October 2022

DHA Case No. MDV 144813 (Wis. Div. of Hearings and Appeals Jan. 18, 2013) (DHS) ↓ Download the original decision The petitioner in this case spent $195,000 on life-insurance-funded burial contracts (LIFBCs) to become eligible for Medicaid. She bought 13 of them, all for her children and their spouses, at a cost of $15,000 each. […] Read more

DHA Case No. MGE 143573 (Wis. Div. of Hearings and Appeals March 13, 2013) (DHS) ↓ Download the original decision This unusual case is fact-specific, involving the interplay of Community Waiver benefits, the community spouse asset share, and the timing of getting a functional screen from the Aging and Disability Resource Center (ADRC). The issue […] Read more

DHA Case No. MDV 146580 (Wis. Div. of Hearings and Appeals April 23, 2013) (DHS) ↓ Download the original decision In this divestment case, the petitioner divested $85,000 to relatives. Those same relatives afterward paid about $89,000 for the petitioner’s nursing home care. Despite this, the agency found only a partial cure, arguing that only […] Read more

DHA Case No. MGE 148648 (Wis. Div. of Hearings and Appeals Sep. 4, 2013) (DHS) ↓ Download the original decision In this straightforward case, the issue was simply whether paying a private-rate nursing home bill reduced the petitioner’s countable assets. Unsurprisingly, it did. It appears the issue came up because the county chafed against a […] Read more

DHA Case No. FCP 155113 (Wis. Div. of Hearings and Appeals May 14, 2014) (DHS) ↓ Download the original decision The issue in this case was whether overnight caregiver costs counted as a remedial expense, which could be deducted from income before determining the cost share. The agency argued these could not be a remedial […] Read more

DHA Case No. MGE 170367 (Wis. Div. of Hearings and Appeals March 2, 2016) (DHS) ↓ Download the original decision This decision discussed two issues at some length. First, whether payments to the petitioner’s daughter were divestments; and second, whether the petitioner’s former home, now rented at fair market value, was countable. On the first […] Read more

DHA Case No. MGE 160646 (Wis. Div. Hearings and Appeals January 9, 2015) (DHS) ↓ Download the original decision This case involved two main issues: (1) the date the petitioner transferred ownership of a life insurance policy to her Wispact sub-account, and (2) the effect of a pending disability determination on retroactive eligibility. On the […] Read more

Out-of-state home exempted

DHA Case No. MGE 185074 (Wis. Div. Hearings and Appeals March 14, 2018) (DHS) ↓ Download the original decision In this straightforward decision, the petitioner owned home property in Michigan but was admitted to a Wisconsin nursing home. Her Medicaid application was denied because the agency “did not receive timely verification of any circumstance that […] Read more