Badgercare:
Wisconsin runs a program, called BadgerCare, for low-income families who have children under the age of 19, are uninsured, and do not qualify for Medicaid. If you do not qualify for Medicaid, this program is another way to get basic insurance.
Medicaid SSI Managed Care Program:
This program provides services to adults with disabilities who receive or are eligible to receive SSI. It covers some people who are also eligible for Medicare, but does not cover any children, people in family care, people in nursing facilities or intermediate care facilities, or anyone participating in the HCBS waiver.
Ages: 19 and older
Community: recreational and wellness programming, transportation
Health: dental, durable medical equipment, early and periodic screening, diagnosis, and treatment, family planning, hearing, hospice, hospitalization, immunization, mental health and substance abuse treatment, laboratory, pediatricians, physician services, skilled nursing facilities, vision, x-ray
Home: home health care, personal care
Social Services: coordination with social and vocational services
Wisconsin Family Care:
This program serves adults with disabilities and other people, including people who are eligible for also Medicare. This program is meant to supplement primary care covered by other insurance.
- Community: transportation
- Health: disposable medical supplies and durable medical equipment, private-duty nursing, intermediate care facilities, in-home psychotherapy, language pathology, mental health community support, occupational therapy, outpatient mental health treatment, substance abuse treatment, physical therapy, respiratory therapy, skilled nursing care, speech therapy
- Home: home health care, personal care
- Social Services: case management
Children Come First:
The goal of this program is to serve children who have mental health needs in their community and help keep them out of institutions. This program provides many services not usually covered by Medicaid and aims to have very personalized care plans. It does not cover people who are also eligible for Medicare, or people who participate in the HCBS waiver.
- Community: community support programs
- Health: crisis management, emergency services, psychiatric hospitalization if needed, inpatient treatment programs for mental health and substance abuse, rehabilitation, support services, outpatient substance abuse treatment
- Social Services: targeted case management
Wraparound Milwaukee (Milwaukee County):
This program provides the same kinds of supports to the same eligible individuals as the Children Come First program, described above. It is a program that takes money that used to pay for institutional treatments and puts it toward community-based care for children with special mental health needs. It provides the same kinds of services as Children Come First, but only to people who live in Milwaukee County.
Restrictions: This program is only run in Milwaukee County.
Wisconsin Partnership Program:
This program is supposed to integrate home and community based services and other kinds of medical care for adults with disabilities and older adults. Some people who are also eligible for Medicare are covered under this plan.
Ages: 18 to 64 for people with disabilities, 65 and over for people with or without disabilities
Level of Care: nursing
- Community: transportation
- Health: dental, durable medical equipment, family planning, hearing, hospice, immunization, hospital services, mental health, substance abuse treatment, laboratory, pharmacy, physician, skilled nursing facilities, vision, x-ray
- Home: home health care
- Social Services: case management
Program of All-Inclusive Care for the Elderly (PACE):
PACE programs are designed for people 55 and older who need nursing care, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary.
Ages: 55 and older
Level of Care: nursing
Restrictions: you must live close enough to an approved PACE care center to be eligible.
- Community: day care, health-related transportation
- Health: primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs
- Home: home care, home and environmental modifications
- Social Services: case management
Work: prevocational services, supported employment