Wisconsin Medicaid for Seniors & Long-Term Care
Updated August 2026
Wisconsin offers two primary pathways for home and community-based long-term services and supports (LTSS) for eligible adults age 18 and older: Family Care and IRIS (Include, Respect, I Self-Direct). The choice between them depends on the individual's preference for managed care vs. self-direction.
$2,000
Individual asset limit (single applicant)
$3,000
Asset limit for married couple applying together
Family Care / IRIS
Two LTSS pathways: managed care or self-direction
Seniors 65+ and LTSS recipients are exempt from new Medicaid work requirements in Wisconsin
Federal Medicaid legislation signed July 4, 2025 (H.R. 1) added community engagement requirements. Individuals age 65 and older, and individuals receiving long-term services and supports (LTSS), are exempt. Contact ForwardHealth at 800-362-3002 with questions.
Family Care and IRIS: Wisconsin's two LTSS pathways
Functional eligibility for both programs requires meeting the nursing home level of care standard and having a disability or aging-related condition. Financial eligibility is determined separately by ForwardHealth. To be evaluated for Family Care or IRIS, contact your local Aging and Disability Resource Center (ADRC).
- Family Care — a managed care program administered by regional Managed Care Organizations (MCOs); members have a care team that coordinates personal care, adult day, community-supported employment, home modification, and other HCBS; available statewide
- IRIS (Include, Respect, I Self-Direct) — a self-directed program where members manage their own services and hire their own providers, including family members in some cases; participants work with a support broker rather than an MCO care team, and IRIS is available statewide as an alternative to Family Care
Asset limits for long-term care Medicaid in Wisconsin
Wisconsin sets separate asset limits depending on whether an individual or a married couple is applying, with the primary home and one vehicle exempt regardless of value (subject to a home equity limit).
| Category | Asset limit | Notes |
|---|---|---|
| Single individual | $2,000 | Countable assets |
| Married (applying as couple) | $3,000 | Combined countable assets, both applying |
| Community spouse CSRA | $50,000–$162,660 (2026) | Wisconsin uses a state-specific asset-share formula within federal limits; exact amount based on asset assessment |
| Home | Exempt | Primary residence, equity limit applies |
| Vehicle | One exempt | One vehicle regardless of value |
Single individual
- Asset limit
- $2,000
- Notes
- Countable assets
Married (applying as couple)
- Asset limit
- $3,000
- Notes
- Combined countable assets, both applying
Community spouse CSRA
- Asset limit
- $50,000–$162,660 (2026)
- Notes
- Wisconsin uses a state-specific asset-share formula within federal limits; exact amount based on asset assessment
Home
- Asset limit
- Exempt
- Notes
- Primary residence, equity limit applies
Vehicle
- Asset limit
- One exempt
- Notes
- One vehicle regardless of value
Nursing facility coverage
Wisconsin Medicaid covers nursing facility care for individuals who meet the nursing home level of care standard and financial eligibility. Residents in a Medicaid-covered nursing facility contribute most of their monthly income toward their care — the state sets a Personal Needs Allowance (PNA) of $55/month (effective January 1, 2026) that residents keep for personal expenses.
Wisconsin operates a comprehensive nursing home survey and certification process through DHS's Division of Quality Assurance. Information about Wisconsin nursing home quality ratings is available through the CMS Care Compare tool.
PACE: program of all-inclusive care for the elderly
Wisconsin has PACE programs operating in select areas, including the greater Milwaukee metro region. PACE serves adults age 55 and older who need nursing facility level of care but can safely live in the community. PACE integrates Medicare and Medicaid services through a single, coordinated care team, and for Medicaid-eligible participants, PACE has no monthly premium.
Wisconsin Medicaid estate recovery
After a Medicaid long-term care recipient dies, Wisconsin must seek to recover Medicaid costs from the estate under the Medicaid Estate Recovery Program (MERP) for services received at age 55 or older. This can affect the home. Recovery is deferred while a surviving spouse, minor child, or disabled child is living.
Wisconsin Medicaid (ForwardHealth)
- Wisconsin ForwardHealth: 800-362-3002
- Aging and Disability Resource Center (ADRC) locator: dhs.wisconsin.gov/adrc
- National PACE Association: npaonline.org
Related guides
Medicaid for Seniors
How Medicaid pays for nursing home and long-term care for older adults.
Read more →Estate Recovery
When states can seek reimbursement from an enrollee's estate after death.
Read more →Medicaid & Social Security
How Social Security benefits and Medicaid eligibility interact.
Read more →