Wisconsin CHIP: Children's Health Insurance Program

Last verified: June 2026

Informational overview of Wisconsin CHIP

For current eligibility thresholds and enrollment, visit https://www.dhs.wisconsin.gov/medicaid/index.htm. CHIP and Medicaid applications are processed together in most states — apply once and both programs are considered.

Wisconsin covers children through BadgerCare Plus up to 300% FPL — no separate CHIP program

Wisconsin does not operate a standalone CHIP program. Children are covered through BadgerCare Plus, which uses CHIP federal funding for children in families between 100% and 300% FPL. For a family of four, 300% FPL is approximately $93,600 (2025). Apply at access.wi.gov or call 800-362-3002.

How Wisconsin covers children: BadgerCare Plus

Wisconsin integrates children's Medicaid and CHIP coverage into a single program called BadgerCare Plus. There is no separate program name for the CHIP component in Wisconsin — children are simply "BadgerCare Plus members" regardless of whether their coverage is Medicaid-funded or CHIP-funded. The income limit of 300% FPL for children is one of the higher limits among all states, including non-expansion states.

Wisconsin is a Medicaid non-expansion state for adults (the BadgerCare adult limit is 100% FPL), which creates an unusual gap structure. But for children, coverage extends generously to 300% FPL — meaning middle-income working families may qualify for their children even when the parents do not qualify for BadgerCare themselves.

Coverage is administered through ForwardHealth, Wisconsin's Medicaid management information system, operated by the Department of Health Services (DHS).

BadgerCare Plus income eligibility for children

Population	Income Limit	Notes
Children 0–18	Up to 300% FPL	Medicaid-funded 0–100%; CHIP-funded 100–300%
Pregnant women	Up to 300% FPL	CHIP-funded for income above Medicaid threshold; coverage extended through 60 days postpartum

Source: Wisconsin DHS BadgerCare Plus eligibility documentation; KFF State Health Facts CHIP/Medicaid eligibility. Wisconsin's 300% FPL child limit applies to the CHIP-funded component. Verify current dollar thresholds at access.wi.gov or call ForwardHealth.

What BadgerCare Plus covers for children

Children enrolled in BadgerCare Plus receive comprehensive coverage under the federal EPSDT mandate (42 U.S.C. § 1396d(r)). Covered services include:

Well-child visits and EPSDT screenings
Sick visits and specialist care
Dental — comprehensive coverage through ForwardHealth (exams, fillings, orthodontics when necessary)
Vision — eye exams and corrective lenses
Mental health and behavioral health services
Substance use disorder treatment
Prescription drugs
Hospital care — inpatient and outpatient
Emergency services
Physical, occupational, and speech therapy

Premiums and cost sharing

BadgerCare Plus has no premiums for children in families at or below 200% FPL. Children in families between 200% and 300% FPL enrolled in the CHIP-funded component may pay modest monthly premiums. Federal law caps total CHIP family cost sharing at 5% of annual income.

For specific current premium amounts, contact ForwardHealth at 800-362-3002 or check the BadgerCare Plus premium schedule at dhs.wisconsin.gov/badgercareplus/premium.htm.

How to enroll a child in BadgerCare Plus

Apply at access.wi.gov, through the MyACCESS mobile app, by calling ForwardHealth at 800-362-3002, or in person at your county human services office. Newborns born to BadgerCare-enrolled mothers are automatically enrolled at birth — parents should confirm enrollment with ForwardHealth within the first few weeks. Children who lose employer-sponsored insurance qualify for a Special Enrollment Period — apply within 60 days of losing other coverage.

What CHIP is

CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.

CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families.

Nationally, CHIP covers approximately 7 million children, according to CMS data. In most states, it is a seamless part of the broader children's health coverage system alongside Medicaid.

What CHIP covers

Federal law requires CHIP to cover certain core benefits. States may add to the list. Standard CHIP coverage includes:

Doctor visits, including well-child checkups and sick visits
Hospital care — inpatient and outpatient
Emergency room and urgent care services
Prescription drug coverage
Mental health and substance use disorder services
Dental care — preventive and restorative
Vision care, including eye exams and glasses
Laboratory and imaging services
Physical, occupational, and speech therapy
Medical equipment, such as wheelchairs or hearing aids when medically necessary

How to apply for Wisconsin CHIP

Apply through Wisconsin Medicaid (ForwardHealth) — the same application covers both Medicaid and CHIP. Online applications are typically fastest and allow document uploads. You can also apply by phone or in person at a local eligibility office.

See the how to apply page for the complete application process, required documents, and what to expect during review.

CHIP and Medicaid income ranges overlap — apply regardless

If you're not sure whether your child qualifies for Medicaid or CHIP, apply anyway. The eligibility system determines which program applies based on your income. A child who earns out of Medicaid may qualify for CHIP, and vice versa. Don't let uncertainty about which program applies prevent you from applying.