SeniorCare: SeniorCare and Medicare Part D
SeniorCare and Medicare Part D are programs that help Wisconsin residents 65 or older pay for prescription drugs and vaccines (PDF). You can enroll in both programs at the same time, or just one.
Our SeniorCare Prescription Drug Assistance Program is considered “creditable coverage.” This means it’s as good as the standard Medicare Part D plan, and you will not have a penalty if you choose SeniorCare instead of Medicare Part D.
If you’re enrolled in SeniorCare, you can keep your coverage and not pay extra if you choose to enroll with Medicare Part D later. If you let your SeniorCare coverage end without enrolling in a Medicare Part D plan, you may have to pay more if you decide to enroll later.
If you don’t have creditable prescription drug coverage for 63 days or longer, your monthly premium for Medicare Part D will go up at least 1% for each month you don’t have coverage.
For example, if you go nine months without coverage, your premium will always be at least 9% higher than what most people pay.
For more information, call SeniorCare Customer Service at 800-657-2038.You can also print this page.
SeniorCare Medicare Part D and Extra Help for SeniorCare Members, P-10074
Enrolling in Medicare Part D
If you enroll in a Medicare Part D plan, your coverage will begin about a month after you enroll. If you need help paying for prescription drugs and you’re currently enrolled in SeniorCare, you should stay on SeniorCare until your Medicare Part D coverage begins.
If you don’t enroll in a Medicare Part D plan when you’re eligible, you can still enroll, you may just have to wait until the next enrollment period. That’s Oct. 15 through Dec. 7, for coverage that begins Jan. 1.
Extra help with Medicare Part D costs
Extra Help is a federal program that helps people with limited income and resources pay Medicare prescription drug program costs, like premiums and deductibles. Nearly one in three people with Medicare qualify for Extra Help, in which case, Medicare will pay for almost all prescription drug costs.
To apply or learn more, visit the federal Extra Help webpage or call the Social Security Administration at 800-772-1213 or 800-324-0778 TTY and ask about the program.
You may be automatically enrolled in Extra Help when you apply for Medicare Part D, or you may have to enroll separately. If you are eligible for Extra Help, you must pick a primary drug plan and enroll in that plan.
Out-of-pocket costs for SeniorCare and Medicare Part D
Out-of-pocket costs for both SeniorCare and Medicare Part D depend on how much income you have. People with a higher income can expect higher out-of-pocket costs.
For Medicare Part D, the out-of-pocket costs also depend on whether you’re eligible for Extra Help and which plan you enroll in. Some plans have higher premiums than others.
People with a lower income who enroll in a Medicare Part D plan may have better coverage if they qualify for Extra Help and the drugs they need are covered by their plan.
More resources
Before you enroll in a Medicare Part D plan, carefully review the coverage it offers. If you need help choosing a prescription drug plan that is best for you, call your local aging and disability resource center (ADRC) and ask for a benefits specialist.
You can also call:
- SeniorCare Customer Service at 800-657-2038 for questions about SeniorCare.
- The Prescription Drug Helpline at 855-677-2783 for questions about Medicare Part D.
We are an equal opportunity employer and service provider. If you have a disability and need to access this information in a different format, or in another language, call SeniorCare Customer Service at 800-657-2038. Translation services are free.
If you have a civil rights question, call 608- 267-4955, TTY: 711 or email dhscrc@dhs.wisconsin.gov.