State of Wisconsin Department of Health Services

Release 24-03 December 18, 2024

View History

16.1 Income   

16.1.1 Income Limits

Population	Income Limits for All Members
Pregnant women	306% FPLFederal Poverty Level
Children under 19*	306% FPL
Parents/Caretaker relatives	100% FPL
Childless adults	100% FPL
Family Planning Only Services	306% FPL

*Children and pregnant women with income above the limit can become eligible by meeting a deductible.

See Section 50.1 Federal Poverty Level Table for the most recent FPL limits.

The income limits under MAGI rules include the following income disregards.

• Children, pregnant women and individuals eligible under Family Planning Only Services will be allowed an income disregard equal to 5% of the FPL in addition to a conversion factor adjustment equal to 1% of the FPL. While the income limit remains 300% FPL, CWW will actually test against an income limit of 306% FPL once the income disregard and conversion factor are included.
• Parents, caretakers, and childless adults already have the income disregard included in the income limit of 100 percent FPL. CWW will test against an income limit of 100% FPL.

Note

Other effective income limits for children under MAGIModified Adjusted Gross Income. MAGI rules are used to determine BadgerCare Plus eligibility for new applicants beginning in 2014 and for existing members as of March 31, 2014, or their next regularly scheduled renewal, whichever is later. MAGI rules are based on tax relationships and family relationships, and they consider taxable income and whether children and tax dependents are required to file. rules will also reflect the addition of the 6% disregard with the exception that the income thresholds for children’s premiums will only be increased by 1%.

16.1.2 Income Under Modified Adjusted Gross Income Rules

All taxable income is counted when determining BadgerCare Plus eligibility. Social Security income is also counted. See Section 16.2 Income Types Not Counted for the list of income that is not counted. These rules apply to families that are filing taxes and those who are not.

Within a MAGI group, income will be counted as detailed in Chapter 2 BadgerCare Plus Group. For any member whose income is budgeted for their assistance group, income under the countable income types listed in Section 16.4 Earned Income and Section 16.5 Other Income will be counted and deductions under the types listed in Section 16.3 Income Deductions will be allowed. See Chapter 2 BadgerCare Plus Group for determining the assistance group size.

All MAGI group members’ income is counted with one exception: If a group member is the child or tax dependent of another group member, their income is only counted if they are “expected to be required” to file a tax return for the current year (see Section 2.8 MAGI Income Counting Rules).

If a member’s income is budgeted for their assistance group, their deductions will be counted for that group. In situations where an individual is planning to file a joint tax return with their spouse, the individual’s deductions may offset the spouse’s income even if the individual has no income.

Note	The availability of income does not affect whether or not the income is counted under MAGI rules

---

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