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Wisconsin Medicaid long-term care: Family Care, IRIS and how to apply

Wisconsin pays for long-term care at home through Family Care, where a managed care organization arranges services, and IRIS, where you direct your own budget. Your local ADRC is the starting point for both.

Carevo editorial team Updated October 27, 2026 Source checked by Carevo editorial team, October 27, 2026

Wisconsin pays for long-term care at home through two Medicaid programs run by the Department of Health Services (DHS): Family Care, where a managed care organization arranges your services, and IRIS, where you direct your own supports within a budget. Your local aging and disability resource center (ADRC) is the starting point for both.

The two programs

Family Care. DHS calls Family Care a Medicaid long-term care program for older adults and adults with disabilities. It says DHS pays managed care organizations (MCOs) a monthly amount for each member, and the MCO arranges services based on your needs, situation and preferences, through a network of long-term care providers. Services range from help with daily tasks at home to mental health care. See Family Care in Wisconsin.

IRIS. DHS calls IRIS (Include, Respect, I Self-Direct) a Medicaid long-term care program for older adults and adults with disabilities in which participants or their legal decision makers choose their own supports and services within a budget. You must live in Wisconsin, be 18 or older, be enrolled in Medicaid, be functionally eligible, and live in a home, apartment, adult family home or residential care apartment complex. See IRIS in Wisconsin.

What changed recently

DHS's Family Care page, last revised September 3, 2026, says DHS has ordered My Choice Wisconsin, the contractor for Family Care and Family Care Partnership, to fix problems, and that My Choice Wisconsin will be under corrective action until it meets all requirements. The page does not say what the problems are or how members are affected. Ask your ADRC what it means for your area.

Who does what

  • ADRC or Tribal ADRS: the local office that explains your options, completes the Long-Term Care Functional Screen and helps with enrollment.
  • Income maintenance agency: DHS says you submit the Medicaid application online or on paper to this agency, which checks income limits.
  • Managed care organization: arranges Family Care services.
  • IRIS consultant agency and fiscal employer agent: help IRIS participants plan and handle payroll.

How to apply

  1. Contact your ADRC. DHS says to start there. They complete the functional screen with you.
  2. Apply for Medicaid. DHS says the income maintenance agency checks income limits, and that if you already have Medicaid or meet its income limits, you also meet them for these programs. The page we read does not give dollar limits.
  3. Choose a program. The ADRC tells you whether you can enroll, then helps you choose a program, a managed care organization and a start date. For IRIS, the apply page links to a separate IRIS page.

DHS's page lists no processing times.

Can a relative be paid

In IRIS Self-Directed Personal Care, yes in part. DHS says you may hire family members, and that the person who represents you cannot also be your paid personal care worker. DHS's IRIS policy on electronic visit verification (EVV), dated 11/2025, says non-live-in participant-hired workers must use EVV, and that failing the EVV rules results in disenrollment from IRIS. Live-in workers are not required to use it. Read paid family caregiver in Wisconsin.

What we have not described

We did not read DHS pages on Family Care Partnership, PACE, the Children's Long-Term Care waivers or the rules on spouses and parents as paid workers, so we do not describe them. We state no pay rates or financial limits. Ask the ADRC.

Where Carevo fits

Carevo is a connection platform and directory. We do not run these programs, assess eligibility or vouch for providers. For paid help now, see home care in Wisconsin, home health in Wisconsin, nursing homes in Wisconsin and developmental disability services in Wisconsin.

Programs in Wisconsin

  • Include, Respect, I Self-Direct (IRIS): IRIS lets Wisconsin adults who qualify for Medicaid long-term care choose their own supports within a budget. DHS says participants manage their own workers, with help from a consultant agency and a fiscal employer agent.
  • Family Care: Family Care is a Wisconsin Medicaid long-term care program where a managed care organization arranges your services. DHS says you start with your local ADRC and the Long-Term Care Functional Screen.

Find providers in Wisconsin

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Common questions

Who runs Medicaid in Wisconsin?

The Wisconsin Department of Health Services (DHS). Medicaid.gov lists DHS at 800-362-3002, and DHS's Family Care page lists the same number for Medicaid Member Services.

What is the difference between Family Care and IRIS?

DHS describes both as Medicaid long-term care programs for older adults and adults with disabilities. In Family Care, DHS pays a managed care organization a monthly amount for each member and the organization arranges services. In IRIS, you or your legal decision maker choose supports and services within a budget, with an IRIS consultant agency and a fiscal employer agent to help.

Who is eligible?

DHS says Family Care applicants must be at least 18, be a frail elder or an adult with a disability, qualify for Medicaid, pass the Long-Term Care Functional Screen and have a long-term care need expected to last more than 90 days. IRIS lists similar conditions, including being 18 or older, enrolled in Medicaid and functionally eligible.

How do I apply?

DHS says to contact your local aging and disability resource center (ADRC) or Tribal aging and disability resource specialist. They complete the functional screen with you, help with the Medicaid application, and help you choose a program and a managed care organization.

Can I hire a relative?

In IRIS Self-Directed Personal Care, DHS says you may hire family members to provide your care. DHS says whoever represents you in that program cannot also provide your personal care. We did not read a DHS page on which relatives are excluded, so ask your IRIS consultant agency.

Does Carevo enroll people in Wisconsin programs?

No. Carevo is a connection platform and directory. Your ADRC and DHS handle screening and enrollment.

Sources

Review status: Carevo checked this page against the primary sources listed above. It has not been professionally reviewed by a registered nurse, licensed social worker, benefits counselor or attorney. See our editorial standards.

This page is general information, not financial, legal or medical advice. Rules and services vary by state and by individual circumstances. Use the official sources and decision-maker named on the page. Carevo is a connection platform, not a care provider.