Paying for assisted living in Wisconsin
Most families in Wisconsin start by paying for assisted living out of pocket. Private funds, retirement income, savings, long-term care insurance, and the proceeds from selling a home are the most common sources. Costs vary widely by region and by the type of community, so use the pricing tables below to compare what you can expect to pay in your area.
Wisconsin licenses two main assisted living settings: Community-Based Residential Facilities (CBRFs) and Residential Care Apartment Complexes (RCACs). Smaller Adult Family Homes are also available. Each has its own pricing and care model, which affects what you pay.
Does Family Care or IRIS cover assisted living in Wisconsin?
Wisconsin's Medicaid long-term care programs — Family Care and IRIS (Include, Respect, I Self-Direct) — can help pay for the care and support services a person receives in assisted living. Like all Medicaid programs, they never pay for room and board itself; you remain responsible for housing and meal costs (though some programs help with these in a Medicaid-certified setting).
A few things to know:
- These programs cover services in a Medicaid-certified CBRF or RCAC. Not every community participates, so ask before you commit.
- Eligibility has two parts: a financial test (income and assets) and a functional test (you need a certain level of help with daily activities).
- IRIS is self-directed, letting members manage their own care budget and choose providers.
To apply or learn whether you qualify, contact your local Aging and Disability Resource Center (ADRC), which handles enrollment for both programs. You can also apply for Medicaid online through the state's ACCESS portal.
Does Medicare cover assisted living in Wisconsin?
No. Medicare does not pay for room and board or for the ongoing custodial care (help with bathing, dressing, eating, and supervision) that defines assisted living.
Medicare may still help with related medical needs, such as:
- Doctor visits, hospital stays, and prescription drugs
- A short, medically necessary stay in a skilled nursing facility after a qualifying hospital admission
- Physical therapy, home health, or hospice when ordered and eligibility rules are met
For free, unbiased help understanding Medicare, Medigap, and Part D options, call Wisconsin's SHIP program — the Medigap Helpline run by the Board on Aging and Long Term Care.
