Page 416

33.1 SeniorCare Introduction SeniorCare is a prescription drug assistance program for Wisconsin residents who are 65 years of age or older and meet the program’s enrollment requirements. SeniorCare is administered by DHS, through EM CAPO. IM consortia and tribal agencies are not responsible for determining eligibility for SeniorCare, but may need to coordinate with workers in the EM CAPO for mixed cases. Mixed cases include people eligible for SeniorCare and: 1. FoodShare, or 2. A Medicare Savings Program, or 3. An unmet Medicaid deductible, or 4. Child care assistance, or 5. Are participating in a Department of Workforce Development (DWD) employment program, such as W-2. Although SeniorCare is a subprogram of Medicaid, only the portions of the handbook that are referenced in Chapter 33 SeniorCare apply to SeniorCare policy. This page last updated in Release Number: 19-01 Release Date: 4/19/2019 Effective Date: 4/19/2019 33.2 Application 33.2.1 SeniorCare Application Introduction An individual interested in participating in SeniorCare must complete a SeniorCare Application form (F- 10076). Applications may be printed from the Department of Health Services' SeniorCare web site at: https://www.dhs.wisconsin.gov/seniorcare/apply.htm. Local Aging and Disability Resource Centers may also have copies of the SeniorCare application. If the applicant is unsure where to obtain an application or wants to have one mailed, they should call 1-800- 657-2038 (TTY and translation services are available). A $30 enrollment fee per person is required as a condition of eligibility. If the enrollment fee is not sent with the application, the eligibility begin date could be delayed (See SECTION 33.3.2 ENROLLMENT FEE). SeniorCare applications should be mailed to: SeniorCare P.O. Box 6710 Madison, WI 53716-0710 Note: For benefit renewal requirements, see SECTION 33.15 ANNUAL ELIGIBILITY RENEWAL. 33.2.2 Application Processing A valid application for SeniorCare is a SeniorCare Application form (F-10076) with the applicant’s: 1. Name, and 2. Address, and