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Medicaid - Title 19

Wisconsin's ForwardHealth Medicaid plans for Elderly, Blind or Disabled provide health care for those who are:

  • Age 65 or older, blind or disabled
  • With family income at or below the monthly program limit
  • Who are United States citizens or legal immigrants

Programs include:

  • Medicaid Standard - Health care coverage if eligible persons meet the income/asset guidelines

  • Medicaid Deductible - The Wisconsin Medicaid Deductible program may be able to help if there are high medical bills and the beneficiary meets all Medicaid rules except their income is too high.  The Medicaid Deductible amount is the difference between their montly income and the monthly program income limits.

    The cost of unpaid and recently paid medical bills can be used to meet the deductible to become eligible for Medicaid.  Examples of medical costs include health insurance premiums, personal medical bills, and medical bills of their children or spouse, and, in some situations, a co-parent not married to and their children.  See the Department of Health Services Medicaid Fact Sheet for more information.

  • Wisconsin Well Woman Medicaid - For women under age 65, not covered by private or other public health insurance that cover treatment for a diagnosis of breast or cervical cancer, or a pre-cancerous condition of the cervix. For more information go to the Wisconsin Department of Health Services Well Woman Program.

  • Long-Term Care Programs
    • Home and Community Based Waivers (HCBW) - These programs enable elderly, blind, or disabled persons to live in community settings rather than in state institutions or nursing homes.  They pay for community services which normally are not covered by Medicaid.  To receive long-term care services throgh these programs, a beneficiary must:
      • Meet level of care requirements as determined by care manager
      • Meet non-financial requirements
      • Meet financial requirements
      • Reside in a setting allowed by HCBW policies
      • Have a disability determination if under the age of 65
      • Contribute toward the cost of waiver services if required
    • Family Care - Provides long-term care services for elderly, blind, or disabled people.  (Family Care is not yet in offered in every county) Financial eligiblity for Family Care is determined the same way it is determined for HCBW.  Family Care also provides long-term care services for people who do not need nursing home level of care but need help to accomplish activities of daily living and caring for their health if:
      • The member meets the financial and non-financial requirements for any non-HCBW plan, and
      • Long-term care services are requested

For more information about Family Care go to Wisconsin Department of Health Services Family Care.

    • Institutional Medicaid - These services provide medical services for those who reside in a medical care facility which includes skilled nursing facilities (SNF), intermediate care facilities (ICF), institutions for mental disease (IMD), and hospitals.  Go to you local county or tribal Income Maintenance Agency for information and eligibility assistance to get help to pay for these forms of services.
    • Spousal Impoverishment Protections - Special financial protections are allowed for the spouse and dependent children of a Long Term Care member to keep assets and income that are above Medicaid financial limits.  See the Wisconsin Department of Health Services Medicaid Fact Sheet for more information.

For more information on Wisconsin Medicaid Programs go to the Wisconsin Department of Health Services Medicaid website.






Last Modified:   7/26/2016 1:48:04 PM   
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Board on Aging & Long Term Care
1402 Pankratz Street, Suite 111
Madison, Wisconsin  53704-4001
FAX:  608 246 7001