Wisconsin Medicaid waiver guide
Learn how Wisconsin Medicaid waiver services work, which state agency to start with, how the application process usually begins, and where to search for home and community-based services.
Last reviewed July 2026. See something out of date? Use the “Suggest an edit” button to let us know.
Wisconsin splits adult long-term care into two paths that cover similar ground very differently: Family Care, delivered through a managed care organization, and IRIS — Include, Respect, I Self-Direct — where you manage your own budget and supports. Both start the same way, at your Aging and Disability Resource Center, and both depend on the Long-Term Care Functional Screen. Children are served through the Children's Long-Term Support waiver, which no longer has a waitlist: Wisconsin replaced it with continuous enrollment.
Search by state, city, or ZIP code to compare provider profiles, services, contact details, and verified status.
Adults 18 and older who are frail elders or have a disability, served through a managed care organization
Adults 18 and older who want to direct their own budget and supports rather than use managed care
Children with substantial long-term support needs — enrolled continuously, without a waitlist
For Family Care you must be at least 18, be a frail elder or an adult with a disability, be eligible for Medicaid, be functionally eligible, and have a long-term care condition expected to last more than 90 days. IRIS requires that you live in Wisconsin, be at least 18, be an older adult or an adult with a disability, be enrolled in Medicaid, live in a home, apartment, adult family home, or residential care apartment complex, and be functionally eligible. Both use the same Long-Term Care Functional Screen, and your ADRC must determine functional eligibility no later than 30 days after receiving your request or expression of interest.
The same screen determines functional eligibility for both Family Care and IRIS. Your ADRC must complete the determination no later than 30 days from receiving your request or expression of interest — a deadline worth knowing if things seem stalled.
You must be at least 18, be a frail elder or an adult with a disability, be Medicaid eligible and functionally eligible, and have a long-term care condition expected to last more than 90 days.
IRIS requires Wisconsin residence, age 18 or older, Medicaid enrollment, functional eligibility, and that you live in a home, apartment, adult family home, or residential care apartment complex.
Children apply through their county health and human services agency, which connects the family to a support and service coordinator. Some families pay a parental payment toward the cost of services.
Wisconsin eliminated the Children's Long-Term Support waitlist by moving to continuous enrollment, under which children are served on a first come, first served basis and counties enroll eligible children using a statewide budget. For adults, access runs through the Long-Term Care Functional Screen rather than a queue, with the ADRC bound by a 30-day determination deadline.
Call 844-WIS-ADRC (844-947-2372) to reach your local Aging and Disability Resource Center or Tribal aging and disability resource specialist. ADRCs are the front door for both Family Care and IRIS, and their help is available to the public regardless of income.
Open linkThe screen determines functional eligibility for both programs. The ADRC must complete the determination within 30 days of your request or expression of interest — note the date you first made contact.
This is the central choice. Family Care delivers services through a managed care organization that arranges your care. IRIS gives you an individual budget and lets you hire and direct your own workers with an IRIS consultant's support. Ask your ADRC to walk through both rather than defaulting.
Open linkBoth programs require Medicaid enrollment alongside functional eligibility.
The CLTS program runs through county health and human services agencies, which connect families with a support and service coordinator. Ask about the parental payment, which varies by family size, income, federal poverty guidelines, and service cost.
Open linkExact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.
IRIS is the self-direction program — Include, Respect, I Self-Direct — giving adults an individual budget and the ability to hire and direct their own workers, supported by an IRIS consultant. The CLTS waiver also includes self-directed options for children's services. Choosing between IRIS and Family Care is the most consequential decision in Wisconsin's system.
Both Family Care and IRIS are Medicaid programs. Once enrolled, there is generally little or no direct cost for covered services, though some members have a cost share.
Some families pay part of the cost of a child's services. The amount depends on family size, family income, federal poverty guidelines, and the cost of the services — so it varies substantially and is worth asking your county to calculate before you assume.
Under IRIS you receive an individual budget to arrange your own supports. Ask your IRIS consultant how the budget is calculated from your functional screen and what happens if your needs change mid-year.
Wisconsin removed the CLTS waitlist through continuous enrollment, with children served first come, first served and counties enrolling eligible children using a statewide budget. Apply through your county agency as soon as needs are apparent.
School districts provide special education under an IEP. CLTS services are separate and additional.
Family Care and IRIS both begin at 18, and CLTS is for children. Start the ADRC conversation before the 18th birthday so the functional screen and program choice are underway rather than beginning after children's services end.
Family Care means an MCO arranges your services; IRIS means you direct your own budget and workers. This is the decision that shapes everything afterward, so use the ADRC to understand both before enrolling.
If eligibility or a service is denied, reduced, or ended, you have appeal rights within the deadline printed on your notice, and managed care members generally have a plan-level appeal as well. Wisconsin also has something unusual and useful: Disability Rights Wisconsin runs a dedicated Family Care and IRIS Ombudsman Program for members of those programs, in addition to its general protection and advocacy services.
Protection & Advocacy agency for Wisconsin
1-800-928-8778Visit site844-WIS-ADRC — the front door for Family Care and IRIS
1-844-947-2372Visit siteWisconsin's self-directed long-term care program
Visit siteCLTS eligibility, applying through your county, and continuous enrollment
Visit siteDedicated advocacy for Family Care and IRIS members, through Disability Rights Wisconsin
1-800-928-8778Visit siteLocal help & referrals — dial 211
Visit siteFamily Care delivers services through a managed care organization that arranges your care. IRIS — Include, Respect, I Self-Direct — gives you an individual budget and lets you hire and direct your own workers, with an IRIS consultant helping. They cover similar ground very differently, and this is the most consequential decision you will make in Wisconsin's system.
Your ADRC must determine functional eligibility no later than 30 days from receiving your request or expression of interest. Note the date you first made contact — that is when the clock starts, and it gives you something concrete to point to if things stall.
No. Wisconsin eliminated the Children's Long-Term Support waitlist by moving to continuous enrollment. Children are served first come, first served, and once found eligible the county works to enroll them using a statewide budget.
Possibly a parental payment, which varies by family size, family income, federal poverty guidelines, and the cost of services. Because the formula considers all four, ask your county to calculate your actual amount rather than assuming.
Yes, and it is worth knowing about. Disability Rights Wisconsin operates a dedicated Family Care and IRIS Ombudsman Program specifically for members of those programs, separate from its general protection and advocacy work.
For Family Care you must be at least 18, be a frail elder or an adult with a disability, be eligible for Medicaid, be functionally eligible, and have a long-term care condition expected to last more than 90 days. IRIS requires that you live in Wisconsin, be at least 18, be an older adult or an adult with a disability, be enrolled in Medicaid, live in a home, apartment, adult family home, or residential care apartment complex, and be functionally eligible. Both use the same Long-Term Care Functional Screen, and your ADRC must determine functional eligibility no later than 30 days after receiving your request or expression of interest.
contact your adrc, complete the long-term care functional screen, decide between family care and iris before you are asked, establish medicaid, then enroll and choose providers. Start with Wisconsin Department of Health Services.
Covered services vary by waiver and assessed need, and commonly include in-home supports, respite, supported employment, day services, behavior support, residential supports. Confirm specifics with the state and provider.
Wisconsin eliminated the Children's Long-Term Support waitlist by moving to continuous enrollment, under which children are served on a first come, first served basis and counties enroll eligible children using a statewide budget. For adults, access runs through the Long-Term Care Functional Screen rather than a queue, with the ADRC bound by a 30-day determination deadline.
Approved waiver services are generally covered by Medicaid at little or no direct cost once enrolled, though some enrollees may owe a monthly patient responsibility based on income.
How to reach your ADRC and what the application process involves.
WisconsinWisconsin's self-directed program — eligibility, enrollment, and participant information.
WisconsinCLTS eligibility, how to apply through your county, continuous enrollment, and parental payments.
WisconsinDedicated free advocacy for Family Care and IRIS members through Disability Rights Wisconsin.
WisconsinFind waiver providers and services in Wisconsin on Waiverly.
Looking for another state? Browse the full resource map