,070 |
| 2 | $1,803 | $3,625 | $5,518 |
| 3 | $2,277 | $4,576 | $6,967 |
| 4 | $2,750 | $5,528 | $8,415 |
| 5 | $3,223 | $6,479 | $9,863 |
| 6 | $3,697 | $7,430 | $11,312 |
| 7 | $4,170 | $8,382 | $12,760 |
| 8 | $4,643 | $9,333 | $14,209 |
| Each additional person | +$473 | +$951 | +$1,448 |
How to read this table:
- If you are an adult without children, your monthly income must be at or below the "Adults (100% FPL)" column for your household size.
- Children in families earning between 201% and 306% FPL may need to pay small monthly premiums, capped at 5% of household income.
- Children in families below 201% FPL pay no premiums.
How to Apply for Medicaid in Wisconsin: Step by Step
Wisconsin offers several ways to apply for BadgerCare Plus. The fastest method is through the online ACCESS portal.
Step 1: Gather Your Information
Before you start, collect the following for each person in your household:
- Social Security numbers for all household members applying
- Proof of identity (driver's license, state ID, passport, or birth certificate)
- Proof of income (recent pay stubs, tax returns, or a letter from your employer)
- Proof of Wisconsin residency (utility bill, lease agreement, or bank statement with your address)
- Immigration documents (if applicable, such as a green card or work permit)
- Health insurance information (details about any current coverage, including employer-offered plans)
- Pregnancy verification (a note from a health care provider, if applicable)
Step 2: Choose Your Application Method
Option A: Apply Online (Recommended)
The Wisconsin ACCESS portal is the fastest and easiest way to apply.
- Go to access.wisconsin.gov
- Create an account or log in
- Click "Apply for Benefits"
- Complete the application (you can save and return later)
- Upload any required documents directly through the portal
- Submit your application
The online application also lets you apply for FoodShare (SNAP), child care assistance, and other programs at the same time.
Option B: Apply by Phone
Call the Wisconsin Benefits Hotline at 1-800-362-3002. A representative can help you complete your application over the phone and answer questions about eligibility.
Option C: Apply In Person
Visit your local county or tribal Income Maintenance (IM) agency. You can find your nearest office using the map on the DHS website. Bring all your documents with you to speed up the process.
Option D: Apply by Mail
Download and print the BadgerCare Plus application packet from the DHS website. Complete the paper form and mail or deliver it to your local Income Maintenance agency.
Option E: Through HealthCare.gov
You can also start an application at HealthCare.gov. If the system determines you may be eligible for Medicaid, it will refer your application to the Wisconsin Medicaid agency.
Step 3: Complete the Application
The application asks about your household composition, income, employment, current health coverage, and immigration status. Answer all questions as accurately as possible. Incomplete applications can cause delays.
Step 4: Submit Required Documents
You may need to provide verification documents after submitting your application. Wisconsin may verify your information electronically, but in some cases, you will be asked to submit proof of income, identity, or residency. You can upload documents through ACCESS, fax them, or bring them to your local office.
Step 5: Wait for a Decision
Wisconsin aims to process Medicaid applications within 30 days (or 15 days for pregnant women applying for presumptive eligibility). You will receive a notice by mail with the decision. You can also check your application status online through the ACCESS portal.
Step 6: Choose a Health Plan
If approved, you will need to select a managed care health plan (HMO) in most parts of the state. You will receive information about available plans in your area. If you do not choose a plan within the specified timeframe, one will be assigned to you.
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
- Dental care
- Vision care and eyeglasses
- Lab tests and X-rays
- Preventive care and screenings
- Maternity and newborn care
- Physical therapy and rehabilitation
- Durable medical equipment
- Transportation to medical appointments
What If Your Income Is Too High for BadgerCare Plus?
If your income exceeds the BadgerCare Plus limits, you still have options:
- Marketplace coverage: Adults with income above 100% FPL can purchase private health insurance through HealthCare.gov and may qualify for premium tax credits that significantly reduce monthly costs. Wisconsin uses the federal marketplace.
- Children's coverage: Children in families earning up to 306% FPL still qualify for BadgerCare Plus, even if parents do not.
- Check for other programs: You may qualify for other assistance like FoodShare, energy assistance, or WIC. Use our free benefits screener to check all programs at once.
Medicaid for Seniors and People with Disabilities
Wisconsin also offers Medicaid coverage for people age 65 and older, blind individuals, and people with disabilities. These programs have different rules:
- Income limits vary by program (generally 100% to 300% FPL depending on the specific category)
- Asset limits apply (typically $2,000 for an individual)
- Long-term care Medicaid covers nursing home care and home/community-based services for those who meet both financial and functional eligibility requirements
To apply for these programs, contact your county or tribal Income Maintenance agency or call 1-800-362-3002.
Tips for a Successful Application
- Apply as soon as possible. Coverage can begin as early as the date you submit your application, so do not wait.
- Apply for multiple programs at once. The ACCESS portal lets you check eligibility for BadgerCare Plus, FoodShare, and other benefits in a single application.
- Respond to requests quickly. If the agency asks for additional documents, submit them promptly to avoid delays or denial.
- Report changes. Once enrolled, report any changes in income, household size, or address within 10 days. You can do this through ACCESS or by contacting your local office.
- Renew on time. BadgerCare Plus coverage must be renewed annually. You will receive a renewal notice before your coverage period ends.
Frequently Asked Questions
How long does it take to get approved for BadgerCare Plus?
Most applications are processed within 30 days. Pregnant women may receive faster processing. You can check your status anytime through the ACCESS portal at access.wisconsin.gov.
Can I apply for BadgerCare Plus if I am undocumented?
Undocumented immigrants are generally not eligible for BadgerCare Plus. However, emergency Medicaid may cover emergency medical conditions regardless of immigration status. Lawfully present immigrants who have been in the U.S. for fewer than five years may qualify for Marketplace coverage with subsidies instead.
Is there a cost for BadgerCare Plus?
For most adults and children in families below 201% FPL, there are no premiums or enrollment fees. Children in families with income between 201% and 306% FPL may pay small monthly premiums, capped at 5% of household income. There are minimal copays for some services.
Can I apply if I already have employer coverage?
Yes, you can apply even if you have employer-sponsored insurance. If you qualify, BadgerCare Plus may serve as secondary coverage or you may choose to switch to BadgerCare Plus. The application will ask about any current coverage you have.
What happens if my application is denied?
If your application is denied, you will receive a written notice explaining the reason. You have the right to request a fair hearing to appeal the decision. The notice will include instructions on how to file an appeal. You typically have 45 days from the date of the notice to request a hearing.
Do I need to be a Wisconsin resident?
Yes, you must live in Wisconsin to qualify for BadgerCare Plus. There is no minimum residency period, so you can apply as soon as you move to the state.
Can college students apply?
Yes, college students in Wisconsin can apply for BadgerCare Plus if they meet the income and residency requirements. Being a full-time student does not disqualify you.
Get Started Today
Applying for Medicaid in Wisconsin does not have to be complicated. The ACCESS portal makes it easy to submit your application online in about 30 to 45 minutes. If you need help, call the benefits hotline at 1-800-362-3002 or visit your local Income Maintenance agency.
Want to see all the benefits you might qualify for? Take our free benefits screening quiz to check your eligibility for BadgerCare Plus, FoodShare, energy assistance, and more in just a few minutes.
