seniorcare

What is SeniorCare? SeniorCare is a prescription drug assistance program for Wisconsin residents who are 65 years of age or older who meet the eligibility criteria. The program is designed to help seniors with their prescription drug costs. Those interested may apply at any time. The Department of Health and Family Services (DHFS) administers the SeniorCare program. To be elegible for SeniorCare: You must be a Wisconsin resident You must be 65 years of age or older You must pay a $30.00 annual enrollment fee per person Your assets, such as bank accounts, insurance polocies, home property, etc., are not counted Your annual income determines the level of coverage
In addition program participants are subject to certain annual out-of-pocket expense requirements depending on their annual income as shown in the table below. Drug coverage may vary by level. See the SeniorCare Covered Drugs fact sheet at http://dhfs.wisconsin.gov/seniorCare/information.htm or call your pharmacy or the SeniorCare Customer Service Hotline.
Income Limits*	Annual Out-Of-Pocket Expense Requirements and Benefits
Level 1 At or below $17,872 per individual or $24,208 per couple annually	No deductible or spenddown $5.00 co-pay for each covered generic prescription drug $15.00 co-pay for each covered brand name prescription drug
Level 2a $17,873 to $22,340 per individual and $24,209 to $30,260 per couple annually	$500 deductible per person Pay the SeniorCare rate for drugs until the $500 deductible is met After the $500 deductible is met, pay a $5.00 co-pay for each covered generic prescription drug and $15.00 co-pay for each covered brand name prescription drug
Level 2b $22,341 to $26,808 per individual and $30,261 to $36,312 per couple annually	$850 deductible per person Pay the SeniorCare rate for most covered drugs until the $850 deductible is met After the $850 deductible is met, pay a $5.00 co-pay for each covered generic prescription drug and $15.00 co-pay for each covered brand name prescription drug
Level 3 $26,809 or higher per individual and $36,313 or higher per couple annually	Pay retail price for drugs equal to the deifference between your income and $23,521 per individual or $31,681 per couple. This is called "spenddown." Covered drug costs for spenddown will be tracked automatically. During the spenddown, there is no discounts on drug costs. After the spenddown is met, meet an $850 deductible per person Pay SeniorCare rate for most covered drugs until the $850 deductible is met. After the $850 deductible is met, pay a $5.00 co-pay for each covered generic prescription drug and $15.00 co-pay for each covered brand name prescription drug
*These income amounts are based on the 2006 federal poverty guidelines, which increase by a small percentage each year. During declaration earned income must also be counted even if you do not receive the income.

What is SeniorCare?

SeniorCare is a prescription drug assistance program for Wisconsin residents who are 65 years of age or older who meet the eligibility criteria. The program is designed to help seniors with their prescription drug costs. Those interested may apply at any time. The Department of Health and Family Services (DHFS) administers the SeniorCare program. To be elegible for SeniorCare:

You must be a Wisconsin resident
You must be 65 years of age or older
You must pay a $30.00 annual enrollment fee per person
Your assets, such as bank accounts, insurance polocies, home property, etc., are not counted
Your annual income determines the level of coverage

In addition program participants are subject to certain annual out-of-pocket expense requirements depending on their annual income as shown in the table below. Drug coverage may vary by level. See the SeniorCare Covered Drugs fact sheet at http://dhfs.wisconsin.gov/seniorCare/information.htm or call your pharmacy or the SeniorCare Customer Service Hotline.

Income Limits*

Annual Out-Of-Pocket Expense Requirements and Benefits

Level 1

At or below $17,872 per individual or $24,208 per couple annually

No deductible or spenddown

$5.00 co-pay for each covered generic prescription drug

$15.00 co-pay for each covered brand name prescription drug

Level 2a

$17,873 to $22,340 per individual and $24,209 to $30,260 per couple annually

$500 deductible per person

Pay the SeniorCare rate for drugs until the $500 deductible is met

After the $500 deductible is met, pay a $5.00 co-pay for each covered generic prescription drug and $15.00 co-pay for each covered brand name prescription drug

Level 2b

$22,341 to $26,808 per individual and $30,261 to $36,312 per couple annually

$850 deductible per person

Pay the SeniorCare rate for most covered drugs until the $850 deductible is met

After the $850 deductible is met, pay a $5.00 co-pay for each covered generic prescription drug and $15.00 co-pay for each covered brand name prescription drug

Level 3

$26,809 or higher per individual and $36,313 or higher per couple annually

Pay retail price for drugs equal to the deifference between your income and $23,521 per individual or $31,681 per couple. This is called "spenddown."

Covered drug costs for spenddown will be tracked automatically. During the spenddown, there is no discounts on drug costs.

After the spenddown is met, meet an $850 deductible per person

Pay SeniorCare rate for most covered drugs until the $850 deductible is met.

After the $850 deductible is met, pay a $5.00 co-pay for each covered generic prescription drug and $15.00 co-pay for each covered brand name prescription drug

*These income amounts are based on the 2006 federal poverty guidelines, which increase by a small percentage each year. During declaration earned income must also be counted even if you do not receive the income.