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.
It 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).
Requests for federal approval
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.
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:
In April 2019, CMS granted the SeniorCare program a 10-year extension. The extension means SeniorCare will operate through at least December 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:
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:
Program evaluations
Program evaluations highlight the success of the SeniorCare program, including its effectiveness and outcomes.
- 2019-2028 Interim Evaluation Design for Years 2024-2028
- 2019-2028 Interim Evaluation for Years 2019-2023
- 2019-2028 Evaluation Design (PDF)
- 2016–2018 Interim Evaluation (PDF)
- 2013–2015 OPIB Evaluation (PDF)
- 2012 Brandeis Evaluation (PDF)
- 2002–2007 Brandeis Evaluation (PDF)
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.
In 2025, more than 32,000 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 91,000 people each month receive services.