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Wisconsin Medicaid Application Guide: Complete Forms and Requirements

Wisconsin Medicaid · F-10101

Program overview

Wisconsin Medicaid provides comprehensive healthcare coverage for eligible residents, including families, seniors, individuals with disabilities, and those with limited income. The program covers essential medical services including doctor visits, hospital care, prescription medications, mental health services, and long-term care services. As of April 2023, income limits for a single person applying for regular Medicaid are $1,616 per month with an asset limit of $2,000, while married couples can have income up to $2,185 per month and $3,000 worth of assets.

The main application form is the Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet (F-10101), though different forms may be required based on your specific circumstances. If you need a disability determination, you must also complete the Medicaid Disability Application (F-10112). The program includes specialized coverage options such as BadgerCare Plus for families and children, and long-term care services through Family Care and IRIS programs.

Wisconsin Medicaid covers a wide range of medical services including preventive care, emergency services, prescription drugs, dental care, vision services, and specialized treatments. The Family Care program provides comprehensive and flexible long-term care services, promoting independence and quality of life while recognizing the need for support. The IRIS program lets people 18 years and older who need long-term support manage their own long-term care services.

When applying, it's crucial to provide complete and accurate information to avoid delays. A decision on your Medicaid application will be mailed to you within 30 days of your application date. It's important to apply as soon as possible since the date your benefits will begin, if you meet all program rules, is based on your application date. You must report changes in household composition, address, income, assets, or employment status within ten days.

Main application form

Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet

Form F-10101

Download form

Additional forms

  • Medicaid Disability Application · F-10112

    Use this form if you need a disability determination

    Download form →

  • Wisconsin Medicaid, BadgerCare Plus, and Family Planning Only Services Registration Application · F-10129

    Use this form to start your application process and set your application date

  • Appoint, Change, or Remove an Authorized Representative: Person · F-10126A

    For appointing a person as your authorized representative

  • Medicaid Change Report · F-10137

    For reporting changes in your circumstances

Where to submit

<cite index="2-1,2-16">Submit completed applications to your local county income maintenance consortium or tribal agency.</cite> <cite index="8-23">You can also mail applications to the Wisconsin Medicaid office at 6406 Bridge Rd., Madison, Wisconsin 53784-0002.</cite>

Watch the guide

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Need healthcare coverage in Wisconsin? Medicaid provides comprehensive medical benefits for eligible residents. You can apply online through ACCESS Wisconsin or download form F-10101 for elderly, blind, or disabled applicants. Income limits are $1,616 monthly for individuals and $2,185 for couples. You'll need Social Security numbers, proof of income, bank statements, and citizenship documentation. Submit to your local county agency or mail to Madison. Applications are processed within 30 days, and coverage begins from your application date. Report any changes within ten days to maintain benefits. Visit dhs.wisconsin.gov for complete details and to start your application today.

Official resources

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