Wisconsin Medicaid income limits
Last verified: June 2026
Verify current limits with Wisconsin Medicaid (ForwardHealth)
Wisconsin adults are covered only to 100% FPL — not 138% as in expansion states
BadgerCare Plus income limits by coverage group (2026)
Wisconsin uses MAGI-based income rules for BadgerCare Plus. MAGI counts wages, self-employment income, unemployment, Social Security income, and most other taxable sources. No asset test applies to BadgerCare Plus — Wisconsin's 1115 waiver specifically eliminates the asset test for most coverage groups under the program.
| Coverage group | FPL % | Annual limit (household of 1) | Annual limit (household of 4) |
|---|---|---|---|
| Adults without children (non-disabled) | 100% FPL | ~$15,060/yr | ~$31,200/yr |
| Children under 19 | 300% FPL | ~$45,180/yr | ~$93,600/yr |
| Pregnant individuals | 300% FPL | ~$45,180/yr | ~$93,600/yr |
| Parents and caretaker relatives | 100% FPL | ~$15,060/yr | ~$31,200/yr |
| Seniors and disabled (non-MAGI) | Separate rules | Varies | N/A |
Source: Wisconsin Department of Health Services BadgerCare Plus program documentation; DHS page last revised March 31, 2026; 2026 HHS Federal Poverty Level guidelines. Annual figures are approximations — DHS uses monthly thresholds. Verify exact current limits at access.wi.gov or call ForwardHealth Member Services at 800-362-3002.
Wisconsin's 300% FPL pregnancy coverage: a notable outlier
Wisconsin covers pregnant people up to 300% FPL — a much higher threshold than most non-expansion states, many of which cover pregnancy only to 133% or 185% FPL. At 300% FPL, a pregnant individual with household income under approximately $45,180 per year qualifies for BadgerCare Plus pregnancy coverage. The coverage includes all pregnancy-related care and extends 60 days postpartum.
This high limit exists because Wisconsin integrated what would otherwise be CHIP and Medicaid pregnancy coverage into a unified BadgerCare Plus structure. The coverage is comprehensive — not limited to pregnancy-specific services — and enrolled members receive a full ForwardHealth card.
Adults above 100% FPL: marketplace coverage instead
Adults with income between 100% and 400% FPL are not eligible for BadgerCare Plus. They can apply for subsidized marketplace plans through healthcare.gov. Adults between 100% and 150% FPL may qualify for zero-premium plans with enhanced tax credits under current federal rules.
Wisconsin's Legislature has repeatedly declined Medicaid expansion. Per the Kaiser Family Foundation, Wisconsin is one of the few non-expansion states where adults below the poverty line do receive Medicaid (up to 100% FPL), rather than falling into the "coverage gap" that exists in states that cover adults only through the traditional Medicaid categories. That difference is significant — it means no Wisconsin adult below the poverty line is in the coverage gap.
How Medicaid income limits work
Medicaid eligibility is tied to the Federal Poverty Level (FPL), a measure the Department of Health and Human Services updates each January. States set their income limits as a percentage of FPL — so when FPL increases, the dollar thresholds for Medicaid also shift.
The Affordable Care Act established a standard income methodology called Modified Adjusted Gross Income (MAGI) for most Medicaid applicants. Under MAGI, the agency counts wages, salaries, self-employment income, Social Security benefits, and most other taxable income. Assets — a savings account, vehicle, home — are not counted for MAGI-based programs. That changed with the ACA and applies in all states.
States that expanded Medicaid under the ACA cover most adults at or below 138% FPL. In non-expansion states, income limits for adults without dependent children are far lower — sometimes as low as a few hundred dollars per month — or eligibility for that category simply doesn't exist.
These are federal guidelines — state limits may differ
What counts as income under MAGI
MAGI (Modified Adjusted Gross Income) is the income standard for most Medicaid applicants — children, adults under 65, pregnant women, and parents. It includes wages, salary, tips, self-employment income, unemployment benefits, Social Security retirement and disability benefits (SSDI), and most other taxable income.
It does not count child support received, gifts, loans, inheritances that are not generating income, or Supplemental Security Income (SSI) payments. One key MAGI rule: the ACA added a 5% FPL income disregard for most adults, which effectively raises the usable threshold by that amount. So a state with a 133% FPL limit effectively covers adults to about 138% FPL after the disregard.
Assets — a bank account, car, or home — are not counted for MAGI-based programs. That's a major difference from old-law Medicaid, where asset tests were common. If you previously didn't qualify because of assets, your eligibility may have changed after the ACA.
Asset limits and long-term care Medicaid
MAGI-based programs have no asset test. But Medicaid programs that cover long-term care — nursing home care, home and community-based services for seniors — use the old income and asset methodology, which does include asset limits.
Asset limits for long-term care Medicaid vary by state and are updated periodically. Generally, countable assets above the limit must be spent down before an applicant qualifies. Exempt assets — the primary home (in most circumstances), one vehicle, and certain personal property — are not counted.
Specific asset limits for Wisconsin's long-term care programs are on the seniors and long-term care page. The thresholds change, so verify current figures with Wisconsin Medicaid (ForwardHealth) directly.