Wisconsin Senior Care Prescription Drug Assistance Program

What is Senior Care?

Senior Care is a Prescription Drug Assistance Program for Wisconsin residents who are 65 years of age (no exceptions) or older who meet the eligibility criteria. The program is designed to help seniors with their prescription drug costs.

When did the program begin?

The program began September 1, 2002.

Those already enrolled in the program since it's inception, will receive a re-enrollment form through the postal service. Personal information will already be typed on the form, you will need only to complete income information for the upcoming year. If you have moved, or changed your phone number, there will be specific locations on the form where you will be asked to provide the new information. Do not cross out the old information - simply add the new information in the spaces provided.

What are the eligibility requirements?

* Must be a Wisconsin resident.

* Must be 65 years of age or older.

* Must pay a $30.00 annual enrollment fee per person.

* Assets, such as bank account, insurance policies, home property, etc...are not counted.

In addition, program participants are subject to certain annual out-of-pocket expense requirements depending on their annual income, as shown in the table below.


Income Limits, Based on 2008 Federal Poverty Levels (FPL)
Annual Out-of-Pocket Expense Requirements and Benefits
At or below 160% FPL
($16,640 per individual and
$22,400 per couple annually).
* No deductible or spenddown.
* Pay a $15.00 co-pay for each name brand drug and a $5.00 co-pay for generic drugs.
Between 160% and 240%
of FPL
($16,641 to $20,800 per individual
and $22,401 to $28,000
per couple annually).
 * $500 deductible.
* Pay discounted price for drugs until the $500 deductible is met.
* After $500 deductible is met, pay a $15.00 co-pay for each name brand drug and a $5.00 co-pay for each generic drug.
($20,801 to $24,960 per individual
and $28,001 to $33,600 per couple annually).
 * $850 deductible.
* Pay discounted price for drugs until the $850 deductible is met.
* After $850 deductible is met, pay a $15.00 co-pay for each name brand drug and a $5.00 co-pay for each generic
Above 240% FPL
($24,961 or higher per individual
and $33,601 or higher per couple annually).
 * Pay retail price for drugs equal to the amount that income exceeds 240% of FPL (also known as spenddown).
* Drug costs for spenddown will be tracked automatically. During the spenddown, there is no discount on drug costs.
* After spenddown is met, meet a $850 deductible.
* Pay discounted price for drugs until the $850 deductible is met.
* After the $850 deductible is met, pay a $15.00 co-pay for each name brand drug and a $5.00 co-pay for each generic drug.

What if program participants have other prescription drug coverage?

Individuals with prescription drug coverage under other health plans will be eligible to enroll in Senior Care. If you already have a health insurance plan, Senior Care will coordinate benefit coverage with your plan. Individuals enrolled in Medicaid will not be eligible for the program, because Medicaid already provides prescription drug coverage.

Call the Aging Resource Center to schedule an appointment for help with the SeniorCare application.

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last updated on 01-08-08