BadgerCare is Wisconsin's Medicaid program, run by the state
BadgerCare Plus is the name Wisconsin uses for its Medicaid program. It is not a separate program — it is how Wisconsin administers Medicaid to its residents. When you hear "BadgerCare," you are hearing about Medicaid in Wisconsin.
Wisconsin has used the BadgerCare name since 1999. The program covers low-income adults, children, pregnant people, and seniors. It is funded by both federal Medicaid dollars and state money, and it is managed by the Wisconsin Department of Health Services.
Because BadgerCare is Medicaid, the federal rules that govern Medicaid apply to it. But Wisconsin also sets its own income limits, decides which services to cover beyond the federal minimum, and runs the day-to-day enrollment and claims work.
Key Takeaways
- BadgerCare Plus is Wisconsin's name for its Medicaid program — they are the same thing, not two different programs.
- Wisconsin sets its own income limits for BadgerCare, which differ from other states' Medicaid limits.
- BadgerCare covers doctor visits, hospital care, prescription drugs, and other services, with the exact coverage depending on which BadgerCare category you fall into.
- You enroll in BadgerCare through the Wisconsin Department of Health Services, either online, by mail, or in person at your county office.
How BadgerCare income limits work in Wisconsin
Wisconsin sets the income threshold for BadgerCare differently than the federal Medicaid baseline. The state has raised its limits over time, and they vary depending on whether you are applying as a parent, a child, a pregnant person, or a non-parent adult.
Income limits change periodically, so the exact number you need to know depends on your household size and the category you fall into. You can find the current limits on the Wisconsin Department of Health Services website, or you can call your county social services office and ask them directly — they handle BadgerCare enrollment and can tell you whether your income qualifies.
Wisconsin also counts income in a specific way. Some types of income are not counted, and some household members' income may not be counted at all. This is why it is worth asking your county office rather than guessing based on your total household earnings.
What BadgerCare covers
BadgerCare covers the core Medicaid services: doctor visits, hospital stays, emergency care, prescription drugs, lab work, and X-rays. It also covers mental health and substance use treatment, dental care for children and pregnant people, and vision care.
Wisconsin has added some services beyond the federal minimum. These include dental care for adults (limited), hearing aids, and certain other services. The exact coverage can depend on which BadgerCare category you are in — for example, coverage for pregnant people includes prenatal and postpartum care, while coverage for children includes well-child visits and immunizations.
You do not pay a premium to be in BadgerCare, but you may have small copays for some services. Copays are usually $1 to $3 per visit or prescription. Pregnant people and children under 19 have no copays.
BadgerCare categories and who qualifies
Wisconsin organizes BadgerCare into different categories based on who you are. Each category has its own income limit and coverage rules. The main categories are parents and caretakers, children, pregnant people, seniors, and non-parent adults without dependent children.
The non-parent adult category is important because it is where many working-age people without children end up. Wisconsin expanded this category in 2014 as part of the Affordable Care Act, which is why many adults who would not have may have access to for traditional Medicaid can now get BadgerCare.
Your category determines not just whether you may have access to, but also what services are covered and whether you have copays. When you enroll, the county will place you in the correct category based on your household situation.
How to enroll in BadgerCare
You can enroll in BadgerCare through three routes: online at the Wisconsin Department of Health Services website, by mail, or in person at your county social services office. Online enrollment is the fastest — you can complete it in one sitting and get a decision within days in many cases.
To enroll, you will need to provide proof of income (recent pay stubs, tax returns, or a letter from your employer), proof of Wisconsin residency (a utility bill or lease), and proof of citizenship or immigration status. You will also need to list everyone in your household.
After you submit your application, the county processes it and sends you a notice saying whether you are approved, denied, or need to provide more information. If you are approved, your coverage usually starts on the first day of the month after the month you applied, though sometimes it is backdated to cover medical bills from earlier in that month.
BadgerCare and other health insurance
If you have other health insurance — through an employer, a spouse's job, or a private plan — BadgerCare becomes your secondary insurance. This means your other insurance pays first, and BadgerCare covers what it does not. You must tell BadgerCare about any other coverage you have when you enroll.
If you lose your other insurance, you should report it to BadgerCare right away. Your coverage may change, or you may become may be able to access for a different BadgerCare category. Wisconsin allows you to report changes online, by phone, or by mail.
Some people choose to stay on BadgerCare even when they become may be able to access for employer insurance because BadgerCare has lower copays or covers services the employer plan does not. This is a personal decision based on your specific situation and the plans available to you.
Renewing your BadgerCare coverage
BadgerCare coverage does not last forever. Wisconsin requires you to renew your coverage periodically — usually every 12 months, though the exact timeline can vary. The county will send you a renewal notice in the mail with instructions on how to renew.
You can renew online, by mail, or in person. Renewal is simpler than the initial application — you mainly need to confirm that your household and income have not changed significantly. If they have, you will need to provide updated documents.
If you do not renew by the deadline, your coverage will end. If you miss the deadline but still need coverage, you can apply again, but there may be a gap in your benefits. It is worth setting a reminder when you receive your renewal notice so you do not miss the deadline.
Frequently Asked Questions
Is BadgerCare the same as regular Medicaid?
BadgerCare is Wisconsin's version of Medicaid. It follows federal Medicaid rules but is run by Wisconsin and has some differences in income limits and covered services. If you live in Wisconsin and are on Medicaid, you are on BadgerCare.
Can I be on BadgerCare if I work?
Yes. BadgerCare has income limits, not work restrictions. Many people on BadgerCare work full-time or part-time. Your total household income is what matters, not whether you are employed. Some BadgerCare categories even have higher income limits to account for working families.
What happens to my BadgerCare if I move out of Wisconsin?
Your BadgerCare coverage ends when you move. You will need to enroll in your new state's Medicaid program. Each state runs Medicaid differently, so income limits and covered services may change. Contact your new state's Medicaid office as soon as you move to understand your options.
Do I have to pay back BadgerCare if my income goes up?
No. BadgerCare is not a loan. If your income increases and you no longer may have access to, your coverage will end at your next renewal, but you do not have to repay the benefits you received while you were covered. You should report income changes to Wisconsin so your coverage status is accurate.
Can I use my BadgerCare card at any doctor?
BadgerCare is accepted at most doctors, hospitals, and pharmacies in Wisconsin, but not all providers take it. Before you schedule an appointment, ask the office whether they accept BadgerCare. You can also call the number on the back of your BadgerCare card to find providers near you.