Wisconsin Medicaid
Updated April 8, 2021 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
