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Wisconsin SeniorCare Pharmaceutical Assistance Program
Page Reviewed / Updated - September 29, 2020
Program Description
SeniorCare Rx is a state-run pharmaceutical assistance program for elderly Wisconsin residents. There are three levels to this program with varying benefits and eligibility requirements for each level. To participate, seniors must pay a small annual fee. SeniorCare provides assistance with prescription drug costs by offering medications for very low co-payment amounts for seniors. Unlike most 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 AFCSP and the Family Care program.
Eligibility Guidelines
To be eligible for this program, seniors must meet the following criteria:
- Be a Wisconsin resident. There is no length of residency requirement.
- Be 65 years of age or older
- Cannot be on Medicaid
- Have income within the limits in the table below. These figures change annually. This content was effective in Feb. 2020 and will likely increase in Feb. 2021.
|
Level |
Individual Income Limit |
Couple Income Limit |
| Level 1 (<160% FPL) | Up to $20,416 | Up to $27,584 |
| Level 2a (160% - 200% FPL) | $20,417 - $25,520 | $27,585 - $34,480 |
| Level 2b (200% - 240% FPL) | $25,521 - $30,624 | $34,481 - $41,376 |
| Level 3 (>240% FPL) | Above $30,625 | Above $41,377 |
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. Some levels have an annual deductible. Once participants have reached their deductible amount in out-of-pocket drug costs in a calendar year, they benefit from the following table of drug co-pays:
- Level 1 - No deductible. $5 co-pay for generic drugs and $15 co-pay for brand name drugs.
- Level 2a - $500 deductible / person. $5 co-pay for generic drugs and $15 co-pay for brand name drugs.
- Level 2b - $850 deductible / person. $5 co-pay for generic drugs and $15 co-pay for brand name drugs.
- Level 3 – No prescription assistance until the participant has spent down their income level to the Level 2b limit ($30,624 for an individual and $41,376 for a couple). At that point, Level 2b deductible ($850 / person) and benefits apply.
Medication therapy management is also available via SeniorCare Rx. Via this benefit, a pharmacist is available to answer questions about the medications one is prescribed.
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.