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Medicaid Expansion vs. Long-Term Care Medicaid

Wisconsin has not adopted the ACA's Medicaid expansion, and that is a different question entirely from long-term-care Medicaid eligibility for seniors.

HomeState RulesMedicaid Expansion vs. Long-Term Care Medicaid

Two separate Medicaid questions

Short answer

Wisconsin has not adopted the ACA's Medicaid expansion. Instead it runs BadgerCare Plus, covering childless adults up to 100% of the Federal Poverty Level. This is a completely separate eligibility pathway from long-term-care Medicaid for seniors, which uses Wisconsin's own aged/blind/disabled (non-MAGI) income and asset rules.

  • BadgerCare Plus covers childless adults up to 100% FPL, without an enrollment cap, but below the ACA's 138% FPL expansion threshold -- adults between 100-138% FPL are directed to marketplace subsidies instead. This classifies Wisconsin as a partial-expansion / non-expansion state.
  • Long-term-care Medicaid for seniors (nursing home Medicaid, and the Family Care/IRIS home-and-community-based pathways) is assessed under a separate aged/blind/disabled income and asset test, not the BadgerCare Plus expansion pathway. Do not conflate the two when researching eligibility for a parent.
The exact current income/asset limits for Wisconsin's institutional (nursing-home) Medicaid pathway were not confirmed from a primary source in our most recent research pass -- pull them directly from DHS's Medicaid eligibility pages before relying on a specific dollar figure.

Questions families ask

How much does in-home care typically cost per hour in Milwaukee?

No verified per-hour rate for Milwaukee specifically was found in this research -- CareScout publishes only a statewide Wisconsin full-time-equivalent monthly median ($6,864/month for homemaker services, $7,245/month for a home health aide), not an hourly figure or a Milwaukee-specific number.

What is an ADRC and what does it do for Milwaukee-area families?

An Aging & Disability Resource Center (ADRC) is a county-run, free information-and-assistance office that helps families navigate senior care options, benefits enrollment, and Medicaid long-term-care programs. Each of the four core Milwaukee-metro counties has its own separate ADRC.

How do I reach the ADRC of Milwaukee County?

The Aging & Disability Resource Center of Milwaukee County can be reached at (414) 289-6874, at 1230 W. Cherry Street, Milwaukee, WI 53205. Services include information & assistance, options counseling, benefits specialists, and dementia care resources.

What is Wisconsin's Long-Term Care Ombudsman Program, and how is it different from the ADRC?

The Wisconsin Board on Aging and Long-Term Care (BOALTC) Ombudsman Program advocates specifically for residents of licensed long-term-care facilities and for Family Care/IRIS participants, acting only with the resident's consent -- a distinct role from the ADRC's broader information-and-assistance function. Statewide phone: 1-800-815-0015.

How do I report suspected elder abuse or neglect in the Milwaukee area?

Call Wisconsin's statewide Adult Protective Services reporting hotline, 833-586-0107, which routes to the correct county, or report online at reportelderabusewi.org. In an emergency, call 911. Milwaukee County's own APS unit also accepts reports through an online referral form.

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