Wisconsin's Family Care program is one of the strongest home care environments in the country because it has no waitlist. Eligible members get services. But Wisconsin added a requirement that changed the enrollment landscape for every HCBS provider: all agencies needed to obtain a Wisconsin Medicaid ID through the ForwardHealth Portal by December 31, 2025, or lose the ability to be paid after April 1, 2026. If you operate in Wisconsin and haven't enrolled, the clock has run. Five MCOs administer Family Care, with Anthem entering as a new MCO in March 2026. Here is the full operational picture.
Wisconsin's managed long-term care program divides into two parallel tracks. Family Care is MCO-managed — the MCO develops care plans, authorizes services, and manages provider networks. IRIS (Include, Respect, I Self-Direct) is participant-directed — members manage their own care budget and hire their own workers. Both have the same financial and functional eligibility requirements. The member chooses which track they prefer.
Both tracks feed from the same entry point: the ADRC. Aging and Disability Resource Centers conduct the Wisconsin Adult Long-term Care Functional Screen, which determines whether a member is functionally eligible for Family Care or IRIS. Members who pass the functional screen and financial eligibility are entitled to services — there is no waitlist in Family Care.
Family Care covers personal care, homemaker, supportive home care, adult day, respite, residential options, and many other supports. Each member is assigned to an MCO based on their county; some counties have multiple MCO options. The MCO care manager conducts needs assessments, develops care plans, and authorizes all services. Providers must be contracted and credentialed with each MCO.
Family Care is statewide. Family Care Partnership (integrated Medicare + Medicaid) is available in select counties and includes an interdisciplinary care team. Income limit approximately $2,901/month (2025). Asset limit $2,000 for individuals.
IRIS gives participants control over their care budget, provider selection, and care management. Members work with an IRIS Consultant Agency for support and use a Fiscal Employer Agency (FEA) to handle payroll and employment tasks. Members can hire family members, neighbors, or community members as their attendants.
IRIS providers still need ForwardHealth Medicaid enrollment. IRIS participants may hire your agency directly as their provider without MCO network credentialing requirements — but your ForwardHealth Medicaid ID is still required to receive payment through IRIS fiscal employer agencies.
Critical: If you have not enrolled with ForwardHealth by December 31, 2025, you cannot be paid for services after April 1, 2026. DHS enforces this for all providers of home and community-based services under adult long-term care waiver programs — including supportive home care agencies (enrollment for these opened August 11, 2025). Applications cannot be backdated. Your effective date is your submission date. Providers who applied late may see a payment lapse while their application is processed. If you are operating in Wisconsin and do not yet have a ForwardHealth Medicaid ID, apply immediately at forwardhealth.wi.gov/WIPortal.
The ForwardHealth Medicaid ID is required for payment from MCOs AND from IRIS fiscal employer agencies. Without it, neither channel can pay you for services after April 1, 2026. The enrollment process can take several weeks — applications submitted in late 2025 or early 2026 may still be processing, and payment lapses are likely for providers who submitted after the December 31 deadline.
Some providers may need to enroll separately for each service location. ForwardHealth enrollment and MCO credentialing are separate processes — ForwardHealth enrollment does not substitute for MCO network credentialing, and MCO credentialing does not substitute for ForwardHealth enrollment. Both are required.
Wisconsin contracts with five MCOs to administer Family Care across different geographic regions. County availability varies — not all MCOs serve all counties. Members in counties with multiple MCO options can choose among available plans. The MCO's care manager is the authorization source for all Family Care services.
| MCO | Geographic Coverage (select) | Notes |
|---|---|---|
| Community Care, Inc. (CCI) | Southeast WI including Milwaukee, Waukesha, Ozaukee, Washington, and others | Largest MCO by enrollment. Strong southeast Wisconsin presence. |
| iCare (merging with Inclusa under Humana) | Multiple counties including Milwaukee | Humana subsidiary; integrating with Inclusa under shared Humana umbrella |
| Inclusa | Multiple counties statewide | Humana subsidiary; email domain transitioning to @inclusa.com from @inclusa.org |
| Lakeland Care, Inc. (LCI) | Northeast and central WI — Door, Florence, Forest, Kewaunee, Langlade, Lincoln, Marinette, Menominee, Oconto, Oneida, Shawano, Vilas, and others | Regional MCO serving northern Wisconsin counties |
| My Choice Wisconsin (Molina subsidiary) | Statewide across many counties including southeast, south central, and western WI | Broad geographic presence; expanding further under Geographic Service Region consolidation |
| Anthem (new) | Entering March 1, 2026 — Geographic Service Region 3 (verify specific counties) | New MCO entering Family Care program March 2026. Credentialing with Anthem is now open for providers in its GSR. |
No. Family Care has no waitlist. Eligible members — those who pass the Wisconsin Adult Long-term Care Functional Screen at the ADRC and meet financial eligibility — receive services. There is no slot cap or interest list. This makes Wisconsin fundamentally different from states like Indiana or Georgia where HCBS programs have waitlists of thousands. Growth in Wisconsin is constrained by your MCO network relationships and clinical capacity, not by state-controlled eligibility queues.
Apply immediately through the ForwardHealth Portal at forwardhealth.wi.gov/WIPortal. Enrollment cannot be backdated to December 31. Your effective date is your submission date. Providers who submitted after the deadline will not be able to receive payment from MCOs or IRIS FEAs until their enrollment is approved — and they cannot backdate payments to cover the gap. If you are currently providing services, you are delivering them without the ability to be paid after April 1, 2026. Submit today. Some providers may also need to enroll separately for each service location.
Under Family Care, you contract and credential with MCOs. The MCO authorizes your services and pays your claims. Referrals come through the MCO care manager. Under IRIS, participants manage their own care and can hire your agency directly — you don't need MCO network credentialing for IRIS participants, but you do need your ForwardHealth Medicaid ID to receive payment through the IRIS FEA. Many agencies serve both Family Care and IRIS members simultaneously. IRIS members typically have more engagement in selecting and managing their providers, which can create a different service delivery dynamic but also stronger referral loyalty.
Wisconsin agencies managing credentialing across five MCOs, ForwardHealth Medicaid enrollment, IRIS participant relationships, and MCO-specific authorization and EVV requirements need operational infrastructure that keeps up with a program that is actively expanding. CareBravo delivers scheduling, EVV compliance, and MCO billing as completed work.