Family Care is a Medicaid long-term care program for older adults and adults with disabilities. The goal is to get members the services they need to live in a home setting when possible.
What is Family Care
Family Care offers long-term care under one benefit program. Long-term care is a service or support a person may need because:
- They have a disability.
- They are older.
- They have a lasting (chronic) illness.
Disability, age, or illness may get in the way of a person being able to do daily tasks:
- Get dressed
- Go to work
- Make meals
- Pay bills
Medicaid renewals underway
For the first time since March 2020, some Family Care, BadgerCare Plus, and other Wisconsin Medicaid members must complete an annual renewal process. If you are a member of Family Care, it’s important to complete and submit your renewal as soon as you can after receiving your renewal packet in the mail. And if you plan to send in your information by mail or fax, build in extra time!
Inclusa contracts with DHS for the Family Care program. DHS has ordered Inclusa to correct issues within its Family Care program. Inclusa will be under corrective action until they meet all requirements.
Corrective action—Community Care
Community Care contracts with DHS for the Family Care program. DHS has ordered Community Care to correct issues within its Family Care program. Community Care will be under corrective action until they meet all requirements.
There are two main groups that work with Family Care members:
- Aging and disability resource centers (ADRCs)—These centers serve the public and offer information. They also help with issues that affect older adults, people with disabilities, and their families. ADRCs make it easy to learn about resources near you.
- Managed care organizations (MCOs)—MCOs coordinate services for the Family Care program. When a person enrolls, they become a member of an MCO. The MCO makes sure members get services based on need, situation, and preference. See which MCOs are in your county using the Family Care Geographic Service Regions (GSR) map, P-01790 (PDF).
What services are covered
Family Care offers long-term care services to its members. Services can range from help with daily tasks at home to mental health.
To get Family Care services:
- Potential members contact their local ADRC to find out if they are eligible. The ADRC will explain what it means to be part of the program.
- Members choose an MCO and enroll to get their services.
Who is eligible
To enroll in Family Care, you must:
- Be at least 18 years old.
- Be a frail elder or an adult with a disability.
- Be eligible for Medicaid.
- Be functionally eligible. The Long Term Care Functional Screen helps confirm eligibility.
- Have a long-term care condition that will last more than 90 days.
People with dementia and a terminal condition also may qualify.
How Family Care works
With Family Care, Wisconsin Department of Health Services (DHS) pays MCOs monthly for each member they serve. The MCO uses the funds to find and schedule services for its members. MCOs have a full list of long-term care providers. They make sure services for members are top quality.
Who to contact for help
If you have questions, either:
- Call Medicaid Member Services at 800-362-3002.
- Email DHSFCWebmail@wisconsin.gov.
Family Care has been around since 1999. It began as an effort to re-do Wisconsin’s long-term care system. The program has made a lot of progress over time:
- 1999—The Family Care program starts.
- 2000—Family Care begins in five counties. They include Fond du Lac, La Crosse, Milwaukee, Portage, and Richland.
- 2007—Family Care expands to more counties.
- 2010—Family Care serves more than 30,000 members in 56 counties.
- 2013—DHS research shows that using Family Care across the state saves $34.7 million. It also gets more services to people who are older or have a disability.
- 2015—Governor Walker and the state expand Family Care to the entire state. The wait list ends. Family Care costs less than other programs but still gives quality care.
- 2018—The last county in the state gets Family Care.
- Today—Family Care serves more than 55,000 members across the state. View Family Care enrollment numbers.