Wisconsin Medicaid Fair Hearing Decisions

1.1 / Applications

1.1.1 / Valid application

1.1.2 / Valid signature

1.1.3 / Filing date

1.1.4 / Time frames

1.1.5 / Begin dates

1.1.6 / Denials and terminations

1.2 / Renewals

2.1 / Elderly, Blind, or Disabled

2.1.1 / Disability determinations

2.1.2 / Blind definition

2.1.3 / MAPP disability

2.2 / Residency

2.3 / U.S. Citizen or Qualifying Immigrant

2.4 / Nonpayment of premium

2.5 / Change Reporting

3.1.1 / Fiscal test group

3.1.2 / Availability

3.1.3 / Prospective income

3.1.4 / Exempt and disregarded income

3.1.5 / Unearned income

3.1.5.01 / Income from trusts

3.1.5.02 / Sick benefits

3.1.5.03 / Unemployment compensation

3.1.5.04 / Retirement benefits

3.1.5.05 / General relief and charity

3.1.5.06 / Gifts

3.1.5.07 / Land contract

3.1.5.08 / Loans, promissory notes, and mortgages

3.1.5.09 / Interest and dividend income

3.1.5.10 / Social Security benefits

3.1.5.11 / Property settlement

3.1.5.12 / Lump sum payments

3.1.5.13 / Money for school

3.1.5.14 / Child support

3.1.5.15 / Profit sharing

3.1.5.16 / Income received by members of a religious order

3.1.5.17 / Federal match grants for refugees

3.1.5.18 / Gambling winnings

3.1.5.19 / Payments to Native Americans

3.1.5.20 / Alimony, maintenance, and other spousal support payments

3.1.5.21 / Reimbursement of living expenses

3.1.5.22 / Income allocation from IS to CS

3.1.5.23 / Rental income

3.1.5.24 / REWARD Wisconsin stipends

3.1.5.25 / Certain COVID-19 payments

3.1.5.26 / Virtual currency

3.1.6 / Earned income

3.1.7 / Self-employment income

3.1.8 / Income deductions

3.1.8.1 / Maintaining home or apartment

3.1.8.2 / Support payments

3.1.8.3 / Plan to achieve self-support

3.1.8.4 / Fees to guardians or attorneys

3.1.8.5 / Medical & remedial expenses

3.1.8.6 / Impairment and work-related expenses

3.1.8.7 / $65 and ½ earned income deduction

3.2.1 / Availability

3.2.2 / Separate and mixed assets

3.2.3 / Joint accounts & jointly held real property

3.2.4 / Burial assets

3.2.5 / Trusts

3.2.5.1 / Revocable trusts

3.2.5.2 / 3d-party irrevocable trusts

3.2.5.3 / 1st-party irrevocable trusts

3.2.5.4 / Special needs trusts

3.2.5.5 / Pooled trusts

3.2.6 / Liquid assets

3.2.6.01 / Personal property

3.2.6.02 / Loans (incl. mortgages and promissory notes)

3.2.6.03 / HUD payments

3.2.6.04 / Annuities

3.2.6.05 / Life insurance

3.2.6.06 / Retirement community entrance fees

3.2.6.07 / Income tax refunds

3.2.6.08 / Earned income and child tax credits

3.2.6.09 / Vehicles

3.2.6.10 / Property settlement

3.2.6.11 / Lump sum payments (Social Security, VA Aid & Attendance)

3.2.6.12 / Land contract

3.2.6.13 / Mortgage

3.2.6.14 / Wisconsin Higher Education bonds

3.2.6.15 / Self-support plan assets

3.2.6.16 / Replacing and repairing exempt assets

3.2.6.17 / Retirement benefits

3.2.6.18 / Gifts

3.2.6.19 / US savings bonds

3.2.6.20 / ABLE accounts

3.2.6.21 / Independence accounts

3.2.6.22 / Other/uncommon

3.2.7 Real property

3.2.7.1 Homestead

3.2.7.2 Life estate

3.2.8 Business property (property essential to self-support)

3.3.01 / Penalty period

3.3.02 / Look back period

3.3.03 / Transfers for FMV

3.3.04 / Transfers of exempt income or assets

3.3.05 / Ownership returned before application (cure)

3.3.06 / Transfers made for purpose other than to qualify for Medicaid

3.3.06.1 / Sufficient resources to cover 5 years of LTC or remaining life expectancy

3.3.06.2 / Unexpected need

3.3.06.3 / Pattern of gifting

3.3.06.4 / Resources spent on support of dependent relatives

3.3.07 / Payments to relatives

3.3.07.1 / For room and board

3.3.07.2 / For services

3.3.08 / Divorce or separation action

3.3.09 / Involuntary loss of property

3.3.10 / Intent to sell for FMV

3.3.11 / Undue hardship

3.3.12 / Homestead property

3.3.12.1 / Transfer of homestead property to spouse

3.3.12.2 / Transfer of homestead property to child under 21

3.3.12.3 / Transfer of homestead property to child who is blind or disabled

3.3.12.4 / Transfer of homestead property to caretaker child

3.3.12.5 / Transfer of homestead property to co-owner sibling

3.3.13 / Transfer of assets to spouse / marital property agreements

3.3.14 / Transfer of assets to blind or disabled child

3.3.15 / Trusts

3.3.15.1 / Trusts for disabled individuals

3.3.15.2 / Trusts established by will

3.3.15.3 / Revocable trusts

3.3.15.4 / Irrevocable trusts—created during or after look back

3.3.15.5 / Irrevocable trusts—created prior to look back, payments made to anyone other than institutionalized person

3.3.16 / Gambling losses

3.3.17 / Irrevocable annuities

3.3.18 / Promissory notes, loans, land contracts, and mortgages

3.3.19 / Making an asset unavailable

3.3.20 / Refusal to claim

3.3.21 / Avoiding receipt

3.3.22 / Community spouse divestment

3.3.22.1 / Before 5 years

3.3.22.2 / After 5 years

3.3.23 / Transfer of income in the month of receipt

3.3.24 / Transfer of right to receive income

3.3.25 / Life estates

3.3.25.1 / Life estate—transfer of property for less than FMV

3.3.25.2 / Life estate—divestment by joint owners

3.3.25.3 / Life estate—termination and payment of less than FMV

3.3.25.4 / Life estate—divestment by remainder person

3.3.25.5 / Purchase of life estate in another’s home

3.3.26 / Life insurance funded burial contracts

3.3.27 / Voluntary foreclosure or repossession

3.3.28 / Jointly held assets

3.4.1 / Exempt Assets

3.4.1.1 / Homestead

3.4.1.2 / Vehicle

3.4.1.3 / Burial assets

3.4.1.4 / Retirement assets of community spouse

3.4.2 / Asset assessment / community spouse asset share (CSAS or CSRA)

3.4.3 / Institutionalized person asset transfer to community spouse

3.4.4 / Non-trust income (name on the check)

3.4.5 / Trust income

3.4.6 / Community spouse income allocation (CSIA or MMMNA)

3.4.7 / Dependent family member income allowance

3.4.8 / Dual spousal impoverishment cases

4.1 / Verification

4.2 / Benefits

4.3 / Estate Recovery

4.3.1 / Recoverable services

4.3.2 / Liens

4.3.3 / Estate claims

4.3.4 / Hardship waivers

4.3.5 / Small estates

4.4 / Overpayments

4.5 / Undue hardship

4.6 / Representatives

4.7 / Notices & fair hearings

5.01 / SSI-Related

5.02 / Special Status Medicaid

5.03 / Medicaid Purchase Plan

5.04 / Institutional Long-Term Care

5.05 / Home and Community-Based Waivers Long-Term Care

5.05.1 / Family Care

5.05.2 / Family Care Partnership

5.05.3 / PACE

5.05.4 / IRIS

5.05.5 / Fiscal test group

5.05.6 / Functional screen

5.05.7 / Effective date

5.05.8 / Groups and cost sharing

5.06 / Katie Beckett

5.07 / Tuberculosis

5.08 / Migrant Workers

5.09 / Medicare Savings Programs

5.10 / SeniorCare

5.11 / Emergency Services

5.12 / Long-Term Care Insurance Partnership

5.13 / Wisconsin Well Woman Medicaid

5.14 / Children’s Long-Term Support Waiver

5.15 / BadgerCare Plus

5.16 / Funeral and Cemetery Aids Program