To apply for Medicaid in Wisconsin, you can file online through the ACCESS Wisconsin portal, mail a paper application to the Central Document Processing Unit in Janesville, call your regional Income Maintenance consortium, or bring your paperwork to a local Income Maintenance agency in person. Whether you qualify depends mainly on your income, household size, and — for older adults and people with disabilities — your assets.
Who Qualifies for Wisconsin Medicaid
You must live in Wisconsin and be a U.S. citizen or hold a qualifying immigration status.1Wisconsin State Legislature. Wisconsin Administrative Code DHS 103.03 – Non-Financial Conditions for Eligibility Beyond that, Wisconsin runs two main tracks: BadgerCare Plus, which covers children, parents, pregnant people, and other adults, and Medicaid for the Elderly, Blind, or Disabled (EBD).
BadgerCare Plus Income Limits
BadgerCare Plus uses the Federal Poverty Level (FPL) as its yardstick. For the period from February 1, 2026, through January 31, 2027, a single adult without children qualifies at monthly income up to $1,330 (100% FPL). A household of four qualifies at up to $2,750 per month at the same threshold.2Wisconsin Department of Health Services. BadgerCare Plus Federal Poverty Level Guidelines Larger households get proportionally higher limits.
Pregnant people and children qualify at much higher income levels, up to 306% of FPL — $4,069.80 per month for a household of one. Children between 201% and 306% FPL keep coverage only if the family pays a monthly premium.2Wisconsin Department of Health Services. BadgerCare Plus Federal Poverty Level Guidelines
EBD Medicaid
EBD Medicaid is for people who are 65 or older, blind, or who have a disability that meets Social Security Administration standards. It applies asset limits on top of income limits: for 2026, $2,000 in countable resources for a single applicant and $3,000 for a couple.3Wisconsin Department of Health Services. Operations Memo 25-21, 2026 Cost-of-Living Adjustment for EBD Medicaid Long-term care applicants face additional rules on home equity and spousal assets that are worth reviewing separately before filing.
Documents to Gather Before You Apply
Pull these together for every household member who wants coverage:
- Social Security numbers and dates of birth for everyone in the household.
- Proof of Wisconsin residency, such as a recent utility bill, signed lease, or property tax statement.
- Proof of citizenship or immigration status. A U.S. passport, birth certificate, Certificate of Naturalization, or green card works. A passport is the simplest because it covers both citizenship and identity in one document.
- Income documentation: recent pay stubs, tax returns for any self-employment income, Social Security award letters, and records of child support, unemployment, or other income.
- Details on any employer-sponsored health plan available to you or your family.
Wisconsin verifies most income electronically. Paper documentation is usually only needed when electronic records don’t exist — self-employment income is the common example — or when what you report doesn’t match what the data source shows.4Medicaid.gov. Wisconsin Updated Verification Plan Template
The Four Ways to Apply
Online Through ACCESS Wisconsin
The fastest route is access.wi.gov. Create an account, complete the application, upload your documents, sign electronically, and you get an immediate confirmation of receipt.5Wisconsin Department of Health Services. ACCESS Wisconsin The MyACCESS mobile app lets you track document status after you file.
By Mail
Download or request Form F-10182 and mail it to: CDPU, PO Box 5234, Janesville, WI 53547-5234.6Wisconsin Department of Health Services. BadgerCare Plus Forms
In Person or by Phone
You can hand-deliver the application to your local Income Maintenance agency and get a receipt. Or call your regional IM consortium and complete the application over the phone; a representative enters the information for you.
Through an Authorized Representative
If you can’t apply yourself, federal law lets you designate an authorized representative — an individual or an organization — to complete and sign the application for you. The designation can be made in writing, electronically, or through a recorded phone call. A guardian or someone holding your power of attorney is automatically treated as your authorized representative.7eCFR. 42 CFR 435.923 – Authorized Representatives
Filling Out the Form
Enter your gross monthly income, the amount before taxes and deductions. Report all sources: wages, self-employment, Social Security, child support, unemployment. The form also asks about deductible expenses like pre-tax health insurance premiums and childcare, which can lower your countable income. Check every entry against your documents before submitting.
After You Submit
How Long It Takes
Standard BadgerCare Plus applications are processed within 30 days. Applications requiring a disability determination — typically EBD Medicaid — can take longer, and federal rules allow states up to 90 days for those.
Verification Requests
A caseworker may contact you for clarification or more documents. Any written request must give you at least 20 calendar days to respond.8Department of Health Services. 20.7 When to Verify Missing that deadline can lead to denial, so respond promptly.
Your Notice of Decision
You’ll get a written Notice of Decision in the mail. Approvals list your enrollment start date, any premium, and next steps. Denials explain the reason and your right to appeal.
Retroactive Coverage
Wisconsin can backdate Medicaid eligibility up to three months before the month you applied. Unpaid medical bills from that window can be covered if you would have qualified at the time.9Department of Health Services. 2.8 Begin Dates This comes from federal law, which requires states to cover care from the three months before your application month when you were eligible in that period.10Office of the Law Revision Counsel. 42 USC 1396a – State Plans for Medical Assistance
Picking a Health Plan
Most Wisconsin Medicaid members enroll in a managed care plan (HMO). You can choose online through ACCESS, by phone at 800-291-2002, or on the HMO Enrollment Choice form. If you don’t choose, the state assigns one and sends you a letter.11Wisconsin Department of Health Services. Wisconsin Medicaid SSI HMO Program Guide You then have a 90-day open enrollment window to switch plans for any reason. After that, a nine-month lock-in applies, and you can only change plans during the lock-in if you’re having trouble getting care.
Premiums for BadgerCare Plus
Most adults on BadgerCare Plus don’t pay premiums. Families with children whose income sits between 201% and 306% of FPL do pay a monthly premium to keep the children’s coverage. The premium is capped at 5% of family income, rounded down to the nearest dollar. Amounts scale with household size and income: a family of four between 201% and 211% FPL pays up to $276 per month, while the same family between 301% and 306% FPL pays up to $413.12Wisconsin Department of Health Services. 2026 Federal Poverty Level Changes for ForwardHealth
Renewing Coverage and Reporting Changes
Wisconsin reviews your eligibility every 12 months. The state first tries an automatic renewal using wage and tax data it already holds. If that’s enough, your coverage renews with no action from you. If not, you’ll get a renewal form in the mail with at least 30 days to return it — online, by mail, by phone, or in person.
Between renewals, BadgerCare Plus members must report income changes when household income crosses certain FPL thresholds for their household size, such as 100%, 200%, or 306%. You have until the 10th of the following month to report a qualifying change.13Department of Health Services. 27.3 Income Change Reporting Requirements Miss it and the state can recover an overpayment later, or you can lose coverage you were still entitled to.
If Your Application Is Denied
You have the right to a fair hearing. File the appeal within 45 days of the date of the action on your notice; the notice itself will state your exact deadline.14Wisconsin Department of Health Services. Medicaid/BadgerCare Plus Fair Hearing Information, F-10151
If you’re already enrolled and your benefits are being reduced or terminated, you can ask for coverage to continue during the appeal. To keep benefits in place, file before the effective date of the change or within 10 calendar days of the adverse notice, whichever is later. If you lose the appeal, the state may require you to repay the cost of benefits received during the appeal period.15eCFR. 42 CFR 438.420 – Continuation of Benefits While Appeal and State Fair Hearing Are Pending At the hearing you can present evidence, bring witnesses, and have someone represent you, and you can appeal an unfavorable outcome through the courts.
One Thing to Know if You’re Applying for Long-Term Care
Wisconsin’s Estate Recovery Program can seek repayment after death for the cost of nursing home care, hospital stays of 30 or more days with a patient liability, and home health or personal care services received at age 55 or older. For long-term care members 55 and older enrolled in managed care, the monthly capitation payments the state made are also recoverable.16Wisconsin Department of Health Services. Wisconsin Estate Recovery Program Handbook Recovery can reach beyond probate to jointly held accounts, payable-on-death accounts, and certain trusts and joint tenancy property. Wisconsin cannot recover if you’re survived by a spouse, a child under 21, or a blind or disabled child of any age, and it must waive recovery for undue hardship.17Medicaid.gov. Estate Recovery Standard BadgerCare Plus coverage for children and working-age adults isn’t subject to this recovery, but it’s worth understanding before applying for long-term care benefits.