How to Get Wisconsin Medicaid Benefits | Best Answers

Last update:

We scoured the internet to bring you everything you need to know about Wisconsin Medicaid Benefits.

Medicaid is a joint federal-state program that provides health insurance to low-income people who satisfy specific criteria, such as children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, by phone, or online.

This article will tell you all you need to know about Medicaid in Wisconsin.

What is the Wisconsin Medical Program?

Adults and families in Wisconsin who meet certain income and resource requirements can receive Medicaid services. Within the confines of stated laws, resources broadly apply to the elderly, blind, or crippled population.

Who is eligible for the Wisconsin Medical Program?

Through the Medicare Savings Plan, Wisconsin Medicaid provides some financial assistance to select limited Medicare beneficiaries who are not eligible for the entire Medicaid benefit package.

  • Expectant mothers
  • People who are blind or disabled, or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*The Maximum Income Level (Per Year)

*Add $14,160 per additional person for households with more than eight people.

Similar Articles:

How do I contact Medicaid in Wisconsin?



Mailing Address

Wisconsin Department of Health Services

P.O. Box 309, Madison, WI 53701-0309.

Fax: (608) 221-8815

What are the Medicaid plans in Wisconsin?

BadgerCare Plus

The state started using managed care to give parents and kids access to Medicaid (BadgerCare in Wisconsin) acute, primary, and behavioral health services. 

Under a federal demonstration waiver, the program, now known as BadgerCare Plus, combined Medicaid and CHIP in 2008 and expanded eligibility to childless adults with incomes up to 200% of the federal poverty level.

Medicaid SSI Managed Care Program

Most BadgerCare Plus beneficiaries must sign up for a managed care plan. The Medicaid SSI Managed Care Program, established in 2005 and offers primary and acute care benefits as well as the coordination of social and vocational services, is another state-run program. 

The state mandates the enrollment in and receipt of services from a risk-based MCO for low-income adults and people with disabilities who reside in specific regions and receive Social Security Income.

Family Care

All Medicaid-covered long-term services also support, as well as adult patient behavioral health, are offered by Family Care, which began in 1999 and has since nearly spread statewide to individuals who are eligible for or at risk of receiving the organizational level of care.

 For more details regarding Medicaid plans in Wisconsin, visit here.

How do I apply for Wisconsin Medicaid?

Call 800-362-3002 to enroll. 

Apply in person at the Wisconsin Department of Health Services

Online:  Download and print the application.

Mail: To P.O. Box 309, Madison, WI 53701-0309.

Fax: (608) 221-8815

What is covered by Wisconsin Medicaid?

Wisconsin Medicaid covers the following services:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsHospital outpatient care
Home health careX-rays and other radiology services

Similar Articles:

Can I have both Wisconsin Medicaid and Medicare?

If you are 65 or older, you can qualify for both Wisconsin Medicare and Medicaid. If your age is below 65, you can only avail of the benefits of Medicaid if other eligibility criteria are fulfilled.

Wisconsin Waiver

  • Children’s Physical Disability Waiver;
  • Children’s Developmental Disability Waiver;
  • Children’s Mental Health Waiver;
  • Community Integration Program – DD;
  • Family Care – Aged / Physical Disability;
  • Community Options Program;
  • Brain Injury;
  • Family Care MR / DD


They do not have to pay a copayment. When a member is 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • The hospital (inpatient)
  • A facility for skilled nursing
  • A nursing home

What is not covered by Wisconsin Medicaid?

In Wisconsin, Medicaid is not required to provide in-home care or private nursing coverage. Bandages, adult diapers, and other disposable products, as well as cosmetic surgery and other elective operations, they are routinely excluded from insurance coverage.

What is the highest income limit for Wisconsin  Medicaid?

The highest annual income threshold for Wisconsin Medicaid is $54,930 for a family of two and $40,770 for an individual.

What if a person’s income is too high to qualify for regular Medicaid benefits?

Even if your income is too high, thanks to the asset spend-down option; you may still be qualified for Wisconsin Medicaid. 

What documents do I need to apply for Medicaid?

The following documents are required with the application:

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origin 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy;
  • When non-parents apply for Medicaid on their behalf, they must provide evidence of their financial position.

Similar Articles:

What is the best Medicaid in Wisconsin?

Because it differs from person to person, the best plan for you is the one that satisfies your requirements and provides the most advantages in terms of health insurance and financial assistance.

Where do I find the letter showing the reason(s) for denial or discontinuance from Wisconsin Medicaid?

By signing into your account at Portal, you can see the progress of your Wisconsin Medicaid application.

Photo of author
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

Leave a Comment