Wisconsin SeniorCare Prescription Assistance
Wisconsin runs SeniorCare, a Medicaid-waiver prescription drug program for residents 65+, that works whether or not you also carry Medicare Part D.
Wisconsin residents 65+ who aren't on full-benefit Medicaid can enroll in SeniorCare for a $30 annual fee. At or below 160% of the federal poverty level, copays are a flat $5 (generic) or $15 (brand-name) with no deductible; higher-income tiers pay a deductible or spenddown first.
Most states no longer run a dedicated State Pharmaceutical Assistance Program (SPAP) — only a handful still do, largely because Medicare Part D, especially after the Inflation Reduction Act's reforms, now covers much of what these programs used to fill in. Wisconsin's SeniorCare is structured differently from most — it runs under a Section 1115 Medicaid demonstration waiver rather than as a standalone state-funded program — but it remains active and serves tens of thousands of residents each month.
What SeniorCare Covers
SeniorCare helps pay for prescription drugs and vaccines. Coverage is organized into income-based levels: at or below 160% of the federal poverty level, there's no deductible and you pay a flat $5 copay for a covered generic or $15 for a covered brand-name drug. Above that, higher income levels require meeting a deductible or Medicaid-style spenddown before the same copay structure applies. SeniorCare works whether or not you also have a Medicare Part D plan.
Who Qualifies
To qualify, you generally need to be a Wisconsin resident who:
- Is 65 years of age or older
- Is a U.S. citizen or a qualifying immigrant
- Is not enrolled in a full-benefit Medicaid program such as BadgerCare Plus
Unlike many other states' SPAPs, Wisconsin doesn't require you to enroll in Medicare Part D to qualify for SeniorCare — you can have SeniorCare on its own, or alongside Part D.
How to Apply
SeniorCare is administered by the Wisconsin Department of Health Services. For current income limits by level and to start an application, visit the official program page.
Apply on dhs.wisconsin.gov →Frequently Asked Questions
Who qualifies for Wisconsin SeniorCare?
Wisconsin residents 65 or older who are U.S. citizens or qualifying immigrants and are not enrolled in a full-benefit Medicaid program like BadgerCare Plus. You can enroll regardless of whether you have Medicare Part D.
How much does SeniorCare cost?
There's a $30 annual enrollment fee. At or below 160% of the federal poverty level, copays are a flat $5 for a generic and $15 for a brand-name drug with no deductible. Higher income tiers pay a deductible or a spenddown before copays apply.
Does SeniorCare replace Medicare Part D?
No. SeniorCare works alongside Part D or on its own — Wisconsin residents can enroll in SeniorCare whether or not they also have a Part D plan, as long as they're not on full-benefit Medicaid.
Illustrative summary — verify exact current income limits by level and copay amounts with the Wisconsin Department of Health Services before relying on this page for an application decision. This site is not affiliated with the State of Wisconsin.