SeniorCare: Waiver Information

SeniorCare is a program for Wisconsin residents who are 65 or older and need help paying for medicine. The program helps seniors pay for prescription drugs.

SeniorCare is available in Wisconsin through a section 1115 research and demonstration program waiver. It operates with approval from the Centers for Medicare & Medicaid Services (CMS). You can find information about requests for federal approval on this page.

The Wisconsin Department of Health Services (DHS) has expanded this program to include coverage for vaccines recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices for people age 65 and older.

We gathered public comments in the fall of 2020 and held a public hearing. CMS approved the waiver amendment in June 2022.

Proposals and attachments

SeniorCare draft waiver amendment proposal (PDF)
SeniorCare 2019-2028 approved waiver (PDF)
Budget neutrality tables:
- Table 1 (PDF)
- Table 2 (PDF)
- Table 2B (PDF)
- Table 4 (PDF)

In April 2019, CMS granted the SeniorCare program a 10-year extension. The extension means SeniorCare will operate through at least Dec. 31, 2028.

Waiver application

DHS submitted the application requesting the extension of SeniorCare on June 15, 2018.

SeniorCare Waiver Application (PDF)
SeniorCare Waiver Appendix A (PDF)
SeniorCare Waiver Appendix B (PDF)
SeniorCare Waiver Appendix C (PDF)
SeniorCare Waiver Appendix D (PDF)
SeniorCare Waiver Appendix E (PDF)

You can find more information on the CMS website.

Draft waiver attachments

Budget neutrality tables:

Table 1A (PDF)
Table 1B (PDF)
Table 2A (PDF)
Table 2B (PDF)
Table 3A (PDF)
Table 3B (PDF)
Table 4 (PDF)

Public input

We gathered public comments in May and June of 2018. We also held two public hearings.

Watch the May 14, 2018, public hearing
View the PowerPoint presentation:
- English (PDF)
- Hmong (PDF)
- Spanish (PDF)

SeniorCare history

The SeniorCare program extends Medicaid eligibility through Title XIX to cover prescription drugs as a necessary primary health care benefit. We received approval from CMS on July 1, 2002, to operate a portion of the program as a five-year demonstration project. On April 12, 2019, we received approval to operate the program for another 10 years.

Who SeniorCare serves

People who are 65 or older with an annual income that’s at or below 200% of the federal poverty level receive services under the SeniorCare waiver (participation levels 1 and 2A). Learn about SeniorCare annual income limits.

More than 45,000 people each month receive services under the SeniorCare waiver (participation levels 1 and 2A). Combined with those who receive services under non-waiver SeniorCare (participation levels 2B and 3), more than 93,000 people each month receive services.