Wisconsin Health Insurance 2026
Health insurance in Wisconsin is sold through Federal (Healthcare.gov), with an estimated 50-85 plans available for 2026. The average Silver-tier premium is $440/mo before subsidies for a 40-year-old non-smoker. Medicaid status: Not expanded.
Marketplace
Federal HC.gov
Federal (Healthcare.gov)
Avg Silver Premium
$440/mo
Before tax credits, age 40
Medicaid
Not expanded
Affordable Care Act status
Wisconsin 2026 Health Insurance Quick Facts
| Field | Value | Notes |
|---|---|---|
| Marketplace | Federal (Healthcare.gov) | Apply via Healthcare.gov |
| Open Enrollment 2026 | Nov 1, 2026 – Jan 15, 2027 | Special enrollment for QLEs year-round |
| Plans available | 50-85 | Bronze/Silver/Gold/Platinum tiers |
| Medicaid expansion | Not expanded | Coverage gap may exist |
Premium and plan counts are estimates for 2026 based on prior-year filings and pending rate approvals. Always verify pricing on the marketplace itself before enrolling.
Wisconsin's Unique BadgerCare Gap and Competitive Marketplace
Wisconsin has a moderately competitive ACA marketplace with 50–85 plans statewide. Molina, Common Ground Healthcare Cooperative, and Quartz are among the leading carriers. Silver premiums average $430–$450/month for a 40-year-old before subsidies. Milwaukee and Madison metros have the most competitive markets; rural northern and western Wisconsin have fewer options. Wisconsin uses Healthcare.gov for marketplace enrollment. The state's marketplace has been shaped by a distinctive Medicaid eligibility structure that affects the income range of ACA-eligible adults.
Wisconsin has technically 'not expanded' Medicaid under the ACA in that it did not accept the full ACA expansion to 138% FPL. However, Wisconsin's BadgerCare program covers adults up to 100% FPL — higher than traditional Medicaid in most non-expansion states. This creates a unique situation where adults between 100–138% FPL qualify for marketplace subsidies (since they are above the Medicaid line), but those below 100% have BadgerCare. The net effect is that Wisconsin has fewer uninsured adults than most non-expansion states, though it foregoes significant federal matching funds for not accepting the full expansion. Governor Evers (D) has repeatedly pushed for full expansion, which the Republican legislature has blocked.
What to Know About Health Insurance in Wisconsin
Top marketplace carriers
Leading 2026 ACA carriers in Wisconsin: Molina Healthcare, Common Ground Healthcare Cooperative, Quartz Health Plan. Plan selection and network breadth vary widely by ZIP code — use the marketplace's plan-finder tool with your ZIP and household income for accurate availability.
Notable state rule
Wisconsin did not expand Medicaid under the ACA but extended BadgerCare to adults up to 100% FPL (not the full 138%), creating a partial coverage situation unique among non-expansion states.
Medicaid eligibility
Wisconsin has not expanded Medicaid. This creates a "coverage gap" where some adults earn too much for Medicaid but too little to qualify for premium tax credits. Check eligibility for traditional Medicaid (parents, pregnant women, disabled, elderly) separately.
Wisconsin Pro Tip
Health Insurance FAQs — Wisconsin
Who runs the health insurance marketplace in Wisconsin?
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Wisconsin uses the federal marketplace at Healthcare.gov. The state does not operate its own exchange.
How much does Silver-tier health insurance cost in Wisconsin before subsidies?
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A 40-year-old non-smoker in Wisconsin typically pays about $430–$450/month for a Silver plan before subsidies.
What income qualifies for Medicaid in Wisconsin?
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Wisconsin's BadgerCare covers adults earning up to 100% FPL — broader than most non-expansion states but less than the full ACA expansion of 138% FPL. Adults between 100–138% FPL may qualify for ACA marketplace subsidies.
Related Guides
Marketplace data sourced from state and federal exchange filings for Wisconsin, April 2026. Premium estimates are 2026-projected.
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed April 2026
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