Wisconsin's unique approach: BadgerCare Plus covers adults up to 100% FPL ($15,960/year individual, $33,000 family of 4). Adults earning 100-138% FPL go to the ACA marketplace with subsidies — no coverage gap.
Wisconsin Medicaid Income Limits 2026
The following table shows the key income thresholds for Wisconsin in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
| 5 | $38,680 | $53,378 | $154,720 |
| 6 | $44,360 | $61,217 | $177,440 |
If your household income falls below the 100% FPL column, you qualify for BadgerCare Plus. If your income is between 100% and 400% FPL, you qualify for ACA marketplace subsidies.
About BadgerCare Plus
Who Qualifies for BadgerCare Plus
In Wisconsin, BadgerCare Plus provides essential health coverage to many residents. You may qualify if your household income is at or below 100% of the Federal Poverty Level (FPL) as a childless adult, parent, or caretaker. For example, a single adult with a monthly income of up to $1,330, a two-person household up to $1,803, or a family of four up to $2,750 could be eligible. Children and pregnant individuals have higher income limits, up to 300% FPL. For a pregnant individual or child in a one-person household, this means a monthly income up to $3,990. Currently, about 1.33 million Wisconsin residents are enrolled in Medicaid or CHIP, demonstrating it's a widely used and crucial program. There is no asset limit for BadgerCare Plus, which can be a significant advantage.
If You're Near the Income Line
If your income is slightly above the BadgerCare Plus threshold, you'll likely transition to the HealthCare.gov marketplace for subsidized coverage. Wisconsin has a seamless transition, as marketplace subsidies begin where BadgerCare Plus eligibility ends. With a benchmark Silver plan costing around $527 per month, subsidies can significantly reduce your monthly premium, making coverage much more affordable. It's important to remember that income changes can shift your eligibility between BadgerCare Plus and the marketplace, so reporting any changes promptly is crucial. If you lost BadgerCare Plus coverage during the recent "unwinding" period, you can reapply at any time if your circumstances change.
What BadgerCare Plus Covers
BadgerCare Plus offers comprehensive benefits, including primary and acute care services, physician visits, inpatient and outpatient hospital care, pharmacy, non-emergency medical transportation, and vision and dental care. Generally, there are no cost-sharing requirements for most BadgerCare Plus members, though some children with higher incomes and individuals on transitional medical assistance may have monthly premiums. Wisconsin also has unique waiver programs like Family Care and IRIS (Include, Respect, I Self-Direct), which provide home and community-based services for eligible elderly and adults with disabilities, allowing them to receive care in their homes instead of institutions.
Tips for Applying
Be aware that processing delays can occur, so submitting all required documentation accurately and on time is essential. During the recent unwinding of continuous Medicaid coverage, many people in Wisconsin had to redetermine their eligibility. Make sure your contact information is always up-to-date with the state to receive important notices about your coverage. You can update your information through the ACCESS website or MyAccess app. Your concrete action step is to visit ACCESS.wi.gov to apply for benefits or update your information.
Marketplace Insurance in Wisconsin
Wisconsin residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Wisconsin costs approximately $527/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Wisconsin might pay for a Silver plan after subsidies, based on the $527/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$80/mo | $447/mo |
| 200% FPL | $31,920 | ~$173/mo | $354/mo |
| 250% FPL | $39,900 | ~$277/mo | $250/mo |
| 300% FPL | $47,880 | ~$392/mo | $135/mo |
| 400% FPL | $63,840 | ~$523/mo | $4/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Wisconsin. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Wisconsin uses the federal marketplace at HealthCare.gov.
How to Apply for BadgerCare Plus
Medicaid enrollment is open year-round — there's no deadline. You can apply through any of these channels:
- Online: Apply through HealthCare.gov — the system automatically checks your BadgerCare Plus eligibility when you enter your income. Or apply directly through BadgerCare Plus.
- Phone: Call Wisconsin's Medicaid helpline for guided help with your application.
- In person: Visit your local human services office or a certified application counselor.
You'll need proof of income (pay stubs or tax returns), proof of Wisconsin residency, and Social Security numbers for household members.
Calculate Your Subsidy in Wisconsin
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Wisconsin.
Frequently Asked Questions
Who qualifies for BadgerCare Plus?
Wisconsin has not expanded Medicaid, so there is no standard income limit for adults. Traditional Medicaid covers specific groups (children, pregnant women, disabled, very low-income parents). Income limits for these groups vary. Children are generally covered up to 200-300% FPL through CHIP.
Is Medicaid expanded in Wisconsin?
Wisconsin has not formally expanded Medicaid but covers adults up to 100% FPL through BadgerCare Plus under a federal waiver. There is no coverage gap because adults above 100% FPL can access marketplace subsidies.
Am I eligible for health insurance subsidies in Wisconsin?
Wisconsin residents with household income between 100% and 400% FPL ($15,960 to $63,840 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the name of Wisconsin's Medicaid program?
Wisconsin's Medicaid program is known as BadgerCare Plus. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and certain other qualifying groups.
What should I do if my BadgerCare Plus coverage is ending?
If your BadgerCare Plus coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
What's the difference between Medicaid and marketplace insurance in Wisconsin?
Medicaid (BadgerCare Plus) is free or near-free with no premiums or deductibles. Marketplace plans in Wisconsin average $527/month before subsidies. If you qualify for Medicaid, it's the more affordable option. If your income puts you just above the cutoff, subsidized Silver plans with cost-sharing reductions are the next best thing.