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Assisted Living Wisconsin
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 2024 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.
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The Cost of Assisted Living in Wisconsin
When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Wisconsin and its 62 cities.
The Cost of Assisted Living in Wisconsin's Top Cities
Assisted living prices vary widely throughout Wisconsin. The state capital, Madison, stands out with one of the highest averages at $7,154 per month. Other cities are closer to the statewide average, such as Milwaukee at $5,275. Yet others are cheaper, such as the monthly average of $4,530 in Green Bay, or Milwaukee's similar price of $4,512. Sheboygan also offers savings over the state average, with costs at $4,270 per month.
Wisconsin
$4,992
Madison
$7,154
Milwaukee
$5,275
Green Bay
$4,530
Sheboygan
$4,270
Inflation's Impact on the Cost of Assisted Living in Wisconsin
Assisted living in Wisconsin is consistently more expensive than the national average, a trend that's been exacerbated by inflation. Between 2022 and 2023, statewide rates rose by 16.9%. The national average also increased, but by a more moderate 9.6%. Most neighboring states experienced price increases, but Illinois is an outlier with rates decreasing by 4.4%. In contrast, costs in Michigan rose sharply by 12.1%. Rates also increased in Iowa, although by a slim 2.3%, while costs in Minnesota increased by just 0.8%. Given the range of inflation rates, it's clear that financial planning is essential for seniors in the region.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| Wisconsin | $4,269 | $4,992 | $5,606 |
| U.S. Average | $4,070 | $4,459 | $4,802 |
| Michigan | $3,668 | $4,111 | $4,577 |
| Illinois | $4,959 | $4,742 | $5,313 |
| Minnesota | $4,399 | $4,433 | $4,314 |
| Iowa | $4,770 | $4,879 | $5,006 |
The Costs of Other Types of Senior Living
The price of senior living greatly depends on factors such as levels of medical care, therapeutic services and community amenities. In Wisconsin, independent living is the most affordable option at $2,760 per month. Assisted living adds services such as grooming assistance and housekeeping, so it's more expensive at $6,083. Memory care is the costliest option, offering specialized dementia and Alzheimer's care for $6,083 per month.
Assisted Living
$4,992
Memory Care
$6,083
Independent Living
$2,760
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
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,620 |
| Two Person | 2 | $65,808 | $4,000 |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
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.
- Online: Wisconsin.gov Access
- Paper: Download the Wisconsin Medicaid Application Package
- In-person: Visit your Income Maintenance or Tribal Agency contact office
- Call: (800) 362-3002
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.
| Program | Contact | Services provided |
|---|---|---|
| Ombudsman Program | (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. |
| Wisconsin Medicaid | (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. |
| Covering 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.
Paying for Assisted Living Facilities in Wisconsin
The Medicaid State Plan is the recognized name of Wisconsin's state Medicaid program. The plan includes waivers that help eligible seniors and adults with disabilities pay for services at RCACS and CBRFs.
The amount that facilities can charge residents for room and board is capped for waiver participants. RCACs and CBRFs may charge the current supplemental security income (SSI) federal benefit rate plus any SSI-E benefits received, minus a $45 personal needs allowance (PNA) that residents keep.
SSI-E is a supplemental security income exceptional expense disbursement of $95.99 per month to eligible SSI recipients requiring over 40 hours of services per month. Wisconsin also allows for family supplementation to help pay for room and board, private rooms and additional services not covered by Medicaid. In some states, family supplementation can affect eligibility.
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.
| Name | 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
There are many resources in Wisconsin that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Area Agencies on Aging | Wisconsin's Area Agencies on Aging handles medical and nonmedical needs for older adults. From Medicare counseling and elder nutrition programs that offer meal delivery to homes and senior dining centers where older adults can access meals Monday through Friday along with other health and nutrition support services, these programs help seniors age at home. AAA services also include caregiver assistance, prescription drug help and fall prevention programs to keep older adults in Wisconsin safe and healthy. |
Cash Assistance Programs
Cash assistance programs in Wisconsin provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Wisconsin seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Meals on Wheels | Wisconsin Meals on Wheels supports seniors in communities statewide by offering nutritious meals, supportive services and safety checks. Seniors must be 60 or over or disabled to be eligible, and meals are provided in a congregate setting or via home delivery for those who aren't mobile. Pricing varies depending on circumstances, and some clients qualify for free meals. Seniors may also access varying support services, including emergency meal delivery during bad weather, pet food delivery and transportation to medical appointments. | |
| Wisconsin Elderly Nutrition Program | 608-266-3746 | The Wisconsin Elder Nutrition Program provides home-delivered meals and senior dining options for residents 60 and older. Hundreds of senior dining centers throughout the state offer qualifying Wisconsinites a space to eat, learn about nutrition and engage with other older adults. A locator allows residents to find the dining centers closest to them. To receive home-delivered meals, seniors undergo an evaluation via an at-home visit, and those who qualify can receive fresh or frozen entrees brought right to their doorsteps. |
| Wisconsin FoodShare | 800-362-3002 | The primary government assistance program in Wisconsin for nutritional needs is the Supplemental Nutrition Assistance Program (SNAP), called Food Share. It gives families in need of help the ability to purchase food at their neighborhood grocery stores and, in some cases, restaurants and convenience stores. |
Health Insurance & Prescription Drug Coverage for Seniors
Wisconsin seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin SeniorCare Prescription Drug Assistance Program | 800-657-2038 | SeniorCare subsidizes prescription drug costs for qualifying Wisconsin seniors, covering most medically necessary drugs with only a $5 copay. For coverage, a drug manufacturer must make a rebate agreement with the SeniorCare program. It may require you to use a generic drug rather than a brand name. If you want to make a special request for a brand-name drug, you may appeal for an exception. More that 95% of Wisconsin's pharmacies accept the SeniorCare card. |
Legal Resources
Many organizations offer free or low-cost legal services to Wisconsin seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Long Term Care Ombudsman Program | 800-815-0015 | The long-term care ombudsman advocates for Stoughton seniors in memory care facilities and helps to ensure that they get the scope of care they're entitled to under state rules. Individuals can contact the ombudsman for help with researching memory care facilities in Stoughton and finding ways to pay for services. The ombudsman can also help facilities identify solutions for gaps in residents' care resulting from challenges related to dementia. |
Senior Engagement
Senior engagement resources and programs in Wisconsin help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Senior Employment Program (WISE) | The Wisconsin Senior Employment Program, also known as the Senior Community Services Employment Program, is available to legal residents aged 55 or older. It offers part-time (subsidized) work to seniors who fall within a specific income range and are currently unemployed. Work placements are often in not-for-profit or government agencies. While the added income is a perk, seniors can also form new friendships and gain skills. Residents can apply via their respective counties. | |
| Alzheimer's and Dementia Alliance of Wisconsin (ADAW) | 888-308-6251 | The Alzheimer's & Dementia Alliance of Wisconsin offers education, personal services and family support for individuals impacted by memory loss. The nonprofit can provide care consultations, resource referrals and educational programs. It also hosts social programs and peer support groups for individuals diagnosed with Alzheimer's. |
| Alzheimer's Association Wisconsin Chapter | 800-272-3900 | The Wisconsin chapter of the Alzheimer's Association provides in-home options counseling to help seniors and families navigate the system and make informed decisions regarding residential memory care services. The chapter has in-person and virtual support groups and early-stage engagement activities to help individuals build social connections and gain practical advice. |
| Wisconsin Memory Screening | 608-266-2536 | Provided by Wisconsin's Department of Health Services, memory screening is available in communities throughout the state to improve early diagnosis. Screening also gives families an opportunity to connect with community-based programs and supports and find early intervention programs. |
| Wisconsin Alzheimer's Institute | 414-219-5083 | The Wisconsin Alzheimer's Institute conducts research initiatives, educational programs and clinical care services to support individuals impacted by Alzheimer's and dementia. In addition to its public health programs and community engagement efforts, the organization sponsors the development of memory clinics across the state to ensure Wisconsinites have access to the care services they need. |
Medicaid Resources
Navigating the Medicaid system is often difficult and confusing. Several Wisconsin resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Family Care | 608-266-1865 | Family Care is a home- and community-based waiver program that helps cover the costs of care services disabled adults need at home or in long-term care settings, such as Community-Based Residential Facilities. Two methods deliver services covered by Family Care: aging and disability resource centers throughout the state and managed Financial Assistance for Senior Living & Senior Care care organizations serving different counties and regions. The program intends to keep disabled seniors in their own homes or communities rather than in the state's licensed nursing facilities, improving outcomes and costs for everyone. |
| Wisconsin Include, Respect, I Self-Direct Program | 888-515-4747 | This program, known as IRIS, gives you the power to direct Medicaid funds toward your choice of care options received at home and in the community. You can use your budget to pay for the following services: • Adaptive and communication aid • Counseling and therapy • Daily living skills training • Emergency response systems • Home-delivered meals • Home modifications • Personal care services • Skilled nursing services • Transportation There is no cost to any of these services if your income is low enough unless you exceed your budget. If your income is high enough, the program may expect you to pay a cost-share for services, which it will include in a monthly bill. |
Social Security Offices
Social Security offices in Wisconsin help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Wisconsin resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Homestead Credit | 608-266-2486 | The Department of Revenue provides a property tax credit up to $1,168 for qualifying homeowners. The amount of your credit depends on your income and the number of dependents living in the home. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Wisconsin retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin Home Energy Assistance Program (WHEAP) | 866-432-8947 | The Wisconsin Home Energy Assistance Program provides funds for low-income households in the state that need help paying their heating and cooling bills. It offers benefits on a long-term basis and in crisis situations. To qualify, households must earn 60% or less of the state median income. Meeting this income requirement doesn't guarantee the household will receive benefits as the program has limited funding. |
Veteran's Services
Wisconsin retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Wisconsin VA Benefits and Health Care | The Wisconsin VA Benefits and Health Care options for veterans ages 65 and older are available at locations throughout the state, including medical centers in Madison, Milwaukee and Tomah and outpatient clinics, community-based programs and vet centers in many cities and rural areas. Seniors can access different types of assistance, such as the specially adapted housing program that helps older vets stay in their homes with modifications and additional monthly funding to pay for in-home care. | |
| Wisconsin Veterans Home at Union Grove | 800-947-8387 | Wisconsin Veterans Home in southeastern Wisconsin provides senior veterans with affordable residences and comprehensive nursing services. Its range of medical services includes doctors' visits, social worker care, medical transportation and skilled nursing. |
Assisted Living Laws and Regulations in Wisconsin
The Wisconsin Department of Health Services licenses and regulates all Community-based Residential Facility (CBRFs) and assisted living facilities in Wisconsin. Residential Care Apartment Complexes (RCACs) are also regulated. The department aims to promote facilities that provide adequate, compassionate and consistent care.
| Topic | Rule |
|---|---|
| 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 can accept terminally ill residents or those with dementia, developmental or physical disabilities, brain injuries, AIDS, a history of substance misuse, or mental health conditions. CBRFs can only admit four residents at a time who require 3+ hours of nursing care. CBRFs cannot accept seniors whose needs the facility cannot meet, or are a danger to themselves. RCACs can discharge a resident for harmful behaviors or their need for more skilled nursing than is available. |
| Assisted living scope of care | CBRFs are required to provide leisure activities, transportation, health monitoring, dementia activities, ADL care, medication, and assistance. RCACs must provide housekeeping, assistance with ADLs, health monitoring, and nursing services. RCACs must also provide 24-hour emergency services. The combination of individual services, including preparation and documentation time, must not exceed 28 hours per week per resident. Recreational activities don't count toward the limit. |
| 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. |
| Assisted Living Facility Requirements | CBRFs can offer private or double-occupancy rooms with a shared bathroom. Smaller and medium facilities need one bathroom and shower per eight residents. Larger facilities must have at least one toilet, bath, and shower per eight residents of each gender. RCAC apartments must be independent of all other units and have lockable doors. The apartments must have a separate kitchen with a microwave or stove. Every unit 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; the facility must employ an administrator and enough personnel to meet residents' needs over 24 hours. The facilities need at least one qualified staff member on duty whenever residents are present. One staff member needs to be awake and on duty overnight. 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 | Each CBRF must provide orientation to every employee. Training includes job responsibilities, facility policies, medication management, residents' rights, dealing with changing behaviors, and reporting abuse. Direct-care staff must be trained in assessing resident needs, making service plans. And providing personal care. CBRF administrators need 15 hours of continuing education annually. RCAC staff need fire safety, first-aid, resident's rights, and emergency plan training. |
| 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. |
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