What Is BadgerCare Plus and Do You Qualify? A Guide for Portage County Families
BadgerCare Plus is Wisconsin's state health insurance program for low-income residents, and Portage County, WI, families may qualify for free or low-cost coverage through it. This guide explains what the program covers, who may be eligible, how income limits work, and when a private plan could be a better fit for families in the Stevens Point area.
What Is BadgerCare Plus?
BadgerCare Plus is Wisconsin's Medicaid program for children, adults, and pregnant women with lower incomes. It blends Medicaid and CHIP funding into a single program, making coverage transitions seamless for families. Members can access primary and acute care services, including physician visits, inpatient and outpatient hospital care, pharmacy services, vision, and dental care. Most members pay no premiums and have minimal or no copays.
Who May Qualify for BadgerCare Plus in Portage County?
Eligibility depends on household size, income, residency, and citizenship status. You must live in Wisconsin and intend to remain, and you must be a U.S. citizen or qualifying lawfully residing immigrant. Here is a general breakdown by group:
- Children ages 0 to 18 may qualify with household income at or below 306% of the federal poverty level (FPL).
- Pregnant women may qualify at or below 306% FPL, with coverage continuing through 60 days postpartum.
- Adults ages 19 to 64 who are not on Medicare and have incomes at or below 100% FPL may also be eligible.
There is no asset test, so your savings, home, or vehicle values do not affect eligibility.
What About Families Whose Income Is Too High?
Adults earning between 100% and 138% FPL do not qualify for BadgerCare Plus but can access subsidized marketplace plans through HealthCare.gov using ACA premium tax credits. Families with children whose income falls between 201% and 306% FPL may be required to pay monthly premiums, capped at 5% of household income.
How to Apply in Stevens Point
Portage County residents have several ways to apply. The fastest option is Wisconsin's ACCESS portal at access.wisconsin.gov, which lets you apply for BadgerCare Plus, FoodShare, and other programs with a single application. One application may also connect you to help with food, housing, and child care.
You can also apply in person at the Portage County Income Maintenance and Central Consortium office at 817 Whiting Avenue, Stevens Point, WI 54481, or by calling 888-445-1621.
When Might a Private Plan Be a Better Fit?
BadgerCare Plus may not cover every need. Families with higher incomes, those who want more provider choice, or those who need specific specialists outside the program's network might find a private plan to be a stronger option. Private plans can offer more flexibility in deductibles, coverage tiers, and add-ons like dental or vision riders. An independent agent can compare your household's options side by side, including marketplace plans with subsidy eligibility.
Talk to a Local Agent About Your Coverage Options
Working with a licensed agent serving Portage County, WI, can help your family determine whether BadgerCare Plus, a marketplace plan, or a private health insurance policy fits your situation best.
Full Service Insurance Agency of Wisconsin serves the Stevens Point area and can walk you through your options at no cost to you.
Contact our team today. You can also explore our
insurance services to see the full range of coverage options available to Portage County families.
