State Pharmaceutical Assistance Program: Wisconsin

Not all Medicare beneficiaries have the money they need to continually pay for their monthly bills and increasing medication costs. Many of these beneficiaries have to decide which medications they can afford to pay for each month along with what bills will be paid each month. There are many Medicare beneficiaries that are surprised they have to make these choices but it’s something they have no choice but to do.

As these beneficiaries have struggled, there are many states that have noticed. These states have noticed the struggles of their residents and they have decided to do something about it. Some, not all, states have decided to offer their residents help through state pharmaceutical assistance programs. These programs allow residents that are eligible to receive the help they need to pay for the medications they are prescribed to maintain their health.

Many of these programs are a boon to those that receive the benefits. These Medicare beneficiaries are able to continue their medications without having to go without the basics they need to maintain their lifestyle.

Wisconsin is a state that offers residents help with a state pharmaceutical assistance program.

Wisconsin SeniorCare

Those that are interested in the Wisconsin SeniorCare program should call 800-657-2038 for more information.

Eligibility Requirements

Those that are interested in the program have to meet specific requirements. Those requirements are as follows:

  • Must be a Wisconsin resident
  • Must be a qualifying immigrant or a natural US citizen
  • Must be 65 years old or older
  • Must have a measurable income
  • Must not be eligible or receiving prescription drug coverage through Medicaid

Who to Contact

Those that are interested and meet the eligibility requirements should mail their applications to:

PO Box 6710

Madison, WI. 53716

What are the Benefits

Income verification is one of the requirements of the program. Because there are many different income levels that are acceptable for this program, there are different benefit levels. Those that qualify for the programs may enjoy different benefits.

Level 1: Income at or below 18,384 per individual or $24,816 per couple

  • No spend down or deductible
  • $5 copay for a 30 day supply of generic medication
  • $15 copay for a 30 day supply of name brand medication

Level 2a: Income between $22,981 to $27,576 per individual or $31,021 to $37,224 per couple

  • $500 deductible per person
  • Must pay the SeniorCare price for medications until the $500 deductible is met
  • After the deductible is met, copays for generic medications will be $5 for a 30 day supply and $15 for a 30 day supply of name brand medication

Level 2b: Income between $22,981 to $27,576 per individual and $31,021 to $37,224 per couple

  • $850 deductible each person
  • Must pay the SeniorCare price for medication until deductible is met
  • After the deductible is met, copays for medications will be as follows: $5 for a 30 day supply of generic medication and $15 for a 30 day supply of name brand medication

Level 3: Income between $27,577 or higher per individual and $37,225 or higher per couple

  • Will have a spend down (determined by the program based on the income of applicant(s))
  • After the spend down has been met, $850 deductible per person
  • Must pay the SeniorCare cost for medications until deductible is met
  • After deductible is met, copays for medications will be as follows: $5 copay for a 30 day supply for generic medications and $15 copay for 30 day supply of name brand medications

Those that still need help with medications will need to apply for help through the Social Security Administration. 

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