Assisted Living in Wisconsin
Wisconsin is an attractive state for seniors looking for a place to retire. It has approximately 5.9 million residents, and 17.5% are aged 65 and older. Wisconsin’s cost of living is nearly 10 points below the national average. Wisconsin offers an assisted living waiver to help those on Medicaid pay for care, and seniors aged 65 and older are allowed an additional $250 personal exemption on state taxes. According to the Genworth Cost of Care Survey for 2021, Wisconsin has an average assisted living cost of $4,600 a month.
Wisconsin has several different designations for assisted living facilities. Community-Based Residential Facilities (CBRFs) house seniors who live semi-independently and may need supportive care but not to the extent that they would in a nursing home. Independent seniors typically live in facilities that are licensed as a Residential Care Apartment Complex (RCAC).
This guide presents information on the cost of assisted living in Wisconsin, financial assistance programs, and a guide to free and low-cost resources for seniors in Wisconsin.
How Much Does Assisted Living Cost in Wisconsin?
Wisconsin’s cost of assisted living is slightly higher than other states in the region and the national average according to the Genworth Cost of Care Survey for 2021. Wisconsin’s assisted living cost of $4,600 a month is $100 more than the national average of $4,500. Minnesota is approximately $90 a month less expensive at $4,508. Michigan is $350 a month less costly at $4,250. Illinois is $112 cheaper at $4,488 a month. Iowa’s average assisted living cost is moderate at $4,367 a month.
The United States
The Cost of Assisted Living in Wisconsin’s Top Cities
Wisconsin has a wide range of assisted living costs. Wausau, located in northern Wisconsin, costs $4,125 a month. In the southeast corner of the state near Milwaukee, Racine has the highest average assisted living cost of $5,450 a month. Madison, the state capital, averages $4,800 a month. Fond du Lac costs $4,175 a month. Janesville, near the southern border with Illinois, matches the state average of $4,600 a month. On the western border with Minnesota, La Crosse is $4,263 a month. Green Bay, home of the Packers, costs $4,450 a month. The state’s largest city, Milwaukee, averages $5,324 a month.
Fond du Lac
The Cost of Assisted Living vs. Other Types of Care
Older adults have a choice of senior living options in Wisconsin besides assisted living. Adult day care is the least expensive option at $1,723 a month. Home care, which provides assistance with some activities of daily living (ADLs), averages $5,529 a month. Home health care, which includes the same services as home care but with additional medical support, averages $5,720 a month. A semiprivate room in a nursing facility costs $9,022 a month, making it the most expensive option for seniors.
Home health care
Adult day care
Nursing care (semiprivate room)
Can You Use Medicaid to Pay for Assisted Living in Wisconsin?
While you cannot use Medicaid to pay for assisted living costs in Wisconsin directly, the state does offer a Medicaid waiver, the Family Care Waiver, which can help seniors cover expenses in assisted living facilities.
The frail elderly, which consists of Wisconsinites aged 65 and older who need help with ADLs, can use the Family Care Waiver to help pay for long-term care services in a Medicaid-certified CBRF or RCAC. This program does not pay for room and board.
Medicaid Coverage of Assisted Living in Wisconsin
Financial assistance under the Family Care Waiver includes assistance with ADLs, transportation, therapeutic and counseling resources and access to medically appropriate supplies and equipment based on the senior’s needs.
Facilities that accept the Family Care Waiver must follow strict residential rights regulations. Eligible seniors should always check with providers as not every CBRF or RCAC participates in the program.
Waiver Programs for Assisted Living in Wisconsin
Family Care Waiver
All low-income Wisconsinites who are aged at least 65 can apply for the waiver. Any individual who is disabled, regardless of age, can also apply. After an individual makes an application, a representative at their local Aging and Disability Resource Center (ADRC) will help them complete the Long-Term Care Functional Screen. This assessment helps determine your need for services and your financial and functional eligibility.
Eligible Wisconsinites receive help with ADLs, transportation and medical equipment, excluding room and board.
Eligibility for Medicaid in Wisconsin
Seniors who wish to apply for Medicaid in Wisconsin must meet specific financial requirements. Their income must be low or very low (see the table below). Medicaid also places limits on assets. If only one senior in a household is applying for Medicaid, the other senior’s asset limit is much higher.
2022 Medicaid Income Limits for Seniors in Wisconsin
|Income Limits*||Asset Limits|
(Only One Person Applying)
|$30,276 for applicant||$2,000 for applicant|
$137,400 for non-applicant
(Both People Applying)
|$60,552||$3,000 for regular Medicaid|
$4,000 for a Medicaid waiver
Besides financial limitations, seniors and others need to meet specific requirements to apply for Medicaid.
- They must be a resident of Wisconsin.
- They must be a U.S. national, a permanent resident or have legal alien status.
- They must need health care/insurance.
Individuals who are eligible for Medicaid include:
- Low-income women who are pregnant
- Anyone responsible for a blind child aged 18 or younger
- Anyone who has a disability or lives with a disabled family member
- All Wisconsinites aged at least 65 who qualify financially
Applying for Medicaid in Wisconsin
There are several ways to apply for Medicaid, including:
Online: Apply at the Wisconsin.gov Access application portal.
Paper: Download the Wisconsin Medicaid Application Package. Once you have completed the application, you can visit your Income Maintenance or Tribal Agency to submit your application. You can also send it by mail.
In-person: Visit your Income Maintenance or Tribal Agency office to apply in person.
Telephone: For more information on how to apply, call (800) 362-3002.
Before You Apply
Whether you apply online, via mail or in person, you’ll need to have certain information or documents available, including:
- Birth certificate
- If married, a marriage document
- Proof of U.S. citizenship or immigration status
- If you’re working, your employer’s name, address and phone number
- Recent paycheck stubs that show income
- Other income, such as unemployment or Social Security
- The names and ages of everyone in your household
Where to Go to Get Help
If you have questions about whether you’re eligible for Medicaid in Wisconsin, several agencies can answer your questions or help you obtain coverage.
|Ombudsman Program||(800) 815-0015||While most people think of ombudsmen as advocates for seniors in long-term care facilities, they can also answer questions about Medicaid eligibility and assist with applications. If Medicaid denies an application or refuses to cover necessary medications, the ombudsman can determine why and help seniors reapply.|
|Wisconsin Medicaid||(800) 362-3002||Wisconsin Medicaid offers answers to almost every question that you might have about applying for Medicaid in Wisconsin. It also provides contact information for assistance in applying for coverage and details on the 11 different types of Medicaid available to eligible Wisconsin residents.|
|Covering Wisconsin||(608) 261-1455||Covering Wisconsin offers free expert help if you have questions about how to enroll in Medicaid. Federally certified and licensed by Wisconsin, Covering Wisconsin also holds regular workshops and information sessions for consumers who need information about health care and for professionals who design health care programs.|
Can You Use Medicare to Pay for Assisted Living in Wisconsin?
Unfortunately, Medicare does not cover the cost of assisted living in Wisconsin. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.
For more information about Medicare visit medicare.gov.
Are There Other Financial Assistance Options for Assisted Living in Wisconsin?
|How to Apply||How It Works|
|Aid and Attendance||Apply 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 Mortgages||Research 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) Insurance||Learn 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 and Low-Cost Resources for Seniors in Wisconsin
Wisconsin offers seniors several helpful free resources that can answer questions about health care, legal matters and low-cost prescription drugs. They also provide details on where to find additional free or low-cost services in the state.
|Aging and Disability Resource Centers||(608) 266-1865||Local Aging and Disability Resource Centers (ADRCs) and Area Agencies on Aging work together to provide Wisconsin seniors with free and accurate information about resources available in their communities. ADRCs answer questions about Medicaid and Medicare and where and how to find transportation, nursing home and assisted living options, home-delivered meals, health care programs and many other free resources.|
|Wisconsin Department of Veterans Affairs||(608) 266-1311||Assisted living is available to Wisconsin’s senior veterans and their spouses or their survivors in three veterans’ homes located across the state. Veterans and their spouses live in community settings that provide assistance with ADLs, medication management and skilled nursing care. The department offers financial assistance programs for low-income veterans to help offset the cost of staying in a facility.|
|Legal Assistance for Older Adults||(608) 266-1865||Seniors in Wisconsin who are aged 60 or older and need advice, information or representation related to a civil legal matter can contact the elder benefit specialists at their local ADRC. The benefit specialists can provide legal information on subjects, such as Medicaid, Supplemental Security Income (SSI), Medicare, issues with housing, utility payments, tenants rights, debt collection and how to apply for financial assistance programs available to seniors.|
|State Health Insurance Assistance Program (SHIP)||(608) 266-1865||If you or your caregivers need information about Medicaid, how to apply and what’s the best Medicaid program for you, Wisconsin’s SHIP counselors can help. These trained volunteers can provide you with free, unbiased and confidential advice about Medicare’s various options, including Original Medicare, Medicare Advantage, long-term care insurance, Part D Prescription Drug Plans and Medigap. You can request a meeting with a counselor either over the phone or in person. The program’s counselors will never tell you to purchase a commercial plan and none of them work for a commercial health care company.|
|SeniorCare Prescription Drug Assistance Program||(800) 657-2038||Your annual income determines your level of SeniorCare assistance and how much of your prescription drug costs it will cover. Every senior enrolling must pay an annual $30 fee. The first time you can apply is during the calendar month of your 65th birthday. You need to be a resident of Wisconsin, a U.S. citizen or legal immigrant and at least 65 years of age to apply.|
COVID-19 Rules for Assisted Living in Wisconsin
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)|
Assisted Living Laws and Regulations in Wisconsin
The Wisconsin Department of Health Services regulates and licenses all assisted living facilities, including CBRFs and RCACs. The department is also responsible for overseeing adult family homes and adult day care facilities. It ensures that these facilities follow relevant regulations and provide compassionate and consistent care.