Wisconsin Medicaid
Last verified: June 2026
Informational resource — not affiliated with Wisconsin
Wisconsin did not expand Medicaid under the ACA — adult income limits are lower than in most states
What is BadgerCare Plus?
BadgerCare Plus is Wisconsin's main public health insurance program for low-income families, children, pregnant people, and adults. The Wisconsin Department of Health Services (DHS) administers it through its Division of Medicaid Services. About 1.3 million Wisconsinites are covered by BadgerCare Plus and Wisconsin's broader Medicaid programs.
Wisconsin is one of a small number of states that has not expanded Medicaid under the ACA. The Republican-led state legislature has declined expansion multiple times. As a result, Wisconsin covers childless adults only up to 100% FPL — not the 138% level available in expansion states. Adults earning above 100% FPL are directed to the federal marketplace at healthcare.gov instead.
Wisconsin operates BadgerCare Plus under a Section 1115 waiver called the BadgerCare Waiver. The waiver gives Wisconsin flexibility in how it structures coverage, including the 100% FPL adult limit. DHS revised the most recent waiver last updated March 31, 2026, per Wisconsin DHS.
Who BadgerCare Plus covers
Children
Children up to age 19 whose family income is at or below 300% FPL. Wisconsin integrates its CHIP population into BadgerCare Plus — there is no separate CHIP program. Children at this income level receive BadgerCare Plus, not a separate CHIP card.
Pregnant individuals
Pregnant people up to 300% FPL for pregnancy-related services. Wisconsin's 300% FPL limit for pregnancy is unusually high — most non-expansion states set this limit well below 200%. Coverage continues through 60 days postpartum.
Adults without disabilities
Non-disabled adults with income at or below 100% FPL. Adults above 100% FPL are not eligible for BadgerCare Plus and are referred to marketplace coverage. This is the key difference from expansion states.
Seniors and individuals with disabilities
Seniors 65 and older and disabled individuals qualify under separate Medicaid eligibility rules with their own income and asset limits. Long-term care coverage is provided through Family Care managed care or the IRIS self-directed program.
How Wisconsin delivers BadgerCare Plus care
Most BadgerCare Plus members receive care through the ForwardHealth program. Wisconsin uses a mix of fee-for-service and managed care, depending on the member's program. HMOs (health maintenance organizations) are available for BadgerCare Plus members in most counties.
Members manage their benefits through ACCESS at access.wi.gov — Wisconsin's online benefits portal — or through the MyACCESS mobile app. The app allows members to check benefits, submit documents, update contact information, and view their digital ForwardHealth card without needing to log into a web browser.
Long-term care services are not part of standard BadgerCare Plus. Seniors and adults with disabilities who need LTSS access separate programs: Family Care (managed LTSS), IRIS (self-directed support), and PACE in areas where it is available.
Wisconsin Medicaid topics
How to apply
Income limits
Dental coverage
Seniors and long-term care
Medicaid renewal
CHIP
What does Wisconsin Medicaid (ForwardHealth) cover?
Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.
The national benefits overview lists required and commonly optional services. Check the Wisconsin Medicaid (ForwardHealth) website for the current state-specific benefit package.
How to apply
Most people can apply online through Wisconsin's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.
Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). Wisconsin must follow that federal timeline.