SeniorCare: Annual Income Limits

SeniorCare is a program for Wisconsin residents who are 65 or older and need help paying for medicine. The program helps seniors pay for prescription drugs.

Annual limits and out-of-pocket expenses by participation level

Your annual income determines how much of your prescription drug costs SeniorCare will cover. The amounts are based on federal guidelines, which change each year. The SeniorCare annual income limits and coverage below is for 2022.

Learn more about deductibles, spenddowns, and out-of-pocket expenses.

Level 1 income limits

Level 1 out-of-pocket expenses

  • No deductible or spenddown (the out-of-pocket expenses toward prescription drugs you have to pay before SeniorCare benefits begin) 
  • $5 copay for each covered generic prescription drug
  • $15 copay for each covered brand-name prescription drug

Level 2A income limits

  • Income above 160% and at or below 200% of the federal poverty level
    • Individual: $21,745–$27,180
    • Couple: $29,297–$36,620

Level 2A out-of-pocket expenses

  • $500 deductible per person
  • The SeniorCare rate for covered drugs until the $500 deductible is met
  • Once $500 deductible is met:
    • $5 copay for each covered generic prescription drug 
    • $15 copay for each covered brand-name prescription drug

Level 2B income limits

  • Income above 200% and at or below 240% of the federal poverty level
    • Individual: $27,181–$32,616
    • Couple: $36,621–$43,944

Level 2B out-of-pocket expenses

  • $850 deductible per person
  • The SeniorCare rate for covered drugs until the $850 deductible is met
  • Once $850 deductible is met:
    • $5 copay for each covered generic prescription drug 
    • $15 copay for each covered brand-name prescription drug

Level 3 income limits

  • Income more than 240% of the federal poverty level
    • Individual: $32,617 or more
    • Couple: $43,945 or more

Level 3 out-of-pocket expenses

  • Retail price for covered drugs during spenddown
  • Once spenddown is met, meet an $850 deductible per person
  • The SeniorCare rate for covered drugs until the $850 deductible is met
  • Once $850 deductible is met:
    • $5 copay for each covered generic prescription drug 
    • $15 copay for each covered brand-name prescription drug
Last Revised: July 15, 2022