What Is the Monthly Income Limit for Medicaid in Wisconsin?

The monthly income limit for Medicaid in Wisconsin depends on which program fits your situation. For 2026, a single adult can qualify for BadgerCare Plus with gross monthly income up to $1,330. A pregnant woman or a child in a one-person household can qualify with income up to $4,069.80 per month. The Elderly, Blind, or Disabled program uses a lower cap tied to Supplemental Security Income: roughly $1,078 per month for an individual and about $1,623 for a couple. All of these figures are tied to the Federal Poverty Level or the federal SSI rate and update each year.

BadgerCare Plus Monthly Income Limits

BadgerCare Plus is Wisconsin’s main Medicaid program for children, pregnant women, parents, caretakers, and other adults without affordable private insurance. The dollar amounts below took effect February 1, 2026, and remain in place through January 31, 2027.¹

Adults, Parents, and Caretakers

Adults without dependent children, along with parents and caretakers, qualify at 100% of the Federal Poverty Level. For 2026 that works out to:

One person: $1,330 per month
Two people: $1,803.33 per month
Each additional household member: add $473.33 per month

These limits come straight from the FPL schedule used by the Wisconsin Department of Health Services.¹

Pregnant Women and Children Under 19

Pregnant women and children qualify at a much higher ceiling: 306% of the FPL.² In practice:

One-person household: $4,069.80 per month
Two-person household: $5,518.19 per month
Four-person household: $8,415 per month¹

One wrinkle for families: children stay eligible up to the full 306% cap, but once family income passes 201% of the FPL (about $2,673.30 per month for a one-person household), the family owes a monthly premium to keep the child’s coverage.¹

Elderly, Blind, or Disabled Medicaid Limits

If you qualify as elderly (age 65 or older), blind, or disabled, you fall under a separate Medicaid category with its own income rules. The limit here is not a straight FPL percentage. Instead, it equals the maximum SSI payment, including Wisconsin’s state supplement, that a person or couple could receive.²

The 2026 federal SSI rate is $994 per month for an individual and $1,491 for a couple.³ With the Wisconsin supplement added, the monthly income limit for EBD Medicaid comes to approximately $1,078 for a single person and roughly $1,623 for a couple.

Asset Limits Also Apply

EBD Medicaid adds an asset test on top of the income test. For 2026 the cap is $2,000 for an individual and $3,000 for a married couple.⁴ Countable assets include savings accounts, stocks, and other liquid resources. Your primary home and one vehicle are generally exempt.

If Your Income Is Over the EBD Limit

Income above the standard EBD cap but below 100% of the FPL ($1,330 per month for a single person in 2026) can still lead to coverage through the Medically Needy pathway.⁵ This is the spend-down described in its own section below.

What Counts as Income

The dollar limits only make sense once you know how Wisconsin measures your income, and the two programs use different methods.

BadgerCare Plus Uses MAGI

BadgerCare Plus applies Modified Adjusted Gross Income rules, which track how income is reported on a federal tax return. MAGI generally includes taxable wages, self-employment earnings after allowable business expenses, and any taxable portion of Social Security benefits. Child support payments, SSI, veterans’ benefits, and workers’ compensation do not count.⁶

The state looks at gross income, meaning the figure before taxes or insurance premiums come out of your paycheck. If you are self-employed, be ready to submit records of income and expenses, such as IRS tax forms, bookkeeping records, or the state’s Self-Employment Income Reporting Form (F-00107).⁷

EBD Medicaid Counts Gross Income Differently

For the EBD category, the state counts gross unearned income from sources like pensions, annuities, and investment returns. SSI payments are excluded entirely.⁶ Cash gifts, including birthday or holiday money, count as unearned income in the month received and then become a countable asset in later months if unspent. Small cash gifts totaling $60 or less per person per calendar quarter are disregarded.⁸

Over the Limit? The Medicaid Deductible (Spend-Down)

If your income exceeds the standard EBD limit but you have significant medical expenses, the Medicaid Deductible program, commonly called a spend-down, may still get you covered.⁹ The state calculates a deductible based on the gap between your monthly income and the program limit, measured over a six-month period.¹⁰

Once you accumulate medical bills equal to that deductible, your coverage activates for the rest of the six-month period. Keep invoices from doctors, hospitals, and pharmacies, and submit them to your local income maintenance agency, which tracks the expenses and confirms when the deductible is met.⁹

A Note on Long-Term Care Medicaid

If you are applying specifically for long-term care Medicaid, such as nursing home coverage, the income rules above still apply, but an additional screen comes into play. The state reviews any asset transfers made during the 60 months before your application.¹¹ Transfers for less than fair market value during that five-year look-back trigger a penalty period during which Medicaid will not pay for long-term care, with the length based on the value of the transfer.¹² This rule does not apply to BadgerCare Plus or to standard EBD Medicaid outside the long-term care context.

Keeping Your Eligibility Current

Once you are enrolled, you have 10 days to report any change in income, address, assets, medical expenses, or living arrangements to your income maintenance agency.¹³ A raise, a lost job, or an added household member can push you across one of the thresholds above and change what you qualify for. If a change is not reported and benefits are paid that should not have been, the state can require repayment.¹⁴

1
Wisconsin Department of Health Services. BadgerCare Plus Federal Poverty Level Guidelines
2
Wisconsin State Legislature. Wisconsin Administrative Code DHS 103.04 – Asset and Income Limits
3
Social Security Administration. SSI Federal Payment Amounts for 2026
4
Wisconsin Department of Health Services. DMS Operations Memo 25-21
5
Wisconsin Department of Health Services. 2026 Federal Poverty Level Changes for ForwardHealth Programs
6
Wisconsin Department of Health Services. 2.8 Modified Adjusted Gross Income Counting Rules
7
Wisconsin Department of Health Services. Financial Verification
8
Wisconsin Department of Health Services. 15.4 Unearned Income
9
ForwardHealth Wisconsin. Spenddown to Meet Financial Enrollment Requirements
10
Board on Aging and Long Term Care. Medicaid or Low Income Options
11
Wisconsin Department of Health Services. 17.2 Evaluation of Transfers for Divestment
12
Wisconsin Department of Health Services. 17.3 Penalty Period
13
Wisconsin Department of Health Services. 12.1 Change Reporting Introduction
14
Wisconsin State Legislature. Wisconsin Code 49.497 – Recovery of Incorrect Medical Assistance or Badger Care Payments and of Unpaid Employer Penalties