Program Description
SeniorCare Rx is a state-run prescription drug assistance program for elderly Wisconsin residents. There are four levels to this program with varying benefits and eligibility requirements. To participate, seniors must pay a small annual fee.
SeniorCare provides assistance with prescription drug costs by offering medications with very low co-payment amounts. 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
General Requirements
To be eligible for this program, seniors must meet the following criteria:
- Be a Wisconsin resident. There is no length of residency requirement.
- Be a U.S. citizen or have qualifying immigrant status.
- Be 65 years of age or older.
- Cannot be on a full-benefit Medicaid program.
Financial Requirements
Seniors must also meet financial requirements. For 2023, the range of incomes in the table below determine which level of benefits the senior receives.
|
Level
|
Individual Income Limit
|
Couple Income Limit
|
|
Level 1 |
Up to $23,328 |
Up to $31,552 |
|
Level 2A |
$23,329–$29,160 |
$31,553–$39,440 |
|
Level 2B |
$29,161–$34,992 |
$39,441–$47,328 |
|
Level 3 |
$34,993or greater |
$47,329 or greater |
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 for 2023:
- 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 ($34,992 for an individual and $47,328 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.
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.
