Management (Income Maintenance) Home >> Customer
Help >> SeniorCare Help >>
To see if you may be able to
get SeniorCare or to
check your benefits, go to access.wi.gov.
At this time, you cannot apply for SeniorCare on ACCESS.
Application — F-10076
(PDF, 152KB) — To apply for SeniorCare Prescription Drug
Authorization of Representative — F-10080
(PDF, 32KB) — Designate someone to apply for SeniorCare for
Fair Hearing Request —
DHA 28 (PDF, 100KB) *(exit
Fair Hearing Voluntary Withdrawal — DHA 17
(PDF, 10KB) *(exit DHS) — If you want to withdraw your request for a hearing.
Member Handbook — P-10079 — To learn more about your SeniorCare Prescription Drug
ACCESS/Marketplace Takeaway Card —
Additional Information about SeniorCare can be found at
Directory - To find the telephone number and address of your local
Limits - To find current income limits.
Legal Services - To find the name and telephone number of who in your area
can provide you with legal help. You may also go to:
Rights of Wisconsin — Disability Rights Wisconsin is a private non
profit organization which helps people across Wisconsin gain access to
services and opportunity through its advocacy and legal expertise.*(exit
November 18, 2013