Medications

Wisconsin SeniorCare Program

SeniorCare provides you prescription drug coverage for an annual enrollment fee of $30. There are four levels of SeniorCare coverage which are based upon the amount of income you get. Here are the benefits offered to you in each level:

Level 1 – Annual income less than $19,424 if you are single or $26,336 if you are married

no deductible
$5 co-pay for each generic prescription drug
$15 co-pay for each brand-name prescription drug

Level 2a – Annual income between $19,425 and $24,280 if you are single or $26,337 and $32,920 if you are married

$500 deductible per person
pay the SeniorCare rate for drugs until the $500 deductible is met
after $500 deductible is met, pay a $5 co-pay for each generic prescription drug and a $15 co-pay for each brand-name prescription drug

Level 2b – Annual income between $24,281 and $29,136 if you are single or $32,921 and $39.504 if you are married

$850 deductible per person
pay the SeniorCare rate for most prescription drugs until the $850 deductible is met
after $850 deductible is met, pay a $5 co-pay for each generic prescription drug and a $15 co-pay for each brand-name prescription drug

Level 3 - Annual income $29,137 or higher if you are single and $39,505 or higher if you are married

pay the pharmacy's price for prescription drugs equal to the difference between your income and $28,945 if you are single or $38,977 if you are married (called the "spenddown")
after the spenddown is met, pay an $850 deductible per person
pay SeniorCare rate for most drugs until the $850 deductible is met
after the $850 deductible is met, pay a $5 co-pay for each generic prescription drug and a $15 co-pay for each brand-name prescription drug

Once you send your application to SeniorCare, it takes the program 4-6 weeks to decide if you can get the program. If you are able to get enrolled in SeniorCare, you will receive an ID card to use when filling your prescriptions at a participating pharmacy. Most pharmacies in Wisconsin will take the SeniorCare card.

Most prescription drugs are covered by SeniorCare except those that are given to you in a doctor's office, drugs that are experimental or have a cosmetic purpose, over-the-counter drugs, and drugs that have not been covered by SeniorCare in the past.

How do I apply?

To apply, print and fill out an application and send it to the SeniorCare program. The program requests that you mail your completed application.

Frequently Asked Questions

Am I eligible?

To get SeniorCare, you must be 65 years of age or older. You can have other health insurance coverage, including Medicare, or prescription drug coverage with another health plan. However, if you have Medicaid, you cannot get help from the SeniorCare program.

How does SeniorCare and Medicare Prescription Drug Coverage work together?

Since SeniorCare is considered to have prescription coverage that is as least as good as what Medicare offers (creditable coverage), you may not need to enroll in Medicare Prescription Drug Coverage. If you do enroll in both SeniorCare and Medicare Prescription Drug Coverage, Senior Care will work with Medicare to cover your prescription drugs.

What will I need?

Proof of State Residency
Proof of Age
Proof of Income

Who should I contact?

Wisconsin SeniorCare Program
P.O. Box 6710
Madison, WI 53716
Toll-Free: (800) 657-2038
TTY/TDD: (608) 266-2555
Fax: (608) 250-6563