Trans Resource Navigator

Gender-affirming care in Wisconsin

Care for adults
Allowed
Care for people under 18
Allowed
BadgerCare Plus (Wisconsin Medicaid, ForwardHealth) pays for hormones
Covered
BadgerCare Plus (Wisconsin Medicaid, ForwardHealth) pays for surgery
Covered
Private plans must cover care
No state rule

Gender-affirming care is legal in Wisconsin for adults and minors. The Legislature passed bans on care for minors in 2023 and 2026, and the governor vetoed both; the 2026 vetoes were sustained in May 2026. Wisconsin Medicaid (BadgerCare Plus) must cover hormones and surgery under a 2019 federal court injunction. There is no state shield law and no state rule requiring private insurers to cover this care.

Draft from official sources, September 24, 2026. Not yet checked by a person. How we verify

On this page
  1. Health centers near you
  2. Hormones by telehealth
  3. Clinics, programs, and funds
  4. Paying for care
  5. Rules for adults
  6. Rules for under 18
  7. Laws and court cases
  8. Sources

Community health centers near you

These federally funded centers must see you whether or not you have insurance, and charge based on income. Many, but not all, prescribe hormone therapy. Call and ask for "gender-affirming care" or "hormone therapy."

Sorting by distance uses your location only on this device. It is never sent anywhere.

Hormones by telehealth

These services prescribe hormones through video visits for people in this state. Point of Pride pays for a year and a half of care with several of them each spring.

  • Plume

    PaidNo Medicaid18+

    Trans-led telehealth service providing informed-consent hormone therapy, lab orders, prescriptions, and letters for surgery and documents, by app and video visit. Self-pay only since January 2026. A Point of Pride HRT Access Fund partner.

    About $99 per month ($90 in NY and NJ), which includes visits, messaging, prescriptions, and document letters. Labs and medications are billed separately and are often cheap with GoodRx or at a community pharmacy. Free for 18 months if you win a Point of Pride HRT Access Fund grant.

  • FOLX Health

    InsuranceTakes insuranceNo Medicaid18+

    LGBTQ-focused telehealth offering hormone therapy, PrEP, primary care, and mental health visits. Accepts major commercial insurance (Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare) but not Medicaid or Medicare. A Point of Pride HRT Access Fund partner.

    In-network with many commercial plans; self-pay membership about $69 to $98 per month all-inclusive.

  • Planned Parenthood

    Sliding scaleTakes insurance

    Many Planned Parenthood affiliates provide informed-consent gender-affirming hormone therapy alongside sexual and reproductive health care, on a sliding scale and with Medicaid. Most affiliates see adults 18 and older; a few see 16- and 17-year-olds with parental consent and a readiness letter. Many start hormone care by telehealth. Self-pay initial consults typically run about $120 to $250 before sliding-scale discounts.

Clinics, programs, and funds

  • Planned Parenthood of Wisconsin, gender-affirming hormone therapy[15]

    Informed-consent hormone therapy for people 18 and older, by telehealth or in person at health centers across Wisconsin; also PrEP, PEP, and STI testing. Costs kept as low as possible; serves patients regardless of immigration status.

    • Sliding scale
    • Telehealth
    • Accepts Medicaid
    • Sees uninsured patients

  • Froedtert & MCW Inclusion Health Clinic (Milwaukee)[16]

    LGBTQ+ primary and specialty care clinic on the Froedtert Hospital campus, 9200 W. Wisconsin Ave. Accepts private insurance, Medicare, and Medicaid; helps uninsured people check eligibility. Call 414-805-2018 and ask about gender-affirming hormone therapy.

    • Insurance
    • Accepts Medicaid
    414-805-20189200 W. Wisconsin Ave, Milwaukee, WI 53226

  • UW Health gender-affirming services (Madison)[17][12]

    University of Wisconsin health system program for gender-affirming care in Madison, plus the PATH clinic for children and adolescents. Services and age policies could not be confirmed; call before relying on it.

    • Insurance
    • Unverified

  • Vivent Health[18][19]

    PrEP, PEP, HIV testing and care, primary care, behavioral health, and pharmacy at 10 Wisconsin sites, including Milwaukee (1311 N 6th St, 414-273-1991) and Madison (600 Williamson St, 608-252-6540). Works so cost is not a barrier.

    • Cost varies

  • Wisconsin DHS free and low-cost clinic finder[10]

    State guide to federally qualified health centers, rural health centers, tribal health centers, and free clinics, with a search tool anyone can use (type "FQHC" in the provider type).

    • Sliding scale
    • Sees uninsured patients

  • Find a community health center (HRSA)[20]

    Federal locator for health centers that must see you regardless of insurance and charge on a sliding scale. Call and ask for "gender-affirming care."

    • Sliding scale
    • Accepts Medicaid
    • Sees uninsured patients

  • Wisconsin DHS HIV Program, PrEP information[11]

    State information on getting PrEP. BadgerCare Plus covers PrEP, and most private plans must cover it without copays.

    • Free

  • Point of Pride funds[21]

    National funds for people who cannot afford care, including the HRT Access Fund (free telehealth hormone therapy), a surgery fund, and free binders and shapewear.

    • Free

  • Genderbands grants[22]

    Small grants for surgery and transition costs, including name change fees; 18 and older.

    • Free

  • Trans Health Project (Advocates for Trans Equality)[23]

    Free templates and guides for appealing insurance denials of gender-affirming care.

    • Free

Paying for care

Medicaid (BadgerCare Plus (Wisconsin Medicaid, ForwardHealth))[6][7][8][9]

Wisconsin's Medicaid rules still list "transsexual surgery" and related hormone therapy as excluded (Wis. Admin. Code DHS 107.03(23)-(24)), but in Flack v. Wisconsin Department of Health Services (W.D. Wis. 2019) a federal court held those exclusions illegal and permanently barred DHS from enforcing them. Medically necessary gender-affirming hormones and surgery are therefore covered, typically with prior authorization for surgery.

Who qualifies: adults 19 to 64 with income up to 100% of the federal poverty level ($1,330 a month for one person, February 2026 to January 2027); children and pregnant people up to 306%. There is no open enrollment. Starting in early 2027 a new federal work requirement will apply to some adults 19 to 64 without dependent children; DHS says it will notify affected members.

Apply online at ACCESS (access.wi.gov, also in Spanish), by phone, or at your county or tribal income maintenance agency.

Apply for coverage

Private insurance[13][14][23]

Wisconsin has no state law that bars private health plans from excluding gender-affirming care, so coverage depends on your plan. Read your plan's exclusions and ask for the medical policy on "gender dysphoria" or "gender-affirming care." If you are denied, file an internal appeal with the plan, then ask for an independent external review; you can also file a complaint with the Office of the Commissioner of Insurance (1-800-236-8517) for state-regulated plans. Employer self-funded plans are federally regulated. The Trans Health Project has appeal templates.

Wisconsin state employee health plans must cover this care after a federal court struck down the state's exclusion (Boyden v. Conlin, 2018).

File an insurance complaint

The rules in detail

Rules for adultsNo state restriction on adult care.

No state restriction on adult care. Planned Parenthood of Wisconsin prescribes hormones on an informed consent basis (no therapist letter) to people 18 and older, by telehealth or at health centers statewide. Telehealth services such as Plume and FOLX also serve Wisconsin.

If you have no insurance and little money, in rough order:

  1. Apply for BadgerCare Plus (Wisconsin Medicaid). Adults 19 to 64 qualify with income up to 100% of the federal poverty level ($1,330 a month for one person in 2026). It covers hormones and, with prior approval, surgery. Wisconsin did not expand Medicaid, so if you earn more than that, look at HealthCare.gov marketplace plans instead.
  2. Go to a community health center (FQHC) or free clinic. They charge on a sliding scale; ask whether they prescribe gender-affirming hormones. Find one with the HRSA locator or DHS's free and low-cost clinic search.
  3. Planned Parenthood of Wisconsin offers sliding-scale hormone care and telehealth.
  4. Point of Pride's HRT Access Fund pays for telehealth hormone care for people who cannot afford it.
[15][8][6][20][10][21]
Rules for under 18Legal. There is no Wisconsin law banning gender-affirming care for minors.

Legal. There is no Wisconsin law banning gender-affirming care for minors. The Legislature passed 2025 Assembly Bill 104 (a ban on puberty blockers, hormones, surgery, and referrals for people under 18) and Senate Bill 405 (a lawsuit right against providers); Governor Evers vetoed both on March 31, 2026, and override votes failed on May 13, 2026. He vetoed a similar ban (2023 AB 465) in December 2023. Care for minors requires parental consent and is offered mainly through specialty clinics; Planned Parenthood of Wisconsin's hormone therapy is for adults 18 and older. Wisconsin has no shield law protecting patients or providers from other states' laws.

[1][2][3][4][5][15]
Laws and court cases1 court case, 1 law

Flack v. Wisconsin Department of Health Services, 395 F. Supp. 3d 1001 (W.D. Wis. 2019)

BadgerCare Plus covers medically necessary gender-affirming care. The exclusion text remains in the code but cannot be enforced.[6]

Held that Wisconsin Medicaid's exclusion of gender-affirming hormones and surgery violated the Equal Protection Clause, Section 1557 of the Affordable Care Act, and the Medicaid Act, and permanently enjoined DHS from enforcing it. Last update 2019-09-16.

Sources

23 sources. Numbers in the text, like [1], point here.Show all
  1. Governor's veto message, 2025 Assembly Bill 104 (March 31, 2026)Wisconsin State Legislature, Official page. accessed
    “The bill would prohibit, with limited exceptions, healthcare providers from engaging in, causing the engagement in or making referrals for certain medical intervention practices if done for the purpose of corresponding the minor's body to a sex that is consistent with the minor's gender identity.”
  2. 2025 Assembly Bill 104, bill historyWisconsin State Legislature, Official page. accessed
    “5/13/2026 Asm. Failed to pass notwithstanding the objections of the Governor ... Status: A - Veto Sustained”
  3. Governor's veto message, 2025 Senate Bill 405 (March 31, 2026)Wisconsin State Legislature, Official page. accessed
    “This bill would create a civil cause of action against a healthcare provider who performs a gender transition procedure, as defined in the bill.”
  4. 2025 Senate Bill 405, bill historyWisconsin State Legislature, Official page. accessed
    “5/13/2026 Sen. Failed to pass notwithstanding the objections of the Governor ... Status: S - Veto sustained”
  5. Governor's veto message, 2023 Assembly Bill 465 (December 6, 2023)Wisconsin State Legislature, Official page. accessed
    “I am vetoing Assembly Bill 465 in its entirety.”
  6. Wis. Admin. Code DHS 107.03, Services not covered (with note on Flack v. Wisconsin DHS)Wisconsin State Legislature, Regulation. accessed
    “In Flack v. Wisconsin Dep't of Health Servs, 395 F. Supp. 3d 1001 (W.D. Wis. 2019), the United States District Court for the Western District of Wisconsin held that ss. DHS 107.03 (23) and (24) and 107.10 (4) (p) violated the Equal Protection Clause ... The court in Flack permanently enjoined the department from enforcing those provisions.”
  7. BadgerCare Plus, full coverage MedicaidWisconsin Department of Health Services, Official page. accessed
    “There's no open enrollment period, you can apply at any time!”
  8. BadgerCare Plus income guidelines (effective February 1, 2026 to January 31, 2027)Wisconsin Department of Health Services, Official page. accessed
    “Adult monthly income limit (100% FPL): 1 person $1,330.00”
  9. Medicaid, new federal work requirementWisconsin Department of Health Services, Official page. accessed
    “Work requirements are coming in early 2027 for some Medicaid members enrolled in BadgerCare Plus.”
  10. ForwardHealth, Free or low-cost health clinicsWisconsin Department of Health Services, Official page. accessed
  11. HIV, How is PrEP paid for?Wisconsin Department of Health Services, Official page. accessed
    “In Wisconsin, BadgerCare Plus also covers PrEP.”
  12. LGBTQ+ Health, Transgender and nonbinary health (last revised June 26, 2026)Wisconsin Department of Health Services, Official page. accessed
  13. File a complaintWisconsin Office of the Commissioner of Insurance, Official page. accessed
    “OCI Complaints 1-800-236-8517”
  14. Boyden v. State of Wisconsin, winning transgender health care accessACLU of Wisconsin, Organization. accessed
    “a federal trial court recently ruled that the state's exclusion of coverage was unlawful sex discrimination that violated federal law.”
  15. Gender-affirming carePlanned Parenthood of Wisconsin, Organization. accessed
    “Gender Affirming Hormone Therapy is available throughout Wisconsin for individuals 18 years and older.”
  16. LGBTQ+ health care, Inclusion Health ClinicFroedtert & the Medical College of Wisconsin, Organization. accessed
    “Call 414-805-2018 for an appointment.”
  17. Gender-affirming treatment and servicesUW Health, Organization. accessed
  18. LocationsVivent Health, Organization. accessed
  19. PrEP (Pre-Exposure Prophylaxis)Vivent Health, Organization. accessed
  20. Find a Health CenterHealth Resources and Services Administration, Official page. accessed
  21. HRT Access FundPoint of Pride, Organization. accessed
  22. GenderbandsOrganization. accessed
  23. Trans Health ProjectAdvocates for Trans Equality, Organization. accessed