Are you eligible for Medicaid? See if you might qualify by using our Medicaid eligibility calculator

Wisconsin Medicaid Eligibility Information - 2022

There are many paths to Medicaid eligibility. Medicaid eligibility can depend on factors such as your household size, household income, household assets, you age, and whether you have a disability. If you're under 65 and don't have a disability, you're eligibility will likely be based on your income only (no asset test).

If you're over 65 or have a disability, you're likely eligible for Medicare. If eligible for Medicare, there are alternate pathways to Medicaid eligibility which typically include asset tests. Additionally, the way that your income is calculated for these programs is more complicated, meaning that your income could be above the income limits and you'd still be eligible. For a more personalized estimate, you can use our Medicaid eligibility calculator.

Please note that there may be other health insurance assistance programs offered by your state not listed here, and there may be other eligibility requirements for these programs that are not listed here. Additionally, the way that household income and household size are calculated can differ from a household's total pre-tax income and the number of people on the tax return.

This information was collected from government resources but is not official. This website is not affiliated with any government organization or Medicaid, CHIP, or health insurance program. Privacy policy.

Medicaid for Children

Medicaid eligibility for children without disabilities is based on total household income. The income limit depends on your household size. There is no asset test.

Medicaid for Children 0 to 1
FPL
306%
1
$3,465/mo
2
$4,669/mo
3
$5,872/mo
4
$7,076/mo
5
$8,279/mo
6
$9,483/mo
7
$10,687/mo
Medicaid for Children 1 to 5
FPL
191%
1
$2,163/mo
2
$2,914/mo
3
$3,665/mo
4
$4,416/mo
5
$5,168/mo
6
$5,919/mo
7
$6,670/mo
Medicaid for Children 6 to 18
FPL
156%
1
$1,766/mo
2
$2,380/mo
3
$2,993/mo
4
$3,607/mo
5
$4,221/mo
6
$4,834/mo
7
$5,448/mo

CHIP / BadgerCare Plus for Children

CHIP eligibility for most children without disabilities is based on total household income. The income limit depends on your household size. There is no asset test.

CHIP for Children 0-18
FPL
306%
1
$3,465/mo
2
$4,669/mo
3
$5,872/mo
4
$7,076/mo
5
$8,279/mo
6
$9,483/mo
7
$10,687/mo

Medicaid for Children with Disabilities

Children with disabilities are often eligible for additional programs. These programs vary state to state. For more information visit kidswaivers.org

Medicaid & CHIP for Parents

If you are a parent or are pregnant, you may also be eligible for Medicaid. Expected children can be counted as part of your household size. The pregnancy Medicaid programs are available until 60 days after the end of the pregnancy.

Medicaid for Pregnant Women
FPL
306%
1
$3,465/mo
2
$4,669/mo
3
$5,872/mo
4
$7,076/mo
5
$8,279/mo
6
$9,483/mo
7
$10,687/mo
Medicaid for Parents of Children 18 or Younger
FPL
100%
1
$1,132/mo
2
$1,525/mo
3
$1,919/mo
4
$2,312/mo
5
$2,705/mo
6
$3,099/mo
7
$3,492/mo

Medicaid for Adults 19-64

Medicaid eligibility for adults that are not eligible for Medicare is based on total household income. The income limit depends on your household size. There is no asset test.

Adults Aged 19-64
FPL
100%
1
$1,132/mo
2
$1,525/mo
3
$1,919/mo
4
$2,312/mo
5
$2,705/mo
6
$3,099/mo
7
$3,492/mo

Aged, Blind, Disabled (ABD) Medicaid Pathway

The aged, blind, and disabled pathway to Medicaid eligibility is the most common pathway to eligibility for those with a disability or over 65 years old. In general, states count your household size as one or two, depending on whether you are married.

While there is an income limit and asset limit for ABD Medicaid, there are significant deductions to your income that may apply, including ignoring half of your earned (from a job) income. For a more accurate estimate use our Medicaid eligibility calculator.

ABD Income Limits
FPL
83%
1
$939/mo
2
$1,266/mo
ABD Asset Limits
1
$2,000 in assets
2
$3,000 in assets

Working People with Disabilities Medicaid Pathway

The working people with disabilities pathway to Medicaid eligibility is for people with disabilities that have at least $1 in earned income. Like ABD Medicaid, there are significant deductions to your income that may apply, including ignoring half of your earned (from a job) income. However, income and asset limits are often much higher than ABD Medicaid. For a more accurate estimate use our Medicaid eligibility calculator.

Working People with Disabilities Income Limits
FPL
250%
1
$2,830/mo
2
$3,813/mo
Working People with Disabilities Asset Limits
1
$15,000 in assets
2
$15,000 in assets, exluding spouse's assets

Medically Needy Medicaid Pathway

The medically needy pathway to Medicaid eligibility allows people who spend a significant amount of their income on medical expenses to "spend down" their income to recieve Medicaid. Like ABD Medicaid, there are significant deductions to your income that may apply, including ignoring half of your earned (from a job) income. Additionally, your monthly medical expenses are subtracted from your income to get the final income that's used in the eligibility calculation. For a more accurate estimate use our Medicaid eligibility calculator.

The medically needy spend down pathway to Medicaid eligibility is available for children, people over 65, people with a disability, and pregnant women.

Medically Needy Income Limits
1
$592/mo
2
$592/mo
Medically Needy Asset Limits
1
$2,000 in assets
2
$3,000 in assets

Medicare Savings Programs

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their Medicare premiums and in some case other Medicare-related expenses. If an individual is eligible for Medicare Part A, they may qualify for one of the MSPs below. The calculated income used for MSP eligibility is the same as that for the Aged, Blind, and Disabled Medicaid pathway.

There are three common levels of MSPs. The Qualified Medicare Beneficiary program covers Part A & B premiums, as well as some other out-of-pocket expenses, while the Specified Low-Income and Qualifying Individuals programs cover Part B premiums only.

For a more accurate eligibility estimate use our Medicaid eligibility calculator.

Qualified Medicare Beneficiaries (QMB)

QMD Income Limits
FPL
100%
1
$1,132/mo
2
$1,525/mo
QMD Asset Limits
1
$8,400 in assets
2
$12,600 in assets

Specified Low-Income Medicare Beneficiaries (SLMB)

SLMB Income Limits
FPL
120%
1
$1,359/mo
2
$1,830/mo
SLMB Asset Limits
1
$8,400 in assets
2
$12,600 in assets

Qualifying Individuals (QI)

QI Income Limits
FPL
135%
1
$1,528/mo
2
$2,059/mo
QI Asset Limits
1
$8,400 in assets
2
$12,600 in assets