- 1). Check eligibility. To enroll in the SeniorCare program, you must be at least 65 years old and a resident of Wisconsin. If you have another form of health insurance with prescription drug coverage, you are still eligible for SeniorCare and the program will coordinate coverage with your insurance provider. If you have Medicaid, you are not eligible for SeniorCare. You may still be eligible if you are temporarily living outside Wisconsin, but are still a registered voter in the state or have a permanent residence in Wisconsin. Check with the SeniorCare Customer Service Hotline at 1-800-657-2038.
- 2). Obtain an application. Applications can be downloaded from the Wisconsin Department of Health and Family Services Web site or your local county or tribal aging office (see Resources).
- 3). Fill out the application. Print all answers in capital letters using blue or black ink. Include your citizenship status, marital status and living arrangements, Social Security number, mailing address where enrollment card should be sent and expected annual income. Non-U.S. citizens should submit a copy of the alien registration card with an application to verify immigration status. If your spouse lives with you, fill in the information for you and your spouse, even if your spouse is not applying for SeniorCare. If your spouse does not live with you, you may leave the spouse information section blank after checking the box "Not Living With Spouse." The expected annual income should include money for you and your spouse. The income from other members of your household is not counted for the purposes of SeniorCare.
- 4). Include all income from the following sources: annual gross Social Security including Medicare premiums if they are withheld; gross wages, salary, bonuses or commissions; interest, dividends and capital gains; net self-employment income; retirement income such as pensions, veterans or railroad retirement benefits, taxable Individual Retirement Accounts or annuities or other income such as cash assistance, unemployment or worker's compensation, alimony, support income or rental payments. The following sources of income should not be included in your expected annual income: Supplemental Security Income; major disaster or emergency assistance payments; payments from an Individual Development Account; reimbursements for expenses given for volunteer work or your job; claims settlement payments for Native Americans; income from the Homestead Tax Credit; low income energy assistance; community service programs; government subsidies for rent, housing or food; Federal Emergency Management assistance; Agent Orange settlement fund or the Foster Grandparents program.
- 5). Submit the application along with the enrollment fee. If you are registering for yourself only, the enrollment fee is $30. If you are registering for yourself and a spouse, the enrollment fee is $60. Make sure to sign the application and read the "Rights and Responsibilities" section before mailing. Mail the application to: SeniorCare, PO Box 6710, Madison, WI 53716.
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