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Wisconsin Medicaid

What You Need To Know

Wisconsin has set up Medicaid to safeguard the health of its residents. It provides health coverage to a large number of people who are unable to pay for their medical treatments. Wisconsin Medicaid aims to help people with disabilities and people who are above 65 years old. It achieves its objective by proving free or low-cost health coverage to people. The limited funds of Medicaid make it impossible for it to help everyone. Therefore, most deserving families receive the greatest benefits.

This joint federal and state program has been successful in providing for over one million residents. It is overlooked by the Wisconsin Department of Health Services. The services included in the Medicaid plan are:

  • Doctor visits
  • Dental and vision care services
  • Specialty care in case of a referral from the primary care doctor
  • Family planning services
  • Behavioral health and substance abuse treatment services.

The Medicaid plan is divided into a simple Medicaid program and a Medicaid Deductible Plan. The former is one that provides free health coverage to its qualified members. The latter requires people to meet their deductible requirements before the full benefits are provided.

Prescriptions are also provided under the Wisconsin Medicaid benefit program. However, the type and cost of the prescription drug can lead to certain changes in the package. These factors are dependent upon the plan the individuals are receiving.

Are You Eligible?


An eligibility criterion has been set to ensure that the neediest families are catered to first. Therefore, the program authority makes sure to see that the applicant fulfills the requirements. In order to enroll, the person must be

  • A resident of the state of Wisconsin
  • Above the age of 65; or blind or disabled.
  • Characterized to have income and assets below the program limit
  • A United States citizen or qualifying immigrant.

Wisconsin Medicaid has been set up to help those individuals who are unable to acquire health care. Therefore, their income is taken into account. To qualify for the program, the annual earnings of the applicant before tax deductions should be in line with guidelines. The amount should not surpass the figures listed below. The table takes into account both the members of the household as well as income level.

Size Of The Household Maximum Annual Income Level ($)
1 16612
2 22491
3 28369
4 34248
5 40127
6 46005
7 51884
8 57762

An additional amount of $5,878 should be added if the household has more than eight members. This amount is on a per-person basis. Accurate guidelines can be followed by people who keep in touch with their managing agency. These agencies prove to be helpful in providing the necessary guidance and assistance.

There are three different Medicaid Long-term care programs available for the elderly of Wisconsin. Their eligibility differs at certain points. The differentiated plans help to ensure that each and every individual receives treatment that is best suited to their needs. These programs include:

  1. Institutional / Nursing Home Medicaid. This is an entitled program only provided in nursing homes.
  2. Medicaid Waivers / Home and Community-Based Services (HCBS). This program has a limited number of participants. Among the benefits, they enjoy there is home adult day care, adult family home or in assisted living.
  3. Regular Medicaid / Elderly, Blind, or Disabled. This is an entitled program that has benefits that are availed in-home or adult daycare.

How To Apply

The application process for Wisconsin Medicaid can be approached in various ways. This allows the residents to choose their favored method so they feel comfortable whilst applying. They can gain access to the application through the online portal on Access. You can also get the application or through the Forward Health Program Resources Page or by calling their telephone number. Once you have the form, you will be expected to complete the Wisconsin Medicaid Application Packet and mail it. The number that can be contacted for these purposes is:



The Medicaid Application requires the applicant to list certain information. This helps to determine their eligibility. The data required includes information about household members. This means their names, birth dates, and social security numbers. It also requires information about the household’s monthly income and assets. Through the help of these, they verify whether the income is in line with the guidelines outlined or not.

For Further Information

Wisconsin Medicaid has set up its webpage to give detailed information about the program and its application. This allows interested individuals to make informed decisions regarding the whole process.

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