In 2014, the state of Wisconsin moved 92,000 low-income adults and families off of BadgerCare Plus by reducing the income requirements from 200 percent of the Federal Poverty Level (FPL) to 100 percent of the FPL.1 This change moved the recently uninsured adults to the Federal Health Insurance Marketplace to purchase health insurance. Today, there are still several health insurance options for low income adults in Wisconsin, including –
BadgerCare Plus provides health insurance for low-income adults, families and children in Wisconsin. Low income adults with an income of up to 100 percent of the Federal Poverty Level (FPL)1 may be eligible. For a single person that limit is $11,880 per year and for a couple, it is $16,020.2 Pregnant women with an income at or below 300 percent of the FPL may also be eligible.
It’s important to note that even with BadgerCare Plus, this health insurance coverage is not free for low income adults. You may have to pay monthly premiums, co-pays and other charges, depending on the health care services you use.3
To find out if you’re eligible for BadgerCare Plus, go to access.wisconsin.gov.
If you are eligible for BadgerCare Plus, you will likely be enrolled in a Health Maintenance Organization, or HMO. This is a health insurance plan that offers coverage when you use the doctors and hospitals in its network. HMO plans are ACA compliant, which means they provide all of the benefits as directed by the Affordable Care Act. This includes preventive screenings and well as essential health benefits.
In Wisconsin, Medicaid provides low income health insurance coverage to adults age 65 and older, blind, or who have a disability. This program also has income restrictions, focusing on low income children and adults. If you are interested in seeing if you qualify, visit access.wi.gov to learn more.
MARKETPLACE PLANS WITH SUBSIDIES
What if your income is low, but is higher than 100 percent of the FPL meaning you don’t qualify for BadgerCare Plus health insurance? You may be eligible for subsidized health insurance with a Marketplace health plan. There’s a quick and easy way to find out if you’re eligible – you can use Quartz's Get a Quote tool to find out.
Two types of subsidies are available. The first is called Advanced Premium Tax Credit. What this does is help you pay for your health insurance premium. How much you actually pay each month depends on the type of plan you choose. The other available subsidy is called a Cost Sharing Reduction. Basically, this helps cover some of the out-of-pocket cost when you go to the doctor (such as reducing the copays or deductibles). Learn more about health insurance subsidies.
One important point you should know about subsidies – Because Wisconsin did not accept federal money to help pay for subsidies through the Affordable Care Act, there is a group of people with an income between 100 percent of the FPL ($12,490) and 138 percent of the FPL ($17,236 for single adults) who may not qualify for subsidies on the Federal Health Insurance Marketplace. When the law was passed, it was assumed that the state would provide coverage to these people using federal funds. This was not the case in the state of Wisconsin.
RESOURCES FOR PAYING FOR HEALTH CARE IN WISCONSIN –
- Dane County residents who make 100 to 150 percent of the FPL may qualify for additional help from HealthConnect through United Way of Dane County. Learn more about HealthConnect
- List of free or low cost clinics in Wisconsin
If you need health insurance and your income is low, contact Quartz’s helpful and experienced customer service representatives. They can help find the plan that is right for you.