Wisconsin Medicaid Income Limits 2026: BadgerCare & Nursing Home

Wisconsin Medicaid income limits come in two versions, and which one applies depends on your age and whether you need long-term care. If you are under 65 and not blind or disabled, BadgerCare Plus measures you on income alone: 100% of the federal poverty level, or $1,330.00 a month for a household of one, with no asset test.1,2 If you are elderly, blind, or disabled, or you need nursing-home or waiver care, a different set of rules governs: a $2,000 asset limit, a medically needy deductible for income over the limit, and spousal protections set above the federal floor, setting an asset share of at least $50,000 for the spouse who stays home and letting income be shifted to bring that spouse up to at least $3,606.66 a month.3,4

This guide gives both sets of 2026 numbers. It covers the BadgerCare Plus (MAGI) limits group by group, why Wisconsin is the one non-expansion state without a coverage gap, what the parents and caretaker-relatives pathway means for a grandparent raising a grandchild, and what changes at 65. It then covers the long-term-care rules in detail: the $2,000 asset limit, how the medically needy deductible works when income is over the limit, what a nursing-home resident keeps, and the two community-spouse protections that make Wisconsin stand out.3,1

The other Wisconsin Medicaid income limits: BadgerCare Plus and the MAGI test

Wisconsin applies two different income tests, and the numbers above are only one of them. The $2,982/month standard, the $2,000 asset limit, and the spend-down all belong to the elderly, blind, and disabled (EBD) and long-term-care pathway. Everyone else is measured with Modified Adjusted Gross Income (MAGI): children, pregnant people, parents and caretaker relatives, and non-disabled adults. Wisconsin's MAGI-based Medicaid and CHIP program is BadgerCare Plus, run by the Department of Health Services.1,2

Wisconsin's position on the adult side is unusual. Wisconsin has not adopted the ACA Medicaid expansion; it is one of 10 states that have not.1 But it is the single exception among them with no coverage gap: under a Section 1115 demonstration waiver, BadgerCare Plus covers childless, non-disabled adults up to 100% of the federal poverty level, or $1,330.00/month for a household of one, for the coverage year running February 1, 2026 through January 31, 2027.1 Waiver coverage isn't the same as the open expansion entitlement, though: medicaid.gov notes that Section 1115 coverage of this kind can carry limits on eligibility and benefits, may not be offered to every resident, or may have an enrollment cap.1 In the other nine non-expansion states, adults below the poverty line can fall into a gap where they earn too much for Medicaid and too little for Marketplace subsidies. Wisconsin residents do not.1 Because the state did not expand, it also does not run the ACA "new adult group" and its effective 138%-of-FPL ceiling. In Wisconsin the adult number is 100% FPL, not 138%, and adults between those two levels can't get Medicaid there.6,1

For a larger household, the percentages stay the same and the dollar figure rises with the poverty guideline. The 2026 federal poverty guideline is an annual figure: $21,640 a year for a household of two and $27,320 for a household of three.7

Two sets of Wisconsin numbers circulate, and both are correct. DHS publishes gross limits; the federal medicaid.gov eligibility table lists the same standards net, five percentage points lower, because MAGI-based rules generally adjust income by an amount equal to a 5% FPL disregard. So 100% FPL gross for adults and parents appears as 95% FPL on the federal table, and 306% FPL gross for pregnant people and children under 1 appears as 301%. The DHS figures above already account for the disregard.1

Parents and caretaker relatives: the pathway a grandparent looks to

If you are raising a grandchild, this is the group to ask about. Parents and other caretaker relatives are a federally mandatory Medicaid group, but the federal floor beneath it isn't tied to the poverty line at all: the lowest standard a state may set is its old cash-welfare (AFDC) income standard as of May 1, 1988, converted to a MAGI equivalent. In a state that hasn't adopted the expansion, that state-set standard, not a poverty-level percentage, decides whether a working parent qualifies.8

Wisconsin does not stop at the floor. BadgerCare Plus covers parents and caretaker relatives at 100% FPL gross, the same $1,330.00/month for a household of one that applies to childless adults, so the federal minimum is not what binds here.1 Whether a particular grandparent counts turns on the federal definition of a caretaker relative in 42 CFR 435.4, so ask about this group when you apply.8

And the contrast that catches families off guard: the MAGI groups have no asset test. Federal law bars a state from applying any assets or resources test to MAGI-based eligibility, and the statute expressly excepts the ABD and long-term-care pathways from that rule, which is why those keep a resource test and BadgerCare Plus does not. The $2,000 countable-asset limit on this page is an EBD and long-term-care rule. A BadgerCare Plus applicant's savings do not count against them; only income does.2

For children, Wisconsin sets the ceiling high. BadgerCare Plus covers children up to 306% FPL gross, with families above the 201% FPL premium threshold paying a premium.1 On the federal eligibility table, the state's children's coverage resolves into net age-tiered Medicaid limits of 301% FPL for children under 1, 186% FPL for ages 1 through 5, and 151% FPL for ages 6 through 18, with a separate CHIP program covering children from age 1 up to 19 at 301% FPL.1 Federal law sets the minimum standard for children's coverage at 133% FPL (higher only for infants, and only in states that had already set a higher infant level by 1989) and lets a state set its standard above that, so Wisconsin's levels sit above the national minimum.9

What changes when a Wisconsin adult turns 65

At 65 the age-based pathways open, and those use the EBD rules rather than BadgerCare Plus's MAGI rules: federal law excepts people 65 or older, when age is a condition of eligibility, from the MAGI no-asset-test rule. Turning 65 doesn't by itself move a person out of MAGI for every purpose, though: someone evaluated for a MAGI group is still measured under MAGI for that group, with no asset test.2 In the 41 states that adopted the expansion (a count that includes the District of Columbia), that birthday can be a double hit: the new adult group is written for people under 65, so its 138%-of-FPL ceiling closes, and a resource test appears where none existed.6,1 In Wisconsin only the second half of that happens.

The income figure barely moves. BadgerCare Plus covers adults to $1,330.00/month, and Wisconsin's EBD medically needy income limit is $1,330.00/month for an individual and $1,803.33/month for a couple, effective February 1, 2026. For one person those are the same number, and above the EBD limit you can still qualify by meeting a deductible rather than being cut off.1,3 What changes is the asset test. BadgerCare Plus cannot apply one; the EBD track applies the $2,000 countable-asset limit.2,3 A 64-year-old on BadgerCare Plus with $10,000 in savings can be over the EBD asset limit at 65 without a dollar of their income or savings changing. The rules that follow govern that track.

The asset limit: $2,000, and what "countable" leaves out

For long-term-care Medicaid in Wisconsin, a single applicant is limited to $2,000 in countable assets, and a group of two is limited to $3,000, under both the categorically needy and medically needy rules.3 Those match the federal SSI resource limits of $2,000 for an individual and $3,000 for a couple.5

"Countable" is the word doing the work. Wisconsin Medicaid doesn't count your home as long as you, your spouse, or a dependent relative lives there, one vehicle, household items, clothing and other personal items, or some burial assets, such as burial insurance, some amounts in irrevocable burial trusts, and plots. The burial exemption is partial, so not every burial arrangement is excluded.3 So the $2,000 applies to things like bank accounts, a second car, and investments, not the roof over your head. The home exemption is subject to a federal home-equity limit of at least $752,000 for 2026, which a state may raise to as much as $1,130,000. An applicant whose equity is over the limit the state applies isn't eligible for long-term-care coverage, unless a spouse or a child who is under 21, blind, or disabled lives in the home, and equity can be brought under the limit with a reverse mortgage or home-equity loan.10

The asset limit is also where the married-couple story gets more generous, but only when just one spouse needs care. That's the spousal-impoverishment protection, covered below, and it's a separate and far larger allowance than the $3,000 two-applicant figure.3

How Wisconsin Medicaid income limits work: the spend-down

Wisconsin sets the income standard for nursing-home coverage and for its Group B community waivers at $2,982/month for 2026, which is 300% of the federal Supplemental Security Income (SSI) benefit rate of $994/month for an individual.3,5 Being over that figure doesn't by itself shut you out.

Wisconsin's EBD Medicaid has both a categorically needy and a medically needy income limit. If income is the only reason you're ineligible, you can still qualify through the medically needy spend-down, which Wisconsin calls a Medicaid deductible. The deductible is your total excess monthly income over a six-month deductible period, and once you've incurred medical costs equal to that amount, you can become eligible for Medicaid. Wisconsin's EBD medically needy income limit used for this pathway is $1,330.00/month for an individual and $1,803.33/month for a couple, effective February 1, 2026.3

One more detail: Wisconsin's EBD rules subtract a $20 general income disregard, so if your income looks up to $20 over a printed EBD limit, don't assume you're over it until that disregard is applied.3

Long-term care: what a nursing-home resident keeps

When Wisconsin Medicaid pays for nursing-facility care, the resident contributes most of their monthly income toward the cost of care. What they keep is the Personal Needs Allowance (PNA), money reserved for the resident's own small expenses like clothing or a haircut. Wisconsin sets its PNA at $55/month, effective July 1, 2024, above the federal floor of $30/month for an institutionalized individual.3,2 The PNA isn't the only deduction: federal rules also protect allowances for a spouse or family at home and certain medical costs, such as health-insurance premiums, before the rest goes to the facility.2

The $55 figure is for nursing-home residents only. Someone on a Wisconsin community waiver, such as Family Care, Family Care Partnership, IRIS, or PACE, keeps a basic allowance of $1,192 a month, which can be higher with earned income or housing costs above $350 a month, up to $2,982.3

The same $2,000 asset limit applies to nursing-home applicants.3 And because income over the limit can be met through the medically needy deductible, a resident with substantial monthly income isn't automatically shut out.3 For the national picture on the PNA and how it's calculated, see our explainer on the Medicaid personal needs allowance.

Protecting the spouse who stays home

This is where Wisconsin stands out. When one spouse is on Institutional Medicaid or a community waiver such as Family Care, Family Care Partnership, IRIS, or PACE, and the other isn't living in a nursing home or medical facility for 30 days or more, spousal-impoverishment rules keep the at-home spouse from being left destitute. Wisconsin's chart sets its floors above the federal minimums.3,4

On assets, if the couple's total countable assets are $100,000 or less, the community spouse's asset share is $50,000, above the federal minimum of $32,532, and the spouse receiving care keeps $2,000. Between $100,000 and $325,320, the share is half the couple's countable assets; at $325,320 or more it is $162,660, the maximum in Wisconsin's table. On income, the applicant's income can be shifted to raise the community spouse to $4,066.50 a month, or to $3,606.66 plus an excess shelter allowance, whichever is less, so the Wisconsin floor sits above the federal minimum of $2,705.00. The excess shelter allowance is the at-home spouse's shelter costs above $1,082.00 a month, and it isn't granted for a waiver case where the spouses live together. $4,066.50 is a standard, not a hard ceiling: Wisconsin's handbook lets a fair hearing or a court order raise the income allocation when the at-home spouse can't meet basic needs on it. Both protections matter most for couples with modest savings.3,4

So a married couple in Wisconsin is in a very different position from a single applicant. With modest savings, the at-home spouse's asset share is $50,000, and the applicant's income can be shifted to bring that spouse to at least $3,606.66 a month while the other spouse receives Medicaid-funded care.3,4 For the full walk-through, see our Wisconsin spousal impoverishment guide.

The five-year look-back

Wisconsin reviews asset transfers made in the 60 months before a long-term-care application.3,10 Giving away money or property for less than fair market value during that window, like gifting a grandchild a down payment, can trigger a penalty period during which Medicaid won't pay for long-term-care services, even though you're otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a blind or disabled child, certain caregiver-child home transfers) and legitimate planning approaches, and a state can waive a penalty for undue hardship.10 Paying a relative for care is a penalized divestment unless the care directly benefited the person and the pay was reasonable. Above 10 percent of the maximum community spouse asset share, it also needs a written agreement naming the service and amount, notarized when the care began; a later agreement does not cover past payments.11 See personal care agreements and paid family caregiving in Wisconsin.

But anything done inside the five-year window deserves an elder-law attorney's review first. For the broader toolkit, see our guide to Medicaid planning strategies.

After death: estate recovery

Federal law requires every state, Wisconsin included, to seek repayment from the estate of a recipient who was 55 or older when they received nursing-facility care, home- and community-based services, and related hospital and prescription-drug services, and a state may choose to recover for more. Recovery is a matter of timing, not forgiveness: it can't happen until a surviving spouse has died, or while there is a surviving child who is under 21, blind, or disabled. Every state must also offer an undue-hardship waiver.12 For Wisconsin's own program, see our Wisconsin Medicaid estate recovery guide, and for how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Wisconsin

Wisconsin Medicaid is run by Wisconsin's Department of Health Services (DHS), through its Division of Medicaid Services.3 You have a few ways to apply, whether you want to file the application yourself or sit down with someone who can walk you through the long-term-care options first.

For the elderly, blind, and disabled track, you can apply online through ACCESS or complete the Wisconsin Medicaid for the Elderly, Blind or Disabled Application Packet (F-10101) and mail it to the address on the form. DHS tells anyone who wants help, or wants to apply in person or by phone, to contact their local agency, and the ADRC helps people arrange long-term care services.3 For the step-by-step, see our Wisconsin Medicaid application guide. Apply even if you think you're over the limit: the medically needy deductible and the spousal protections exist for exactly that situation.

Learn More

Find personalized help working through Wisconsin Medicaid eligibility for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.