Home Medicaid and BadgerCare Information

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Medical Assistance (Medicaid) and BadgerCare

Medicaid is the state/federal program designed to provide health insurance for the poor and disabled.  Many mentally ill patients rely on Medicaid to pay for their doctor visits and prescription drugs.  BadgerCare is essentially the same program with different income cutoffs and you must have a child under 19 to qualify.  Medicaid eligibility is complex: There are several different ways to qualify and you should not assume that you cannot get benefits just because you do not have the same situation as someone else who receives it. 

If you receive SSI, you automatically qualify for Medicaid.  Other eligibility categories are less straightforward.   Your income must be below the cutoff point for the specific program for someone with the family size you have.  The major eligibility categories are: 

     Over 65
     Blind or disabled according to the Disability Determination Bureau
     Under age 19
     Pregnant and have verification from healthcare professional
     Relative caring for a child under 19

A complete list of the various ways to qualify can be viewed on the Health and Human Services website*.  Current income cutoff amounts by family size are also available.  If you have high medical bills the income limit can be raised, according to their website.  Review the information on their website carefully and do not assume you will not qualify too quickly.  If you are not certain, speak to your county social services department.  Their contact information is:

Or call Recipient Services for the entire state at (800)362-3002.

*In the Medical Assistance Payment Plan (MAPP) , you do not have to have competitive employment.  This eligibility category has the highest income cutoffs.  You do not have to earn more than a few dollars a month and can be employed by a family member or friend for a small amount of time per month.  Whether or not you have to pay a premium depends on your income.  Some MAPP beneficiaries do not pay premiums.

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