Wisconsin Chronic Disease Program

To be eligible for the state funded Chronic Renal Disease Program (CRD), members must be Wisconsin residents diagnosed as having end-stage renal disease. In addition, members that are eligible for Medicare must pay Medicare Part B premiums in order to receive WCDP renal disease benefits. If the member is eligible for Medicare but chose to delay Medicare participation, the member is not eligible to receive WCDP renal disease benefits until the member begins paying Medicare Part B premiums.

If a CRD member is a Medicare participant at the time of application, the eligibility date is determined by the date of the initial treatment. However, if the member is Medicare-eligible but has chosen not to pay for premiums, the WCDP eligibility date is designated as the date that Medicare benefits are initiated.

CRD members are eligible to receive the following WCDP covered services:

• Inpatient and outpatient dialysis and transplant treatments.
• One pre-transplant dental examination, and X-rays.
• Kidney donor transplant-related medical services.
• Certain prescription medications.
• Certain home supplies.
• Certain laboratory and X-ray services.

• Financial Need Cover Memo - F-01194, Statement - F-01189, and Instructions -F-01189A
• Application - F-01186, and Instructions - F-01186A
• Residency and Health Care Benefits Verification - F-01143
• Income Deductible for the Wisconsin Chronic Disease Program - P-01190
• Important Notice about the Wisconsin Chronic Renal Disease Program Drug Benefit - F-01058
• Liability Chart - P-01193
• Wisconsin Chronic Renal Disease Program Brochure - P-01147A

To be eligible for the state funded Hemophilia Home Care (HHC) program, the member must be a Wisconsin resident diagnosed by a comprehensive hemophilia treatment center as having hemophilia. The member must also enter into a written agreement with a comprehensive hemophilia treatment center for compliance with a maintenance program. Hemophilia Home Care members become eligible for Wisconsin Chronic Disease Program (WCDP) benefits on the date the application is received by the WCDP.

Hemophilia Home Care members are only eligible to receive services for blood derivatives and supplies necessary for home infusion. A $10 member copay will be applied to each prescription and blood product covered by the program.

HHC Forms and Publications

• Financial Need Cover Memo - F-01195, Statement - F-01187, and Instructions - F-01187A
• Application - F-01184, and Instructions - F-01184A
• Residency and Health Care Benefits Verification - F-01145
• Income Deductible for the Wisconsin Chronic Disease Program - P-01190
• Liability Chart - P-01191

To be eligible for the state funded Adult Cystic Fibrosis Program (ACF), a member must be a Wisconsin resident diagnosed by the medical director of a cystic fibrosis treatment center as having cystic fibrosis and be 18 years of age or older. Adult cystic fibrosis participants are not eligible for retroactive eligibility; therefore, they become eligible for Wisconsin Chronic Disease Program (WCDP) benefits on the date the application was received by the WCDP.

Adult Cystic Fibrosis members are eligible to receive the following WCDP covered services:

• Inpatient and outpatient services directly related to the disease.
• Certain physician services.
• Certain laboratory and X-ray services.
• Certain prescription medications.
• Certain home supplies.

ACF Forms and Publications

• Financial Need Cover Memo - F-01196, Statement - F-01188, and Instructions - F-01188A
• Application - F-01185, and Instructions - F-01185A
• Residency and Health Care Benefits Verification - F-01144
• Income Deductible for the Wisconsin Chronic Disease Program - P-01190
• Liability Chart - P-01192