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Wisconsin Medicaid

Wisconsin Medicaid is a health care program for people with disabilities, people 65 years and older. The program offers free or low-cost health care coverage to many Wisconsin residents.

Program Name Wisconsin Medicaid
Expanded Medicaid No
Website dhs.wisconsin.gov
Phone 800-362-3002
Apply Online https://access.wisconsin.gov/access
Appeal a Denial Request a Hearing
Find a Local Office County Contact Information

Eligibility Requirements

To be eligible for Wisconsin Medicaid, you must be a resident of the state of Wisconsin, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:

  • Pregnant
  • Be responsible for a child 18 years of age or younger
  • Blind
  • Have a disability or a family member in your household with a disability
  • Be 65 years of age or older

Annual Household Income Limits (before taxes)

Household Size* Maximum Income Level (Per Year)
1 $17,131
2 $23,169
3 $29,207
4 $35,245
5 $41,284
6 $47,322
7 $53,360
8 $59,398

*For households with more than eight people, add $6,038 per additional person.

Available Services Include:

Chiropractic services Nursing services
Dental services Optometric services, including eyeglasses
Family planning Pharmacy services
Home health services Physical and occupational therapy
Hospice care Physician services
Hospital services Podiatry services
Laboratory and X-ray services Rural health clinic services
Maternity services Speech, hearing, and language therapy
Medical supplies and equipment Substance abuse treatment
Mental health services Transportation to medical appointments

Copayments

You may have to pay copays if your monthly income is more than the amount listed in the table below for your family size.

Family Size Monthly Income
1 $531
2 $718
3 $905
4 $1,091
5 $1,278
6 $1,465

Copays for Wisconsin Medicaid are based on the cost of the service.

Up to $10.00 $0.50
From $10.01 to $25.00 $1.00
From $25.01 to $50.00 $2.00
Over $50.00 $3.00

Copayments are not required for the following:

  • Children under age 19
  • Children in foster care
  • Children in adoption assistance
  • Pregnant women during the pregnancy and for at least 60 days postpartum
  • American Indians or Alaska Natives
  • People getting hospice care who are terminally ill
  • Nursing home residents

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