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twelve-month benefit period unless they choose to do so. Deductible: Has a $500/$850 deductible based on Participation Level. Required deductible is prorated based on number of months of eligibility and amount of deductible. Spenddown: Unmet Original FTG of 2 Covered prescription drugs of Spouse 1 used to meet spenddown until Spouse 2 is added. Once spenddown is met, Spouse 1 has a deductible of $850. Projected income from Spouse 1’s application will be used to determine Spouse 2’s eligibility. Covered prescription drugs of both spouses are used to meet the spenddown. Once spenddown is met, Spouse 2 has a prorated deductible.

Spenddown: Met Original FTG of 2 No change in spenddown for Spouse 1. No new spenddown when Spouse 2 is added. Spouse 2 has a prorated deductible. Spenddown: Unmet Original FTG of 1 No change in spenddown for Spouse 1. Spouse 2 has a prorated spenddown and deductible. Spenddown: Met Original FTG of 1 No change in spenddown for Spouse 1. Spouse 2 has a prorated spenddown and deductible.

Note If Spouse 1's eligibility is terminated prior to Spouse 2's request, a new application is required for a new 12- month benefit period. This page last updated in Release Number: 26-03 Release Date: 08/12/2026 Effective Date: 08/12/2026 33.10 SeniorCare Changes 33.10.1 SeniorCare Changes Introduction The following changes must be reported to the SeniorCare program within 10 days: 1. Address (including a change in mailing address or permanent residency outside of Wisconsin). 2. Household Composition (including marriage, divorce, separation, or someone moving to a nursing home or other medical facility). 3. Death. Changes may be reported by phone to the SeniorCare Customer Service hotline at 1-800-657-2038. Changes may also be reported by writing to: SeniorCare P.O. Box 6710 Madison, WI 53716-0710 Members are asked to include an SSN or case number on any written correspondence.