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Guide to Senior Living in Wisconsin

Wisconsin has a total population of 5.8 million, and around 989,000, or 17%, of its residents are aged 65 or older. This number is projected to increase by 72% between 2015 and 2040, especially in rural areas. By 2040, older adults will represent more than 21% of the population in the majority of Wisconsin’s counties, and in 18 counties, it’s expected that at least 33% of the total population will be 65 or older.

Currently, there are more than 1,800 residential senior living facilities across the state. This number is expected to rise, which will give older adults access to even more senior living options. The average cost for assisted living in the state is $4,350 per month, which is higher than the national average, although some areas are more affordable than others. There are also programs available to help seniors manage the cost of senior living. This guide includes information about the cost of care, financial resources available and local programs and agencies that can support seniors in need.

The Cost of Senior Living in Wisconsin

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Depending on their needs, senior Wisconsinites have several long-term care options from which to choose. These options depend upon their living preferences, budgets and care needs. Independent living offers a relaxed lifestyle that gives seniors time to follow their interests and enjoy other pursuits. Seniors who need help with activities of daily living (ADLs) and some medical care should investigate assisted living. Special units in assisted living facilities provide memory care for seniors with Alzheimer’s. Seniors who require continuous care and monitoring that only skilled nursing services can provide will find nursing homes to be the best setting.

According to estimated costs from the Genworth Cost of Care Survey 2021, Wisconsin seniors will pay $2,990 a month to reside in an independent living community in the state. Assisted living costs approximately $1,500 extra, averaging $4,600 a month. Memory care, which usually takes place in a special assisted living unit, averages $5,750 a month. Seniors in Wisconsin who need constant nursing care will pay $9,022 a month for a semiprivate room in a nursing home.

$4600

Assisted living

$9022

Nursing home facility (semiprivate room)

$2990

Independent Living

$5750

Memory Care

The Cost of Assisted Living in Wisconsin

Wisconsin’s average monthly cost of assisted living of $4,600 is $100 more expensive than the national average of $4,500. Minnesota’s average monthly cost of $4,508 is about $90 cheaper than Wisconsin. Illinois averages $4,488 a month. Iowa is about $121 less expensive than Illinois at $4,367 per month. Michigan has the lowest cost of living in the region at $4,250 a month.

$4600

Wisconsin

$4500

TThe United States

$4508

Minnesota

$4488

Illinois

$4250

Michigan

$4367

Iowa

The Cost of Nursing Care in Wisconsin

Nursing care costs for a semiprivate room can be expensive in the northern states near Wisconsin. In Wisconsin, nursing care averages $9,022 a month, approximately $1,100 a month more expensive than the national average of $7,908. Minnesota is almost $2,500 a month more expensive than Wisconsin, averaging $11,601. Michigan costs $9,095 a month. As you move further south, prices for nursing home care plummet. Iowa costs $6,874 a month, while Illinois is $6,266 a month.

$9022

Wisconsin

$7908

The United States

$11601

Minnesota

$6266

Illinois

$9095

Michigan

$6874

Iowa

Can You Use Medicaid to Pay for Senior Living in Wisconsin?

Many Wisconsinites will need to turn to long-term care as they grow older. Fortunately, Wisconsin has several levels of financial assistance that will help them cover their monthly costs. Medicaid, particularly for Wisconsin seniors who need nursing home care, provides financial assistance that helps them cover long-term care services they cannot afford.

Medicaid covers all eligible seniors in nursing homes. While not directly covered by Medicaid, senior Wisconsinites in assisted living or memory care units are eligible for the Family Care Waiver, which helps with assisted living and memory care costs. Some residents may also qualify for the Program of All-Inclusive Care for the Elderly (PACE), but this is only available in certain counties.

Since independent living is designed for seniors who don’t need assistance with ADLs or medical care, Medicaid does not cover any of these expenses. There are no Medicaid waivers that help pay for the cost of independent living either.


Medicaid Coverage LevelType of Medicaid CoverageEntitlement?* 
Assisted LivingPartialMedicaid WaiversYes
Independent LivingNoneN/AN/A
Memory CarePartialMedicaid WaiversYes
Nursing Home CareFullMedicaid Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” participant caps could be in place, and there may be a waiting list. 

Medicaid’s Coverage of Assisted Living & Memory Care in Wisconsin

The Family Care Waiver helps pay for many costs associated with assisted living and memory care. The Family Care Waiver and PACE will not pay for room and board in assisted living or memory care. PACE assists with other costs of residing in assisted living or memory care units. Wisconsin eliminated waiting lists for all Medicaid waiver services in 2021.

Family Care Waiver

Any Wisconsinite aged at least 65 can apply for the waiver.

Eligible seniors receive assistance with:

  • Case management
  • Activities of daily living (ADLs), including grooming, bathing, dressing, laundry, housekeeping, etc.
  • Transportation to medical appointments
  • Counseling and therapeutic resources
  • Specialized medical equipment

After you make a Family Care Waiver application, a representative from your local Aging and Disability Resource Center (ADRC) will visit to help you complete the Long-Term Care Function Screen. It assesses your need for care services and your financial eligibility to determine if you are functionally eligible for the program. Not every assisted living or memory care unit in Wisconsin accepts the Family Care Waiver, so it’s essential to check with the facility.

PACE

PACE is only available to seniors in Kenosha, Milwaukee, Racine and Waukesha counties. For residents of those counties eligible to receive PACE, the program provides a full range of health care services as well as prescription drugs and long-term care for seniors with chronic needs. Some of the services that PACE delivers include:

  • Primary care, including nurse and physician services
  • Emergency services
  • Dentistry
  • Prescription drugs
  • Medical transportation
  • Physical, recreational  and occupational therapies
  • Hospital and nursing home care
  • Podiatry
  • Optometry
  • Lab services, including X-rays

Aside from living in one of the four counties mentioned above, eligible seniors must be at least 55, qualified for nursing home care and able to live in the community without assistance. Any senior interested in enrolling in PACE should contact their local ARDC for help with enrollment.

Medicaid’s Coverage of Nursing Home Care in Wisconsin

Medicaid covers eligible individuals for nursing home care in Wisconsin if they require nursing home care for at least 30 days. Seniors who are aged at least 65 and meet income and asset requirements are eligible. Seniors must also require a level of care appropriate for nursing home placement.

The same screening tool used to determine eligibility for the Family Care Waiver is used to determine eligibility for nursing home care.

Eligibility for Medicaid in Wisconsin

Seniors who apply for Medicaid or a Medicaid waiver to help pay for assisted living, memory care or nursing home care must meet specific financial requirements. Only those seniors whose financial situation can be categorized as low or very low income will satisfy these requirements. For an individual, they cannot earn more than $30,276 a year. For a two-person household, that figure is $60,0552.

Seniors also have limits on their assets. An individual’s assets may not exceed $2,000 a year. In a two-person household where only one person is applying, the nonapplicant spouse has an asset limit of $137,400. In a two-person household where both seniors are applying, they may only have $4,000 in joint assets when applying for Medicaid long-term care or a Medicaid waiver.

2022 Wisconsin Medicaid Income Limits 



Income Limits*Asset Limits
Single Applicant$30,276$2,000
Two-Person Household
(Only One Person Applying)
$30,276 for applicant$2,000 for applicant
$137,400 for nonapplicant
Two-Person Household
(Both People Applying)
$60,052$4,000 for Medicaid waivers

*Per year

There are additional requirements. Seniors applying for Medicaid must:

  • Be a resident of Wisconsin
  • Be a U.S. national or permanent resident or have legal alien status
  • Need health care/insurance
  • In some cases, require a nursing home level of care

Applying for Medicaid in Wisconsin

You can apply for Medicare in Wisconsin in several ways. You can visit the Wisconsin government Access Online application portal on your computer, tablet or smartphone. You can also download the Wisconsin Medicaid Application Package. Once you have completed the application, you can drop it off or mail it to your local Income Maintenance or Tribal Agency, or you can visit one of these locations where a staff member will help you complete an application. To get more details, you can call (800) 362-3002.

Before You Apply

If you wish to expedite the application process, you’ll need to have several important documents on hand. You can use original documents or photocopies of:

  • Birth certificate
  • Proof of U.S. citizenship or immigration status
  • If married, a marriage document
  • If you’re working, your employer’s name, address and phone number
  • Proof of income, including pay stubs if you’re working or unemployment or Social Security if you’re not
  • The names and ages of everyone in your household

How to Get Help

If you have questions about whether you’re eligible for Medicaid in Wisconsin, several agencies can provide answers or help you obtain coverage.

 Contact What You Should Know
Ombudsman Program(800) 815-0015Besides advocating for seniors in conflict with their long-term care facilities, ombudsmen can also act as impartial third parties that provide seniors with information about Medicare eligibility and assist them with enrollment. They can also help seniors file an appeal when they have been denied Medicaid services or medications.
Wisconsin Medicaid(800) 362-3002Wisconsin Medicaid provides contact information and assistance in applying for Medicaid and details on the 11 different types of Medicaid available to eligible seniors in Wisconsin. This division is a vital source for information and answers to any questions that you may have about Medicaid in Wisconsin.
Covering Wisconsin(608) 261-1455Covering Wisconsin provides information and access to resources on all health care issues in Wisconsin. Its experts can answer questions about enrolling in Medicaid. The organization holds regular workshops for health care professionals and consumers who need information about topics related to Medicaid in Wisconsin.

Can You Use Medicare to Pay for Senior Living in Wisconsin?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.


Medicare CoverageMedicare Coverage DurationCoinsurance Requirement?
Assisted LivingNoneN/AN/A
Independent LivingNoneN/AN/A
Memory CareNoneN/AN/A
Nursing Home CareLimited100 Days Per Benefit PeriodYes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

  • Meals
  • A semiprivate room
  • Medications
  • Skilled nursing services
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Audiologist care
  • Medical supplies
  • Medical social services
  • Nutritional counseling
  • Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support and Resources in Wisconsin

Seniors and caregivers often have important questions about Medicare, such as which plan would be the best for their situation? Do all Medicaid Advantage Plans provide prescription drug coverage? What about out-of-pocket costs? Fortunately, several resources in the state can provide seniors and caregivers with answers to these questions.

Resource
ContactWhat You Should Know
State Health Insurance Assistance Program (SHIP)(608) 266-1865SHIP’s trained volunteer counselors can provide you with free, unbiased and confidential advice about Medicaid and its various options, including Original Medicaid, Medicaid Advantage Plans, long-term care benefits, Part D Prescription Drug Plans and Medigap. Your caregiver can request a meeting with a counselor over the phone or in person. None of the counselors work for a commercial health care company.
Wisconsin Aging Advocacy Network(715) 677-6723The Wisconsin Aging Advocacy Network (WAAN) is composed of organizations and individuals working to shape public policy that improves the quality of life for Wisconsin’s older adults. Its member organizations can provide information on Medicare and other critical health care and quality of life issues for elder Wisconsinites.
Wisconsin Department of Health Services(608) 266-1865The Department of Health lists programs and services available to senior residents in Wisconsin. This includes links to your local Area Agency on Aging, which can answer many of your questions about Medicare, Medicaid and community-based services.

Are There Other Financial Assistance Options for Senior Living in Wisconsin?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Wisconsin. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.


How to Get StartedWhat You Should Know
Aid and AttendanceApply online at va.gov.If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse MortgagesResearch and learn about the different types at ftc.gov.If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) InsuranceLearn about how to receive LTC insurance benefits at acl.gov.While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in Wisconsin

Wisconsin offers seniors several free resources that can assist with health care, legal matters, financial assistance, prescription drugs and dementia care. These resources also provide details on where seniors can find additional free or low-cost services in the state.


ContactWhat You Should Know
Aging and Disability Resource Centers(608) 266-1865Local ADRCs provide seniors with up-to-date information about their communities’ resources. ADRC staff members answer questions about Medicaid, Medicare, transportation for seniors (often free of charge), assisted living and memory care. They also offer information about free legal advice, health care programs, home-delivered meals and nursing home care.
Alzheimer’s Association Wisconsin ChapterSeveral offices are located throughout the state. Find the nearest office here.The Wisconsin Chapter of the Alzheimer’s Association offers information and resources for caregivers and seniors affected by dementia. The chapter can provide information on appropriate assisted living facilities with memory care units, support programs for seniors with dementia and caregivers and what respite care is available in Wisconsin.
Legal Assistance for Older Adults(608) 266-1865Many seniors face complex legal issues but may be hesitant to seek legal advice because of financial constraints. However, seniors aged 60 and older can often find information, advice or even representation on their legal matters at their local ADRC office. Seniors can have questions answered about debt collection, tenants’ rights, Medicaid, Medicare, Supplemental Security Income and utility payments. ADRC staff who provide advice on civil legal issues can’t offer help or provide representation on matters of criminal law, divorces or lawsuits.
SeniorCare Prescription Drug Assistance Program(800) 657-2038The SeniorCare program offers financial assistance with prescription drug medications for seniors aged 65 and older who meet eligibility guidelines. You need to be a resident of Wisconsin and a U.S. citizen or legal immigrant. Your previous year’s annual income determines the level of financial assistance that you can receive. If you’re eligible for SeniorCare, you’re required to pay an annual $30 enrollment fee. You can apply for the program during the calendar month of the year that you turn 65. Benefits begin the month after your application.
Extra Help(800) 772-1213Medicare beneficiaries can save about $5,000 a year on prescription drug costs when they’re eligible for Social Security’s Extra Help. It can help with monthly premiums, annual deductibles and copays related to prescription drug coverage under Medicare. To qualify, seniors must be receiving Medicare and have a low or very low income. You must also live in the United States.

COVID-19 Rules and Restrictions for Wisconsin Senior Living Facilities

The following information is based on research done on several government websites, including dhs.wisconsin.gov/covid-19 and cms.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?Yes
Will my loved one be required to self-quarantine after I visit him or her?No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives? Yes
Are visitors being screened for elevated temperatures?Yes
Are visitors being asked questions about health, travel, and potential virus contact?Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons? Not Available*
Are residents of senior living facilities who leave and return required to self-quarantine? Not Available*
Are senior living facilities required to cancel all group outings?Yes
Are residents still eating together in the dining hall?No
Are facilities still allowed to host group activities within the community?No

*NOTE: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?Yes
Are staff members and contractors being tested for Coronavirus? Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?No
Are staff members required to take residents’ temperatures?Yes
Are residents being tested for coronavirus?Yes (Conditions Apply)

Senior Living Laws and Regulations in Wisconsin

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

The state government sets rules and policies for senior living facilities to abide by to ensure that seniors receive the best care. The two main types of residential senior living facilities in Wisconsin are community-based residential facilities (CBRFs) and residential care apartment complexes (RCACs). The state also licenses adult day care facilities and adult family homes. All are overseen by the Wisconsin Department of Health Services, Bureau of Assisted Living, Division of Quality Assurance.

Admission Requirements

Admission requirements differ depending on the type of facility. CBRFs can admit people with a range of conditions, including dementia and physical disabilities. However, these facilities are designed for people who need an intermediate level of care, which is defined as no more than three hours of nursing care per week. There are people who cannot be admitted, including those who are bedridden, destructive, abusive or present an imminent risk of harm to staff and other residents.

RCACs cannot accept anyone who has been deemed incompetent by a court, physician or psychologist. This is generally defined as someone who is unable to recognize danger, summon assistance, express a need or make their own care decisions. The only exception is if they intend to share an apartment with a competent person who takes responsibility for them, such as a spouse. RCACs can provide up to 28 hours of services each week.

Staffing Requirements

There are no minimum staffing ratios for senior living facilities in Wisconsin; however, facilities must have sufficient numbers available to meet residents’ needs as defined in the service agreement. All staff must receive training in safety procedures, resident rights, abuse reporting and managing challenging behaviors. Additionally, CBRF staff must be trained in medication management. Both RCACs and CBRFs must provide adequate training to ensure that staff can provide all offered services.

Memory Care Regulation

CBRFs that offer memory care must ensure that all staff receive specialized dementia care training. This should cover the characteristics of people with dementia as well as medication and treatment needs. The facility must offer structured activities for people with dementia that are integrated into residents’ daily routine.

Medication Management Requirements

Residents of CBRFs may self-administer medications; however, facilities are licensed to provide medication management. CBRFs can choose to have medication administration supervised by a registered nurse (RN), nurse practitioner or pharmacist, and these individuals will coordinate and inspect the process. If not supervised by one of these individuals, the facility must arrange for a pharmacist to package and label each resident’s medication in individual doses. Certain medications, mainly those not taken orally, must be administered by an RN, licensed nurse practitioner or unlicensed assistant if delegated by a licensed nurse.

RCACs can offer medication administration, which is defined as giving or assisting residents in taking the correct dosage of medication at the right time. Alternatively, they can provide medication management, which is defined as oversight by a health care professional to minimize the risks associated with taking those medications. In both cases, medications can be administered by an RN or an unlicensed staff member under the supervision of a nurse or pharmacist.

Frequently Asked Questions

How much does assisted living cost in Wisconsin?

The cost of assisted living in Wisconsin averages $4,350 per month, which is higher than the national average. There are also significant regional price differences. For example, the average cost in Madison is $3,950, while seniors in Racine pay $4,788, or $838 more per month.

Are there financial assistance programs for assisted living in Wisconsin?

Yes. The Wisconsin Medicaid program Include, Respect, I Self-Direct (IRIS) can help pay for assisted living services. Additionally, the Wisconsin Supplemental Security Income (SSI) – Exceptional Expense Supplement is available to eligible seniors in some assisted living facilities.

What types of care are provided by assisted living facilities?

Most assisted living facilities provide a package of services that support residents’ physical, mental and emotional well-being. This includes assistance with activities of daily care, such as grooming and bathing, medication management and meals. Facilities also arrange activities that encourage socialization and engagement, and many have transportation available to take seniors to medical and other appointments.

What is the difference between assisted living and nursing homes?

The main difference between assisted living facilities and nursing homes is the level of care provided. Both offer assistance with activities of daily living and medication management, but nursing homes can also provide skilled nursing and limited medical treatments. Generally, the environment is different as well. Nursing homes typically provide services in a clinical setting, and assisted living facilities strive to maintain a homelike setting with plenty of social interaction.

Who should consider assisted living?

Assisted living is aimed at seniors who are still mostly independent but need help with some tasks. It’s a good choice for people who are having difficulty with some activities, such as meal preparation, bathing and housekeeping. People who are at risk in their own homes may also benefit from a move to assisted living. This risk may be due to falls, a health condition that requires monitoring or the possibility of forgetting to take an important medication. Lastly, many seniors choose assisted living because it provides a built-in social circle with many activities to keep them engaged.

Learn More About Senior Living in Wisconsin

For more information about specific types of senior living in Wisconsin read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Wisconsin

Learn more about the cost of senior living in the top Wisconsin cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.

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