Continuing the Program

Current Status of Waiver

Wisconsin has received formal approval from the Centers for Medicare and Medicaid Services (CMS), extending the SeniorCare Waiver through December 31, 2015 without any changes to drug coverage. In addition, the new SeniorCare Waiver includes Medication Therapy Management (MTM). This is a new covered service for SeniorCare members. MTM is part of a national trend in healthcare that reimburses pharmacies for value-added services that assist members in managing their medications.

SeniorCare has provided affordable, comprehensive prescription drug coverage to thousands of Wisconsin seniors since 2002. “I am pleased to announce to the tens of thousands of Wisconsin parents, grandparents, friends and neighbors who depend on SeniorCare that SeniorCare was just extended and this very successful program will be available through at least December 31st of 2015,” said Governor Walker.

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History of the Program

On July 1, 2002, The State of Wisconsin received the necessary waiver approvals from the Center for Medicare & Medicaid Services (CMS) to operate a portion of SeniorCare, a prescription drug benefit for seniors, as a five-year demonstration project. Through its partnership with the federal government, the SeniorCare waiver extends Medicaid eligibility through Title XIX to cover prescription drugs as a necessary primary health care benefit.

Population and Numbers Served

The target population for services under this demonstration project is seniors 65 years of age or older with income at or below 200% of the federal poverty level (FPL), which is $22,340 for an individual and $30,260 for a two-person family in 2012. Each month the SeniorCare waiver program serves about 60,000 seniors.

Last Revised: March 06, 2013