|
State of Wisconsin |
Release 26-02 |
|
2026 Per-Member Copay Limits |
|||||||||||
| Status |
Assistance Group Income Tier as Percentage of the Federal Poverty Level |
||||||||||
|
0-50% |
>50-100% |
>100-150% |
>150-200% |
>200-250% |
>250-300% |
>300-350% |
>350-400% |
>400-450% |
>450-500% |
>500% |
|
| Individual |
$0 |
$26 |
$53 |
$79 |
$106 |
$132 |
$159 |
$186 |
$212 |
$239 |
$265 |
| Prorated (split between counted spouses) |
$0 |
$13 |
$26.50 |
$39.50 |
$53 |
$66 |
$79.50 |
$93 |
$106 |
$119.50 |
$132.50 |
If the assistance group income is less than the applicable amount listed below, no copays are charged.
| Assistance Group Size | Monthly Income |
| 1 | $665 |
| 2 | $901 |
| 3 | $1,138 |
| 4 | $1,375 |
| 5 | $1,611 |
| 6 | $1,848 |
This page last updated in Release Number: 26-01
Release Date: 02/13/2026
Effective Date: 02/01/2026
The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10171