In-Home Care in Wisconsin

Wisconsin is a vibrant state with coastlines on Lake Michigan and Lake Superior, international villages and world-class museums, providing an enriching environment for retirement living. Retirement-aged residents account for nearly 18% of the population, and this demographic is experiencing growth that outpaces any other age group.

Wisconsin is among the more affordable U.S. states to live in, with an overall cost of living that’s about 10% less than the national average and housing prices that are 20% less. The number of doctors per capita is comparatively high, which may make it easier to schedule primary and specialty care services, and access to high-performing medical facilities such as University of Wisconsin Hospitals and Clinics promote lifelong health.

Wisconsin also offers high-quality long-term care options for residents, including numerous home care agencies that provide non-medical services to enable older adults to age in place. On average, seniors in Wisconsin pay $5,529 per month for this type of care. Home health care, by contrast, includes skilled nursing services and typically has higher monthly costs.

This guide provides more information on home care in Wisconsin, including what home care costs in major cities throughout the state and your options for funding services.

Data compiled in the 2021 Genworth Cost of Care Survey shows that home care agencies in Wisconsin charge $5,529 per month on average for 44 hours per week of non-medical care. This is considerably higher than the national average of $4,957, but it’s consistent with care costs in other states in the Upper Midwest. In Minnesota, monthly rates are much higher at $6,673. However, in Iowa and Michigan, rates are the same as in Wisconsin at $5,529. In Illinois, seniors pay $5,339 for services, and in Indiana, rates are among the lowest in the region at $4,767.

Home care rates across Wisconsin are fairly consistent with the state median, though some cities have slightly more affordable care. Green Bay has the lowest surveyed home care rates in the state at $5,053, and in Eau Claire, fees are higher but still cost-effective compared to the state average of $5,339. In Fond du Lac, seniors pay $5,720 for monthly services. In La Crosse, home care agencies charge $5,958, and in Sheboygan, care costs are the highest surveyed in the state at $6,101.

Seniors in Wisconsin have multiple long-term care options to fit their goals, budgets and lifestyle preferences. At $5,529 per month, in-home care is moderately priced compared to other options. Older adults who need skilled nursing services at home pay a slightly higher monthly rate of $5,720. Seniors who want to live at home and conserve more of their retirement income may opt for adult day health care, which is the cheapest option at $1,723 per month. Residential care is a cost-effective alternative to private in-home care, with seniors in assisted living paying $4,600 monthly. Nursing home care provides the highest degree of care outside a hospital and is several thousand dollars more per month than in-home care at $9,022.

Home care can be a considerable expense, but fortunately, qualifying seniors in Wisconsin have access to several programs that may help them cover services. Wisconsin Medicaid provides coverage for medically necessary services. This includes medical home health care services and personal care. The regular Medicaid program also covers transportation services by reimbursing rides using public transportation, non-emergency ambulances and specialized motor vehicles.

Regular Medicaid’s coverage for home care is limited, and the program’s strict financial eligibility guidelines may block care from seniors who need services. To expand coverage and meet the needs of those who aren’t on a low income but are unable to afford home care services, Wisconsin Medicaid has several programs and waivers. These include the Family Care Waiver, the Family Care Partnership Waiver, the IRIS program and the Program of All-Inclusive Care for the Elderly.

Regular Medicaid is an entitlement guaranteed to everyone who qualifies. Waiver programs, on the other hand, have enrollment caps. Even if you qualify for coverage, you may be placed on a wait list if the enrollment limit is met.

Seniors can apply for Medicaid online through ACCESS, Wisconsin’s benefits portal for Medicaid and other income-based assistance programs. Alternately, seniors can fill out a paper application and fax it to (888) 409-1979 (within Milwaukee County) or (855) 293-1822 (outside Milwaukee County). Those who want to apply in person can do so at their local Income Maintenance and Tribal Agency.

What Information You Will Need 

To ensure an efficient enrollment process, you should have information and supporting documents on hand to verify your eligibility. These include:

• Social Security number 
• Birth certificate 
• Driver’s license or state-issued ID 
• Proof of marital status 
• Proof of U.S. citizenship or immigration status 
• Employer information, if relevant  
• Proof of all income 
• Proof of all assets 
• Names and relationships to other members of your household 
• Information for any existing health insurance, such as Medicare 

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

• Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
• Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
• Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
• Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.