In-Home Dementia Care in Wisconsin

Paying for care in Wisconsin: Family Care (with IRIS as the self-directed alternative)

Medicare does not pay for the long-term help dementia requires. In Wisconsin the programme that can is Family Care, administered by the Wisconsin Department of Health Services, through Aging and Disability Resource Centers for eligibility and managed care organizations for services.

Who qualifies

Applicants must be 18 or older, be a frail elder or an adult with a disability, be eligible for Wisconsin Medicaid, and be found functionally eligible through the Long-Term Care Functional Screen, which an ADRC screener completes in a face-to-face interview. The cited page does not describe any dementia-specific eligibility route, so ask the office that administers the programme how a dementia diagnosis is weighed in that assessment.

The financial limits

Single applicant

Not published on the cited page; set by Wisconsin Medicaid financial eligibility rules

Married couple

Not published on the cited page; spousal rules apply

Look-back period

Not published on the cited page; standard Medicaid transfer-of-asset rules apply

How to apply

Contact the local Aging and Disability Resource Center, which explains the program and completes the Long-Term Care Functional Screen. Once eligible, the member chooses a managed care organization serving their county and enrolls.

What is unusual about Wisconsin

Wisconsin offers a genuine choice of delivery model: Family Care, where an MCO coordinates services, or IRIS (Include, Respect, I Self-Direct), where the participant self-directs their own budget and hires their own workers.

Rules and figures change. Confirm the current position with the programme itself before making a financial decision.