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Wisconsin Medicaid

Looking for no- or low-cost health coverage in Wisconsin? Learn about UnitedHealthcare Medicaid plans in Wisconsin.

All Wisconsin residents deserve affordable health care, including you. That’s why we offer many plans to help you get healthy — and stay healthy. We cover children, expecting moms, people with disabilities and adults with our Wisconsin Medicaid plan.

We offer Dual Special Needs plans for those who qualify for both Wisconsin Medicaid and Medicare. We also offer Marketplace Individual and Family Plans to help provide affordable coverage options for individuals, families and small businesses in Wisconsin.

See why Wisconsin chooses UnitedHealthcare

We offer more ways to use your benefits and get the most out of your plan.1

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Community resources

Our network includes programs that offer no or low-cost food, housing and help paying utility bills

UnitedHealthcare Healthy First Steps®

Learn how we can help you have a healthy pregnancy and baby

UnitedHealthcare® app

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Find plans

Medicaid

Medicaid SSI

Our Medicaid SSI plan is for Wisconsin residents who receive Supplemental Security Income (SSI). The program offers extra support to adults with special health care needs or a disability. The plan lets you choose your own doctor, and you’ll never pay a copay.

View more about Medicaid SSI
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BadgerCare Plus

Our BadgerCare Plus plan is for pregnant women, children to age 19, families and adults who meet income requirements. The BadgerCare Plus plan offers a wide range of benefits, including well and sick care, behavioral health support, vision, hearing and dental care, and more. You can even choose your own doctor.

View more about BadgerCare Plus
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Dual Special Needs plans (D-SNPs)

Dual Special Needs plans (also called Dual Health plans or D-SNPs for short) are for people who have both Medicaid and Medicare. D-SNPs offer more benefits than those you get with original Medicare or Medicaid. They cover most doctor visits, hospital stays and prescription drugs.

View all Dual Special Needs plans

Individual & Family ACA plans

UnitedHealthcare offers Individual & Family ACA plans in Wisconsin. They’re designed to give you the affordable coverage you need. Choose from plans in the Bronze, Silver and Gold metal levels. They each come with a variety of benefits, including reliable support from our customer service experts.

See Individual and Family ACA plans (Opens in a New Tab)

Eligibility and enrollment

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Eligibility

UnitedHealthcare Community plans offer health coverage to children, expecting moms, people with disabilities and adults with our Wisconsin Medicaid plan.

Our Medicaid SSI plan is for Wisconsin residents who receive Supplemental Security Income (SSI).

Our BadgerCare Plus plan is for pregnant women, children up to age 19 and adults who meet income requirements.

Enrollment

Join or switch to UnitedHealthcare Community plan. Open enrollment for Wisconsin Medicaid plans is available year-round.

Applying for Medicaid is easy and can be done in-person, by phone or online. To learn more about eligibility and enrolling in Medicaid, visit the steps to enroll page.

Renewals

Don’t lose benefits

With the State of Wisconsin MyACCESS mobile app, you get renewal reminders from ForwardHealth to help you stay enrolled with UnitedHealthcare. You can also use the app to check your state benefits, submit documents, and check eligibility for grocery support, childcare costs and career skills help 24/7.

Download the MyACCESS app (Opens in a New Tab)

Benefits and features

We want to help you live healthier lives and to have the best possible member experience.

Get the Calm Health app for no-cost mental health support

With the Calm Health app, there's an easier way to care for your mental health and well-being. As a member of UnitedHealthcare Community Plan, you can use it anytime at no cost. The app offers:

  • Mental health screening
  • Self-guided digital programs
  • Support for your emotional well-being

To get started, download the UnitedHealthcare app and go to Coverage & Benefits to find the Calm Health app.

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Hearing and vision services

UnitedHealthcare Community Plan covers hearing and vision care services when you visit network providers. Covered services may include:

  • Hearing: screenings, check-ups and hearing aids
  • Vision: eye exams, glasses and contact lenses

Virtual visits

It’s not always easy to visit a doctor in person. Virtual visits let you talk to a doctor 24/7 using your computer, tablet or smartphone. This is a good choice for common conditions that have standard treatments, like:

  • Cold, flu, and fever
  • Cough, aches and sore throat
  • Allergies, skin rash and irritation
  • Urinary tract/bladder infection
  • Ear infections
  • Sinus infections
  • Migraine/headache
  • Back pain or sports injuries 

Behavioral health services

Behavioral health is just as important as physical health. That’s why coverage includes both mental health and substance use disorder treatment services for problems like: 

  • Stress
  • Depression
  • Anxiety
  • Use of drugs or alcohol
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Pregnancy coverage

We help mother and baby:

  • Find a provider and a pediatrician (child doctor)
  • Get an OB/GYN, nurse-midwife 
  • Schedule rides for doctor visits

Healthy First Steps® offers: 

  • Gift card rewards  
  • Baby scripts™ pregnancy app  
  • Baby and breastfeeding supplies  
  • Women, Infants and Children (WIC) services and more  
Extra member benefits Extra member benefits

Additional benefits

Sometimes you need a little extra help. That’s why we give you more options for your care and well-being at no cost to you. This includes:

  • UnitedHealthcare Healthy First Steps® program for moms and babies
  • Diabetes prevention program
  • Virtual visits
  • Unlimited primary care
  • Urgent care
  • Personal care managers
  • Text4Baby
  • Help with quitting smoking
  • Member advocates
  • Reminder programs to help you meet your personal health goals

Download the Medicaid newsletter

Our HealthTalk newsletter is now online. The newsletters are a great way to learn about our health plan and important health topics.

You can read it whenever, wherever you want.


Disclaimer information

(scroll within this box to view)

Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Special Needs plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. Benefits, features and/or devices may vary by plan/area.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only. Access to this service is subject to terms of use.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2026.

Formularies

The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.