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Family Care/IRIS vs. Nursing Home Medicaid

Family Care and IRIS pay for care inside the community; nursing home Medicaid is a separate institutional benefit with its own rules.

HomeComparisonsFamily Care/IRIS vs. Nursing Home Medicaid
Short answer

Family Care and IRIS are Wisconsin's home-and-community-based Medicaid programs, covering care services in a CBRF, RCAC, adult family home, or private residence. Nursing home Medicaid is a separate institutional long-term-care Medicaid benefit category with its own income and asset rules, for residents in a licensed skilled nursing facility.

Different settings, different rules

Family Care and IRIS keep someone in the community — a CBRF, RCAC, adult family home, or their own home — but generally do not pay room and board. Nursing home Medicaid is an institutional benefit for residents already in a licensed nursing facility, and covers both room and board plus nursing care once financial eligibility is met.

Exact current income/asset limits for Wisconsin's institutional nursing-home Medicaid pathway were not confirmed from a primary source in our most recent research pass -- pull them directly from DHS's Medicaid eligibility pages before citing a specific figure.

Questions families ask

What is Wisconsin's Long-Term Care Functional Screen?

It's the assessment DHS uses to determine whether someone is functionally eligible for Family Care, IRIS, or other long-term-care Medicaid programs, administered through the local ADRC as part of the enrollment process.

How much does assisted living cost in Wisconsin?

The 2024 CareScout Cost of Care Survey found a Wisconsin statewide median of $73,800 per year (about $6,150/month) for assisted living -- higher than the national median of $70,800/year, and there is no published Milwaukee-metro-specific figure.

How much does a nursing home cost in Wisconsin?

The 2024 CareScout survey found Wisconsin statewide medians of $120,815/year (about $10,068/month) for a semi-private nursing-home room and $135,050/year (about $11,254/month) for a private room -- both above the respective national medians of $111,325/year and $127,750/year.

How much does in-home care cost in Wisconsin?

The 2024 CareScout survey found Wisconsin statewide medians of $82,368/year for homemaker services (about $6,864/month full-time-equivalent) and $86,944/year for a home health aide (about $7,245/month full-time-equivalent) -- both above the national medians and among the 17 highest-cost states surveyed.

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