Wisconsin SeniorCare Pharmaceutical Assistance Program

Page Reviewed / Updated - May 2014

Program Description

SeniorCare is a state pharmaceutical assistance program for elderly Wisconsin residents. There are 4 levels to the program with varying benefits and eligibility requirements for each level. The program requires a small annual fee and provides assistance with the prescription costs by offering medications at very low co-payment amounts. Unlike many state pharmaceutical assistance programs, there is no requirement that program participants be enrolled in a Medicare Part D plan.

Did You Know?  Wisconsin has several programs that provide assistance to help elderly residents remain living in their homes.  Learn about COP, AFCSP and the Family Care program.

 

Eligibility Guidelines

To be eligible for this program, seniors must meet the following criteria:

  • Be a Wisconsin resident.
  • Be 65 years of age or older
  • Cannot be on Medicaid
  • Have income within the limits in the table below

Level Individual Income Limit Couple Income Limit
Level 1 (<160% FPL) Up to $18,672 Up to $25,168
Level 2a (160% - 200% FPL) $18,673 — $23,340 $25,169 — $31,460
Level 2b (200% - 240% FPL) $23,341 — $28,008 $31,461 — $37,752
Level 3 (>240% FPL) Above $28,009 Above $37,753



Benefits and Services

To participate in Wisconsin's SeniorCare Rx program there is a flat annual fee of $30 per individual. The same fee amount applies regardless of the level of assistance for which the applicant qualifies.

 

  • Level 1 - No deductible. $5 co-pay for generic drugs and $15 co-pay for brand name drugs.
  • Level 2a - $500 deductible. $5 co-pay for generic drugs and $15 co-pay for brand name drugs.
  • Level 2b - $850 deductible. $5 co-pay for generic drugs and $15 co-pay for brand name drugs.
  • Level 3 – No prescription assistance until participant has spent down their income level to the Level 2b limit. At that point, Level 2b benefits apply.

 

How to Apply / Learn More

An application form is available in several languages and can be downloaded on this webpage. One can also apply in person at their local Area Agency on Aging or over the phone by calling the toll free number at (800) 657-2038.   More information is available on the SeniorCare Rx Website.

 

 

The state of Illinois has two programs designed to provide financial assistance to the elderly to help them purchase their prescription drugs. Rx Basic is for individuals without Medicare insurance and the Rx Plus is designed for those on Medicare.

Rx Plus is known as a Medicare wraparound program which means the benefits wrap around those benefits provided by a Medicare Part D plan. When making a prescription purchase, Medicare Part D is the first payer and then this program contributes towards those costs the Part D plan does not cover.