Wisconsin CHIP: Children's Health Insurance Program
Updated August 2026
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 306% FPL for children is one of the higher limits among all states, including non-expansion states.
306%
FPL income limit for children
BadgerCare Plus
Program name — no separate CHIP
201%
FPL — children's premium threshold
Wisconsin covers children through BadgerCare Plus up to 306% 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 with income between the premium threshold (201% FPL) and 306% FPL. For a family of four, 306% FPL is approximately $8,415/month (effective February 1, 2026–January 31, 2027). Apply at access.wi.gov or call 800-362-3002.
How Wisconsin covers children: BadgerCare Plus
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 306% 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
Source: Wisconsin DHS "BadgerCare Plus: Income Guidelines" (dhs.wisconsin.gov/badgercareplus/fpl.htm), effective February 1, 2026–January 31, 2027. These amounts are based on federal poverty guidelines, which change annually.
| Family size | Children premium threshold (201% FPL) — monthly | Pregnant people & children limit (306% FPL) — monthly |
|---|---|---|
| 1 | $2,673.30 | $4,069.80 |
| 2 | $3,624.69 | $5,518.19 |
| 3 | $4,576.11 | $6,966.61 |
| 4 | $5,527.50 | $8,415.00 |
| 5 | $6,478.89 | $9,863.39 |
| 6 | $7,430.31 | $11,311.81 |
| Each extra person, add | $951.39 | $1,448.39 |
1
- Children premium threshold (201% FPL) — monthly
- $2,673.30
- Pregnant people & children limit (306% FPL) — monthly
- $4,069.80
2
- Children premium threshold (201% FPL) — monthly
- $3,624.69
- Pregnant people & children limit (306% FPL) — monthly
- $5,518.19
3
- Children premium threshold (201% FPL) — monthly
- $4,576.11
- Pregnant people & children limit (306% FPL) — monthly
- $6,966.61
4
- Children premium threshold (201% FPL) — monthly
- $5,527.50
- Pregnant people & children limit (306% FPL) — monthly
- $8,415.00
5
- Children premium threshold (201% FPL) — monthly
- $6,478.89
- Pregnant people & children limit (306% FPL) — monthly
- $9,863.39
6
- Children premium threshold (201% FPL) — monthly
- $7,430.31
- Pregnant people & children limit (306% FPL) — monthly
- $11,311.81
Each extra person, add
- Children premium threshold (201% FPL) — monthly
- $951.39
- Pregnant people & children limit (306% FPL) — monthly
- $1,448.39
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)).
- 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 the 201% FPL premium threshold. Children in families between 201% and 306% 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.
Wisconsin Medicaid (ForwardHealth)
- Apply for BadgerCare Plus: access.wi.gov
- ForwardHealth phone line: 800-362-3002
- Wisconsin DHS Medicaid: dhs.wisconsin.gov/medicaid/index.htm
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