Medicaid in Wisconsin (2026): Eligibility and How to Apply

What Is BadgerCare Plus?

Medicaid is a joint federal-state health insurance program that provides free or low-cost coverage to people who meet income and eligibility requirements. In Wisconsin, the Medicaid program is called BadgerCare Plus. It is administered by the state but jointly funded by state and federal governments.

Wisconsin Has NOT Expanded Medicaid

Wisconsin has not expanded Medicaid under the ACA. Medicaid eligibility for non-disabled, non-pregnant adults without children remains very limited — generally below approximately $21,597 per year. Most low-income adults in Wisconsin who do not fit a traditional Medicaid eligibility category must use the ACA marketplace for coverage.

Adults earning below 100% FPL in non-expansion states like Wisconsin fall into the "coverage gap" — they earn too little to qualify for marketplace subsidies (which start at 100% FPL) but too much for their state’s Medicaid program. The ARP and IRA extended enhanced subsidies, but the coverage gap remains a significant issue in non-expansion states.

Wisconsin Medicaid Eligibility Categories

Beyond the general adult expansion (in states that expanded), Medicaid covers several other groups:

• Children: All states cover children in families at much higher income thresholds than adult Medicaid, often up to 200-300% FPL or more through CHIP
• Pregnant women: Covered at higher income thresholds (typically 185-250% FPL) in all states
• People with disabilities: SSI recipients and people with qualifying disabilities are eligible in all states
• Elderly adults: Adults 65+ with limited income and resources qualify through the Medicare Savings Programs

Marketplace as Alternative in Wisconsin

If you don’t qualify for BadgerCare Plus, the ACA marketplace is your primary option. Wisconsin marketplace carriers include: Common Ground Healthcare, Dean Health Plan, Security Health Plan, Medica, WPS Health Insurance. ACA premium tax credits are available for households earning between 100% and 400% FPL (~$15,650–$62,600 for a single adult in 2026).