Wisconsin has a larger than average senior population, with 17.5% of its almost 5.9 million residents aged 65 and older. Seniors may enjoy the cost of living in Wisconsin, which is nearly 10 points below the national average. Wisconsin features a number of great hospitals, including the University of Wisconsin Hospital—nationally ranked in seven categories, as well as the Froedtert Hospital and the Medical College of Wisconsin—nationally ranked in three categories.  

The state ranks in the top 10, specifically ninth overall, in our 2022 Senior Living Report, and it’s fifth in the country for community involvement and, perhaps more important for seniors, fourth in affordability. Assisted living costs across the state average $4,600 per month, just $100 more than the national average. 

Wisconsin’s Department of Health Services licenses four kinds of assisted living facilities:

  • Community-based Residential Facilities (CBRFs)
  • Residential Care Apartment Complexes (RCACs)
  • Adult Family Homes
  • Adult Daycare

Community-based Residential Facilities are created for seniors who are semi-independent and require some supportive care but not nursing home level care. This guide will focus on CBRFs: the cost of care in Wisconsin as well as ways to afford care, including Medicaid and Medicare support and free and low-cost resources for seniors in assisted living. 

The Cost of Assisted Living in Wisconsin

According to the Genworth Cost of Care Survey 2021, Wisconsin has a higher cost of assisted living than the national average and other states in the region. Wisconsin’s average cost of assisted living is $4,600. That’s $100 a month more than the national average of $4,500. It’s about $90 a month higher than Minnesota’s average monthly cost of $4,508. Illinois averages $4,488 a month. Iowa costs $4,367 a month. Michigan’s average monthly cost of assisted living is $350 less than Wisconsin, averaging $4,250, the lowest price in the region.

$4600

Wisconsin

$4500

The United States

$4508

Minnesota

$4488

Illinois

$4250

Michigan

$4367

Iowa

Assisted living costs in Wisconsin range within approximately $1,500 of each other. The lowest cost is in Wausau, in the northern part of the state, at $4,125. The highest cost is in Racine at $5,450 a month. Janesville, in the southern part of the state, averages $4,600. Madison, home to the University of Wisconsin and the state capital, costs $4,800 a month. Fond du Lac averages $4,175 a month. Milwaukee, the state’s largest city, is $5,324 a month. Next to the border with Minnesota, La Crosse is $4,263 a month, while Green Bay averages $4,550 a month.

$4600

Janesville

$5450

Racine

$5324

Milwaukee

$4800

Madison

$4175

Fond du Lac

$4450

Green Bay

$4263

La Crosse

$4125

Wausau

Assisted living is not the only option for seniors in Wisconsin. Home care, which includes help with some activities of daily living, light housekeeping and companionship, is $5,529 a month. Home health care, just like home care but includes medical assistance, is approximately $200 a month more expensive at $5,720. Adult day care remains the least costly option at $1,723 a month. Seniors who need more intensive care at a nursing facility, in a semiprivate room, can expect to pay an average of $9,022 a month.

$5529

Home Care Services

$5720

Home Health Care

$1723

Adult Day Health Care

$4600

Assisted Living

$9022

Nursing Home Facility (semiprivate room)

Does Medicaid Cover Assisted Living in Wisconsin?

While Wisconsin’s Medicaid plan covers nursing home care for senior and disabled individuals, it does not directly cover assisted living. Instead, Wisconsin has a Medicaid waiver, known as the Family Care Waiver, that seniors can use to help cover costs for services in assisted living facilities. Seniors can obtain waivers in all of Wisconsin’s 72 counties without having to go on a waiting list if they’re eligible.

What Assisted Living Services Are Covered by Medicaid in Wisconsin

The Family Care Medicaid Waiver helps individuals aged 65 and older who need help with activities of daily living pay for long-term care services, including room and board, in a Medicaid-certified CBRF or RCAC.

Assisted Living Waiver Programs in Wisconsin

Family Care Waiver

The Family Care Waiver coverage includes:

  • Case management
  • Assistance with activities of daily living (ADL)
  • Counseling and therapeutic resources
  • Specialized medical equipment and supplies
  • Transportation
  • Room and board

Not every CBRF or RCAC will accept the family care waiver, so it’s important to check first. Facilities that participate in the Family Care Waiver must follow strict residential rights regulations, such as providing transportation services and the proper amount of required space.

The plan is open to all low-income individuals aged 65 and older or those who are disabled. A representative of your local Aging and Disability Resource Center (ADR) will visit to help you complete a web-based application called Long-Term Care Functional Screen, which assesses your level of need for services and functional eligibility for the Family Care benefit.

How to Know If You’re Eligible for Medicaid in Wisconsin

To be eligible for Medicaid in Wisconsin, you must meet specific financial requirements. Your financial income needs to be characterized as low-income or very low-income (see actual limits below). The number of assets you own also has limitations, although if you live in a household where only one person is applying for Medicaid, the other spouse has a much larger asset limit.

2022 Medicaid Income Limits for Seniors in Wisconsin

Annual Income Limits

Asset Limits

Single Applicant

$17,131

$2,000

Two-Person Household

(Only One Person Applying)

$23,169

$2,000 for applicant

$137,400 for non-applicant

Two-Person Household
(Both People Applying)

$23,169

$3,000 for regular Medicaid

$4,000 for a Medicaid waiver

In Wisconsin, there are more than just financial requirements for Medicaid:

  • You must be a resident of the state, a U.S. national, a permanent resident or a legal alien
  • You must need health care/insurance

You must also be one of the following:

  • Have a disability or a family member living with you who is disabled
  • Be at least 65 years of age

How To Apply For Medicaid In Wisconsin

Wisconsin has several Medicare plans and ways to apply.

Information you’ll need includes:

  • Social Security number
  • Date of birth
  • Marital status
  • Address
  • U.S. citizenship or immigration state
  • Job information, including employer’s name, address and phone number
  • Job income
  • Other income, such as Social Security or unemployment compensation
  • Household composition

How to Get Help Applying for Medicaid

Several agencies and programs help Wisconsin seniors determine and get the Medicaid coverage they need. The resources below can assist you in finding the best plan for your needs, learning about Medicaid benefits and disputing a denied application or service.

Resource 

Contact 

Description 

(800) 815-0015

The local Long-Term Care Ombudsman Program serves as an impartial third party regarding denied Medicaid applications or claims for prescription drug coverage. It can help you determine why Medicaid denied you coverage and how you should reapply. Individuals can contact the ombudsman if Medicaid refuses to cover necessary medications.

(800) 362-3002

The Wisconsin Medicaid site has all the details for everything you need to know about applying for Medicaid or the Family Care Waiver in Wisconsin. You'll find details and contact information on all 11 different Medicaid plans available in Wisconsin.

(608) 261-1455

Covering Wisconsin, a federally certified and state-licensed entity, offers free expert help with health insurance questions in Wisconsin. This includes questions about how to enroll in Healthcare.gov or Medicaid in Wisconsin. If you have questions, you can call one of Covering Wisconsin's navigators for assistance.

Does Medicare Cover Assisted Living in Wisconsin?

The short answer is that no, Medicare does not cover the cost of assisted living in Wisconsin. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Wisconsin.

Other Financial Assistance Options for Assisted Living in Wisconsin

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Wisconsin

Budgeting is very important for many seniors, as is access to important information about health care and other important resources. The following offer details on health care, legal assistance and finding other vital resources available for free or at low cost for seniors in Wisconsin.

Resource

Contact

Service

(608) 266-1865

You'll find free, unbiased and accurate answers to many of your questions at the local Aging and Disability Resource Center (ADRC), including nursing and housing options, transportation, Medicare, Medicaid and home-delivered meals programs.

(608) 266-1311

Wisconsin offers assisted living for senior veterans and their spouses in three veterans' homes throughout the state. These homes provide assisted living within a broader community and include help with ADLs, medication administration and skilled nursing care if needed.

(800) 815-0015

In Wisconsin, long-term care ombudsmen are specially trained volunteers who advocate for seniors in conflicts with assisted living facilities. When an ombudsman receives an alleged complaint of neglect or abuse from a senior or caregiver, they investigate the allegation. When their investigation is complete, they attempt to resolve the conflict between the senior and the facility. Ombudsmen also advise seniors on billing issues, questions about Medicaid or Medicare and where they can find resources in their community. They also act to educate the broader community about the rights of seniors in long-term care facilities.

(608) 266-1865

If you live in Wisconsin, are aged 60 or older and need information, advice, or legal representation, contact an elder benefit specialist at your local ADRC. Benefit specialists give free, confidential counseling and advocacy on a wide range of services, including Medicare, Medicaid, senior care, Supplemental Security Income (SSI), debt collection, housing and utilities, evictions, tenant rights, and financial assistance programs.

(608) 266-1865

Seniors often have questions about applying for Medicare. The trained volunteers of Wisconsin's SHIP program can answer these questions. They provide free, confidential advice on all of Medicare's programs, including Original Medicare, Medicare Advantage, Medigap, Part D Prescription Plans and Long-Term Care Insurance. They work with seniors or their caregivers. Appointments with SHIP counselors can happen in person or over the phone, and they do not work for any commercial health care company.

COVID-19 Rules for Assisted Living in Wisconsin

The following information is based on research done on several government websites, including The Wisconsin Department of Health. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Wisconsin Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Wisconsin Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Not Available*

Are residents who leave required to quarantine when they return?

Not Available*

Are senior living communities required to cancel all group outings?

Yes

Are residents allowed to eat meals together in a common area?

No

Are residents allowed to gather in common areas for group activites?

No

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

COVID-19 Safety Measures for Staff and Residents

Rules for Wisconsin Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in Wisconsin

The Wisconsin Department of Health Services licenses and regulates all assisted living facilities in Wisconsin. The department aims to promote facilities that provide adequate, compassionate and consistent care.

WISCONSIN LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

All prospective residents in a CBRF are assessed for their physical and mental conditions and abilities before admission.

The facility must then develop a temporary service plan to address the resident's immediate needs and a comprehensive plan within 30 days of admission. Reassessments are performed annually or anytime a resident has a change in condition.

RCACs perform similar evaluations.

Assisted living admission requirements

CBRFs are licensed to accept terminally ill residents or those who may have dementia, developmental or physical disabilities, brain injuries, AIDS, a history of drug abuse or alcohol abuse or mental health issues. CBRFs can only admit four residents at a time who require three or more hours of weekly nursing care. They cannot accept seniors who have needs that the facility cannot meet or are a danger to themselves.

RCACs can admit more independent seniors. However, a senior who wishes to live alone cannot be determined by a court to be incompetent, subject to guardianship or incapable of recognizing danger or summoning help.

Assisted living scope of care

CBRFs are required to provide:

  • Leisure activities
  • Supervision information and referral services
  • Transportation
  • Health monitoring
  • Dementia activities

  • ADL care
  • Independent living skills
  • Medication assistance and administration
  • Behavior management

RCACs must provide at a minimum:

  • Housekeeping
  • Personal services, including assistance with ADLs
  • Health monitoring
  • Nursing services, if needed
  • Medication administration

RCAC must also provide 24-hour emergency services.

Assisted Living Medicaid Policy

Wisconsin's Medicaid program provides waiver options for seniors who qualify for nursing care but don't require the intensive care setting it provides. Waiver participants can't be charged more than the current Social Security Insurance federal benefit rate and SSI-E disbursement for room and board.

Wisconsin allows family supplementation for room and board fees, private rooms and additional services.

Not all facilities accept Medicaid as a form of payment. Contact your prospective assisted living facility for its policy.

Assisted Living Facility Requirements

All assisted-living facilities in Wisconsin have minimal faculty requirements concerning occupancy, showers, bathrooms and sinks.

CBRFs can offer private or double-occupancy rooms with a shared bathroom. Smaller and medium facilities must have one bathroom and shower for every eight residents. Larger facilities must have at least one toilet, bath and shower for every eight residents of each gender.

RCAC apartments must be independent of all other units and have lockable doors. Only a resident's spouse or a roommate of their choosing can live with them in the apartment. The apartments must have a separate kitchen that includes a microwave or stove. Units also require a sleeping and living area, although they don't need different rooms. Every department needs a bathroom with a door, toilet, sink and shower or tub.

Medication Management Regulations

Residents of CBRFs found capable by their physicians can self-administer medications. Trained staff members may administer medication for other residents under the supervision of a registered nurse, a nurse practitioner or a pharmacist.

Residents of RCACs will administer their medications or have them administered by trained staff who are supervised by a registered nurse or pharmacist.

Staffing Requirements

There is no minimal staff to resident ratio in a CBRF in Wisconsin, but the facility must employ enough personnel to meet residents' needs over 24 hours. The facilities need to have at least one qualified staff member on duty whenever residents are present. One staff member needs to be awake and on duty overnight whenever any resident has intermittent care needs or cannot evacuate the facility within four minutes.

RCACs need to have enough staff to meet all planned and unplanned needs of the residents. They also need a service manager to ensure that each resident's needs are met.

Staff Training Requirements

Wisconsin requires each CBRF facility to provide orientation training to every employee before hiring. This training includes their job responsibilities, facility policies, medication management for residents, residents' rights, dealing with changing behaviors and reporting abuse.

Direct care staff must be trained in assessing the needs of each resident, how to develop a service plan and how to provide personal care. CBRF administrators must receive 15 hours of relevant continuing education each year.

RCAC staff need to be trained in fire safety, first-aid, resident's rights and the emergency plan for the facility.

Direct care staff need to be trained in the characteristics of aging within the RCAC's population, their assigned responsibilities and the philosophy and purpose of assisted living.

Background Checks for Assisted Living Staff in Wisconsin

CBRFs need to conduct background checks on all employees before hiring and every four years after that. They cannot employ anyone convicted of certain crimes. RCACs must perform a background check on all employees or caregivers directly in contact with residents. They need to use the Wisconsin Department of Justice and state registries.

Requirement for reporting abuse

If you believe a facility has not lived up to its responsibilities, contact the Long-Term Care Consumers Board or the Long-Term Care Ombudsman.

If you or someone you love has been abused, call Wisconsin's Victim Resource Center at (800) 446-6564. If that abuser is a caregiver, contact the office of caregiver quality at (608) 261-8319.

Assisted Living Facilities in Wisconsin (142)