48.1.3 Five Percent Premium Caps for Children

The table below displays the 5% caps of BadgerCare Plus premiums for children in certain households with incomes above 201% and at or below 306% of the FPL. Families are charged the combined premiums for the children but no more than 5% of the family’s countable income.

Example 1 A family with 11 children and an income of 302% of the FPL would ordinarily owe premiums amounting to 11 times $97.53, which equals $1,072.83. However, if the children’s assistance group size, including the parent, is 12, the 5% cap found in the table below is $983. That is the maximum premium amount that the family should be charged for that month.

Group Size 201 - 211% 211% - 221% 221 - 231% 231 - 241% 241 - 251% 251 - 261% 261 - 271% 271 - 281% 281 - 291% 291 - 301% 301% - 306% 1 $133.00 $140.00 $146.00 $153.00 $160.00 $166.00 $173.00 $180.00 $186.00 $193.00 $200.00 2 $181.00 $190.00 $199.00 $208.00 $217.00 $226.00 $235.00 $244.00 $253.00 $262.00 $271.00 3 $228.00 $240.00 $251.00 $262.00 $274.00 $285.00 $297.00 $308.00 $319.00 $331.00 $342.00 4 $276.00 $290.00 $303.00 $317.00 $331.00 $345.00 $358.00 $372.00 $386.00 $400.00 $413.00 5 $323.00 $340.00 $356.00 $372.00 $388.00 $404.00 $420.00 $436.00 $452.00 $468.00 $485.00 6 $371.00 $389.00 $408.00 $426.00 $445.00 $463.00 $482.00 $500.00 $519.00 $537.00 $556.00 7 $419.00 $439.00 $460.00 $481.00 $502.00 $523.00 $544.00 $565.00 $585.00 $606.00 $627.00 8 $466.00 $489.00 $513.00 $536.00 $559.00 $582.00 $605.00 $629.00 $652.00 $675.00 $698.00 9 $514.00 $539.00 $565.00 $590.00 $616.00 $642.00 $667.00 $693.00 $718.00 $744.00 $770.00 10 $561.00 $589.00 $617.00 $645.00 $673.00 $701.00 $729.00 $757.00 $785.00 $813.00 $841.00 11 $609.00 $639.00 $669.00 $700.00 $730.00 $760.00 $791.00 $821.00 $851.00 $882.00 $912.00 12 $656.00 $689.00 $722.00 $754.00 $787.00 $820.00 $853.00 $885.00 $918.00 $951.00 $983.00 13 $704.00 $739.00 $774.00 $809.00 $844.00 $879.00 $914.00 $949.00 $984.00 $1019.00 $1,055.00 14 $752.00 $789.00 $826.00 $864.00 $901.00 $939.00 $976.00 $1013.00 $1,051.00 $1,088.00 $1,126.00

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