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Wisconsin Department of Health Services

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Should I Apply?

Am I Eligible?
(ACCESS)

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SeniorCare Application Form and Instructions

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SeniorCare - Prescription Drugs for Wisconsin Seniors

Should I Apply for SeniorCare?

ACCESS to Eligibility Support Services for Health and Nutrition (ACCESS) can help you decide if you should apply for SeniorCare. This is a quick and easy way for people who live in Wisconsin to find out if they may be able to get help with buying prescription drugs. It will also tell you if it looks like you’re eligible for other health and nutrition programs.

ACCESS will ask you some simple questions about yourself, the money you receive, your housing costs and a few other bills. Based on the information you provide, ACCESS will give you an idea of whether you are eligible for SeniorCare. It will provide information on what kind of out-of-pocket expenses you might have to pay and what benefits you would receive. You may print out your results and a SeniorCare application that can be completed and mailed in to apply.

Before you start, you may want to assemble some information about your income information, which may include Social Security payments, pensions, earnings from a job or self-employment, or dividends and interest. The type of documents that may assist you include your pay stubs, last year’s tax return, Social Security Benefit statement, IRS form 1099s or other income documents.

Please keep in mind that ACCESS is just a test to see if you might be able to get benefits. You’ll have to apply for SeniorCare to get a final decision about benefits, but we’ll let you know how to do that.

On the ACCESS Welcome Page you have the option to begin right away or learn more about how to use the Web site.

SeniorCare Application Form and Instructions

Date Last Revised: June 07, 2007