Wisconsin Medicaid Long-Term Care

Quick answer: Wisconsin covers long-term care through institutional Medicaid and four home- and community-based waiver programs: Family Care, Family Care Partnership, PACE and IRIS. Institutional Medicaid generally applies after 30 or more consecutive days in a medical institution, or an expected stay that long.

Wisconsin splits its long-term-care Medicaid into two related tracks. Institutional Medicaid covers people in a qualifying medical institution — a category that, per the Wisconsin Department of Health Services, includes anyone who has been in a medical institution for 30 or more consecutive days, anyone expected to stay that long, and Community Waivers participants. Medical institutions in this definition include skilled nursing facilities, intermediate-care facilities, hospitals, and institutions for mental diseases, subject to the handbook's other conditions.

For adults who remain in the community, four Home and Community-Based Waiver programs apply: Family Care, Family Care Partnership, PACE, and IRIS. These are built to help elderly, blind, or disabled people stay in community settings instead of a state institution or nursing home, and Medicaid can pay for services these programs cover that ordinary Medicaid wouldn't normally reach.