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Am I Eligible for Medicaid in Wisconsin?

Access to quality medical care is an essential part of our lives. Everyone needs to know that they have coverage that allows them to visit the doctor or hospital when they need treatment. Without proper medical care, individuals and families could face financial problems in order to pay for medical services or might be turned away when they need treatment. Medicaid is a healthcare program that is available for some people in Wisconsin.

What is Medicaid?

It is helpful to understand what Medicaid is so you can determine eligibility. Medicaid is a healthcare program available to senior citizens, age 65 or over, as well as to a select number of other citizens. The program provides free or low-cost health care benefits. Medicaid gives you essential access to critical medical services in your area. Various medical providers are part of the Medicaid approved network. If you are age 65 or older you are automatically eligible for Medicaid benefits. If you are under age 65 but have low income or disabilities, you may also qualify for benefits through the program.

Eligibility for Medicaid in Wisconsin

In order to get Medicaid benefits in Wisconsin you must meet the eligibility requirements. These include:

  • Wisconsin resident
  • S. citizen, permanent resident or legal alien
  • Low income
  • Or, legally blind
  • Or, pregnant
  • Or, have a disability or family member with a disability
  • Or, be age 65 or older

If you are not age 65, blind, disabled, or pregnant, you must meet the low-income standards. For a household of two people, the total annual household income, before taxes, is currently set at $24,353. It is important to check the current standards since they could change. The amount of income varies based on the number of people in your household.

How Do I Apply for Medicaid?

If you meet the qualifications for Medicaid, you can submit an application. You can apply online or you may obtain or print an application and send it in. If you are applying for Medicaid benefits due to a disability, you will need to provide proof of your disability. The application process can be lengthy and if you do not provide the necessary documentation your application will be delayed or denied. You must be prepared to provide medical records and reports that detail the exact conditions of your disability. You should receive a response indicating whether your application was approved. If it was not approved, you can file an appeal.

What if My Application Was Denied?

If they denied your application, you have the right to file an appeal. Keep in mind that many applications for disability get denied due to lack of adequate paperwork. An experienced attorney will review your claim and help you gather the necessary documents to prove your need for Medicaid assistance. You can appeal the decision if you feel your benefits were denied completely, or were limited, delayed or reduced. You must submit an appeal through the proper channels to get a review.

Medicaid is a benefit available to all those who qualify. If you need assistance applying for Medicaid or with the appeal process, do not hesitate to ask for help. Contact our legal team online at Moen Sheehan Meyer, Ltd. or call (608) 784-8310.

Published August 1, 2022
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