Assisted Living in Wisconsin

Wisconsin's Medicaid program for people who are 65 or older, blind, or disabled. The state also calls it SSI-Related Medicaid. It pays for doctor visits, hospital care, prescriptions, and other health care. It does not pay assisted living rent or meals. To get help paying for care in assisted living, you also need to join Family Care, Family Care Partnership, or IRIS, listed next.

If you get SSI, you already have Medicaid and do not need to apply. If your income is over the limit, you may still qualify by meeting a deductible. This means you first pay a set amount of medical bills yourself, and then Medicaid pays.

The long-term care programs use a higher income limit. If your spouse stays at home while you get long-term care, your spouse can keep up to $162,660 of the couple's assets in 2026, plus some of your income.

Wisconsin's main Medicaid long-term care program for older adults and adults with disabilities. You join a managed care organization (MCO), and a care team that includes a care manager and a nurse plans and arranges your services. Family Care can pay for care in a licensed community-based residential facility (CBRF), a licensed or certified adult family home, or a certified residential care apartment complex (RCAC), as long as the home works with your MCO. It cannot be used in a registered RCAC, which serves only private-pay tenants. Family Care also pays for care in your own home.

Family Care does not pay room and board. You pay that yourself. If you owe a monthly cost share, Medicaid first lets you keep a $1,192 allowance plus the part of your housing costs over $350, including the room charge in a CBRF, RCAC, or adult family home. The total you keep can be up to $2,982 a month.

Family Care has been in every Wisconsin county since 2018. DHS says its wait list ended when the program expanded statewide.

A Medicaid program that combines long-term care with your doctor, hospital, and other health care in one plan. It works like Family Care: you join a managed care organization (MCO), and a team that includes your doctor, nurses, and social workers makes your care plan. The MCOs also hold Medicare contracts, so people who have both Medicaid and Medicare get all their care through one plan. Like Family Care, it does not pay room and board.

Partnership is offered only in some counties, by three MCOs: Community Care Health Plan, Independent Care (iCare) Health Plan, and My Choice Wisconsin Health Plan. DHS has placed My Choice Wisconsin under a corrective action order until it fixes problems in its Family Care and Partnership programs.

A Medicaid long-term care program where you direct your own care. You get a yearly budget based on your care needs, and you choose and hire your own workers and providers. An IRIS consultant helps you plan, and a fiscal employer agent handles payroll and background checks. There is no cost to join, but some people owe a monthly cost share based on their income.

IRIS can pay for care in a 1-2 bed or 3-4 bed adult family home or a certified residential care apartment complex (RCAC), as well as in your own home. It cannot be used in a community-based residential facility (CBRF) or a registered RCAC. IRIS does not pay room and board. You pay that yourself.

Wisconsin adds a state payment to every federal SSI check. You do not apply for it separately. If you qualify for any federal SSI payment, you get the state payment automatically, and you have Medicaid. The table shows the most a single person can get each month as of May 2026, with and without SSI-E. Your federal payment is lower if you have other income, such as Social Security.

The Exceptional Expense Supplement (SSI-E) adds up to $105.59 a month to the state payment for SSI members with high living costs. It can help pay room and board in assisted living. It is paid to people who live in a licensed or certified adult family home, a community-based residential facility (CBRF) with 20 beds or fewer, or a certified residential care apartment complex (RCAC). People who live in their own home or someone else's home can also get it if they need at least 40 hours a month of long-term care help.

The federal health insurance program for people 65 and older. Part A covers hospital stays and a short period of skilled nursing care after a hospital stay. Part B covers doctor visits, outpatient care, and medical equipment. Medicare does not pay for assisted living rent or for help with daily tasks like bathing and dressing. In 2026, Part B costs $202.90 a month with a $283 yearly deductible, and the Part A hospital deductible is $1,736.

Plans sold by private insurers that replace Original Medicare. They must cover everything Original Medicare covers, and many add drug, dental, vision, or hearing coverage. Plans, costs, and doctor networks vary by county.

Drug plans that add prescription coverage to Original Medicare. Each plan has its own list of covered drugs and its own premium. Most Medicare Advantage plans already include drug coverage.

A federal program, also called the Part D Low-Income Subsidy, that pays most Part D premiums, deductibles, and drug copays. People who get Medicaid, SSI, or a Medicare Savings Program qualify automatically.

Wisconsin Medicaid programs that pay Medicare costs for people with limited income. Anyone in QMB, SLMB, or SLMB+ also qualifies for Extra Help. If you get SSI and Medicare, Medicaid already pays these costs and you do not need to apply.

Qualified Medicare Beneficiary (QMB) pays Part A and Part B premiums, deductibles, and coinsurance. Specified Low-Income Medicare Beneficiary (SLMB) and SLMB+ pay the Part B premium. SLMB+ is Wisconsin's name for the program most states call Qualifying Individual (QI), and you cannot have full Medicaid at the same time. Qualified Disabled and Working Individual (QDWI) pays the Part A premium for people with disabilities who work.

Monthly income for retired workers, based on what you earned during your working years. You can spend it on anything, including assisted living. You need at least 40 work credits, which is about 10 years of work. Benefits can start at 62, and the monthly check is larger if you wait until full retirement age or later.

A monthly federal payment for people who are 65 or older, blind, or disabled and have very little income and savings. Getting SSI usually qualifies you for Medicaid as well.