Medicaid
Wisconsin Medicaid eligibility
Wisconsin has not adopted the ACA expansion, but a state waiver covers adults with income up to 95% of the federal poverty level, about $1,263 a month for one person in 2026.
Source: Medicaid.gov: Medicaid, CHIP, and Basic Health Program Eligibility Levels (state decisions as of 2023-12-01, read 2026-10-23), as of December 1, 2023.
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Quick facts
- ACA expansion
- No
- Adults 19 to 64
- Not an expansion state; a waiver covers adults up to 95% FPL
- Parents
- 95% FPL
- Pregnant women
- 301% FPL
- Children 6 to 18
- 151% FPL
- State agency
- Wisconsin Medicaid agency
Wisconsin income limits by group
| Group | Income limit | Monthly, household of 1 (2026) |
|---|---|---|
| Adults 19 to 64 (expansion group) | Not an expansion state; a waiver covers adults up to 95% FPL | $1,263 |
| Parents and caretaker relatives | 95% FPL | $1,263 |
| Pregnant women (Medicaid) | 301% FPL | $4,003 |
| Pregnant women (CHIP) | No separate program | |
| Children under 1 (Medicaid) | 301% FPL | $4,003 |
| Children 1 to 5 (Medicaid) | 186% FPL | $2,473 |
| Children 6 to 18 (Medicaid) | 151% FPL | $2,008 |
| Children (separate CHIP) | 301% FPL, ages 1 up to19 | $4,003 |
Medicaid.gov notes that MAGI rules generally adjust income by an amount equal to a 5% FPL disregard, so a person can qualify with income about 5 percentage points of FPL above the standard shown. Other rules apply too, such as citizenship, immigration status, and state residency. The state agency makes the decision.
Notes from medicaid.gov
- The state has a section 1115 demonstration , which provides Medicaid coverage to some additional low-income adults. In some cases, coverage: Includes limitations on eligibility and benefits. Includes an enrollment cap.
Related pages
Questions
Who qualifies for Medicaid in Wisconsin?
Wisconsin has not adopted the ACA expansion, but a state waiver covers adults with income up to 95% of the federal poverty level, about $1,263 a month for one person in 2026.
Did Wisconsin expand Medicaid?
Medicaid.gov lists Wisconsin as "No/95% 9" for the adult expansion group.
How do I apply for Medicaid in Wisconsin?
Apply any time through the state Medicaid agency or with a HealthCare.gov Marketplace application, which sends your information to the state if you may qualify.