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• With family income at or below the monthly program limit, and
• Who are United States citizens or legal immigrants.
If you are eligible, Medicaid will pay for most health care costs, including nursing home and
community-based care.
Nursing Home Care
Medicaid is a major source of payment for nursing home care. About 64% of all nursing home
residents in Wisconsin receive help with their nursing home costs. To qualify for Medicaid
nursing home benefits, you must require medical, nursing, and/or therapeutic care daily, and
be under a doctor’s plan of treatment. Even if you become eligible for Medicaid, most of your
income must be used to pay nursing home bills, with Medicaid paying the remaining costs.*
When first admitted, many residents of nursing homes can pay for their care themselves. Over
the course of a long nursing home stay, many people use most of their savings to pay for their
care and then become eligible for Medicaid.
*Wisconsin Department of Health Services
Home Health Care
Medicaid may pay for services you receive in your home. However, you must be under a
doctor’s plan of care, have medical needs that can be met in your own home, and receive
services from a home health care agency certified by Medicaid.
Personal Care
Medicaid also pays for personal care, such as assistance with bathing, dressing, eating, or
getting in and out of bed. To be paid by Medicaid, you must be under a doctor’s plan of care,
and you must receive services from a personal care agency certified by Medicaid. You may
also be eligible for a limited amount of necessary household help, such as grocery shopping,
meal preparation, or laundry.
Aging and Disability Resource Centers (ADRCs)
ADRCs are designed to be a single-entry point where older people and people with disabilities
and their families can get information and advice about a wide range of resources available to
them in their local communities. ADRCs help people understand all of the long-term care
options available to them, including publicly funded programs like Family Care, IRIS, and PACE,
as well as private service providers. Information about ADRCs available in your area is available
at dhs.wisconsin.gov/adrc/index.htm.
Spousal Impoverishment Protections
If you are married and have a spouse who is receiving long-term care in a nursing home, the
law permits you to keep a certain amount of monthly income and retain a certain amount of