Wisconsin Medicaid Income Limits
Updated August 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.
Wisconsin adults are covered only to 100% FPL — not 138% as in expansion states
Wisconsin did not expand Medicaid. Non-disabled adults without children qualify only up to 100% of the Federal Poverty Level. Adults with income from 100%–400% FPL should apply for marketplace coverage at healthcare.gov instead. Children and pregnant people have much higher income limits. Verify at access.wi.gov or call 800-362-3002.
BadgerCare Plus income limits by coverage group (2026)
| Coverage group | FPL % | Annual limit (household of 1) | Annual limit (household of 4) |
|---|---|---|---|
| Adults without children (non-disabled) | 100% FPL | $15,960/yr | $33,000/yr |
| Children under 19 | 306% FPL | ~$48,838/yr | ~$100,980/yr |
| Pregnant individuals | 306% FPL | ~$48,838/yr | ~$100,980/yr |
| Parents and caretaker relatives | 100% FPL | $15,960/yr | $33,000/yr |
| Seniors and disabled (non-MAGI) | Separate rules | Varies | N/A |
Adults without children (non-disabled)
- FPL %
- 100% FPL
- Annual limit (household of 1)
- $15,960/yr
- Annual limit (household of 4)
- $33,000/yr
Children under 19
- FPL %
- 306% FPL
- Annual limit (household of 1)
- ~$48,838/yr
- Annual limit (household of 4)
- ~$100,980/yr
Pregnant individuals
- FPL %
- 306% FPL
- Annual limit (household of 1)
- ~$48,838/yr
- Annual limit (household of 4)
- ~$100,980/yr
Parents and caretaker relatives
- FPL %
- 100% FPL
- Annual limit (household of 1)
- $15,960/yr
- Annual limit (household of 4)
- $33,000/yr
Seniors and disabled (non-MAGI)
- FPL %
- Separate rules
- Annual limit (household of 1)
- Varies
- Annual limit (household of 4)
- N/A
Wisconsin's 306% FPL pregnancy coverage: a notable outlier
Wisconsin covers pregnant people up to 306% FPL — a much higher threshold than most non-expansion states, many of which cover pregnancy only to 133% or 185% FPL. At 306% FPL, a pregnant individual with household income under approximately $48,838 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.
Medicare Savings Programs (QMB) in Wisconsin
Wisconsin is one of the few non-expansion states where adults below the poverty line still qualify for BadgerCare Plus, as the callout above notes — and the state offers a similarly meaningful benefit to Medicare enrollees with limited income through three Medicare Savings Programs (MSPs), administered through ForwardHealth rather than Medicare. Apply through access.wi.gov or by calling 800-362-3002.
| Program | Situation | Monthly income limit |
|---|---|---|
| QMB | Individual | $1,350 |
| QMB | Married couple | $1,824 |
| SLMB | Individual | $1,616 |
| SLMB | Married couple | $2,184 |
| QI | Individual | $1,816 |
| QI | Married couple | $2,455 |
QMB
- Situation
- Individual
- Monthly income limit
- $1,350
QMB
- Situation
- Married couple
- Monthly income limit
- $1,824
SLMB
- Situation
- Individual
- Monthly income limit
- $1,616
SLMB
- Situation
- Married couple
- Monthly income limit
- $2,184
QI
- Situation
- Individual
- Monthly income limit
- $1,816
QI
- Situation
- Married couple
- Monthly income limit
- $2,455
Qualified Medicare Beneficiary (QMB) is the most generous MSP tier: it pays the Part A premium for enrollees who owe one, the full $202.90 monthly Part B premium in 2026, and all Medicare deductibles, coinsurance, and copayments. Federal law bans providers from billing a QMB enrollee for these costs, whether or not the provider participates in ForwardHealth.
Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) only cover the Part B premium, with no cost-sharing help. QI is funded from a capped annual pool distributed first-come, first-served and must be reapplied for each year, so Wisconsinites near the QI limit should apply early. QMB, SLMB, and QI enrollees are all automatically enrolled in Extra Help, which caps 2026 covered prescription-drug costs at $12.65 per drug.
Wisconsin Medicaid (ForwardHealth)
Visit the official Wisconsin Medicaid websiteIncome Limits in Nearby States
Related guides
Income Limits
Current income cutoffs by state and household size, tied to the Federal Poverty Level.
Read more →Spend-Down
How to qualify by deducting medical bills from income that's above the limit.
Read more →QMB Program
What the QMB program covers, what a QMB card proves, and how to apply.
Read more →