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Get WI F-10076A 2018-2024

RCare Prescription Drug Program. This is not an application for any other benefit program. For help with this form, contact the SeniorCare Customer Service Hotline at 1-800-657-2038, Monday through Friday, 8:00 a.m. to 6:00 p.m. (TTY and translation services are available.) Help may also be available at your local aging office, senior center, or aging resource center. Information is available on the Wisconsin Department of Health Services (DHS) website at: dhs.wisconsin.gov/seniorcare. IMPORTANT.

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