SeniorCare: Continuing the Program

Draft Waiver Amendment

The Wisconsin Department of Health Services (DHS) will submit an application to the Centers for Medicare & Medicaid Services (CMS) asking for an amendment of its section 1115 research and demonstration project waiver, known as the SeniorCare Prescription Drug Assistance Program. DHS plans to submit the waiver amendment request to CMS by November 20, 2020.

Through a section 1115 demonstration waiver amendment, Wisconsin seeks to expand the pharmacy benefit for people who qualify for SeniorCare to include vaccination coverage.

Draft Waiver Amendment Proposal and Attachments

Public Input

There will be a public comment period for the SeniorCare waiver amendment application. Public comments will be accepted October 19 through noon on November 18, 2020.

If you would like to comment, you can:

  • Write to:

Wisconsin Department of Health Services
Division of Medicaid Services
Attn: Tiffany Reilly
1 W. Wilson St., PO Box 309
Madison, WI 53703

A public hearing to seek input on the SeniorCare waiver renewal application was held virtually on November 2, 2020.

Approved Waiver Extension Request

In April 2019, CMS granted a 10-year extension of the SeniorCare Prescription Drug Assistance Program. SeniorCare, which is designed to help seniors age 65 and older with their prescription drug costs, will continue to operate through December 31, 2028, as a result of the extension.

With the 10-year extension, DHS remains committed to providing quality and affordable prescription drug coverage to Wisconsin's seniors. 

SeniorCare Waiver Application Submitted to CMS

On June 15, 2018, DHS submitted an application requesting a 10-year extension of its Section 1115 Research and Demonstration waiver, known as the SeniorCare Prescription Drug Assistance Program, to CMS.

 

Additional information about the waiver application is available on the CMS website.

Draft Waiver Attachments

Budget Neutrality Tables
Public Input

A 30-day public comment period for the SeniorCare waiver renewal application was held May 7 through June 7, 2018. DHS held public hearings to seek input on the SeniorCare waiver renewal application.

May 10, 2018, 2:00–4:00 p.m.
Wilson Park Senior Center
Milwaukee, WI 53221
Meeting Agenda

May 14, 2018, 9:00 a.m.–12:00 p.m.
Wisconsin Department of Health Services
Madison, WI 53703
Meeting Agenda

 

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History of SeniorCare

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. On July 1, 2002, Wisconsin received the necessary waiver approvals from CMS to operate a portion of SeniorCare as a five-year demonstration project. On April 12, 2019, Wisconsin received approval from CMS to operate the SeniorCare program for an additional 10 years.

Population and Numbers Served

Seniors age 65 and older with income at or below 200 percent of the federal poverty level receive services under the SeniorCare waiver (levels 1 and 2A). 

Over 45,000 seniors per month receive services under the SeniorCare waiver (levels 1 and 2A). With the addition of seniors with income over 200 percent of the federal poverty level who receive services under non-waiver SeniorCare (levels 2B and 3), over 93,000 seniors receive SeniorCare services each month.

Last Revised: November 12, 2020