Financial eligibility for Medicaid generally requires a single individual’s countable, available assets to be less than $2,000. In this case, the petitioner submitted a bank statement in her sole name with a balance of more than $69,000, but her representative argued the funds were actually his. ALJ John Tedesco concluded that because the funds were in a bank account title in the petitioner’s sole name, the agency did not err in denying the application.
This decision was published with support from the Wisconsin chapter of the National Academy of Elder Law Attorneys and Krause Financial.
Preliminary Recitals
Pursuant to a petition filed on May 8, 2025, under Wis. Stat. § 49.45(5), and Wis. Admin. Code § HA 3.03(1), to review a decision by the Marinette County Health & Human Services regarding Medical Assistance (MA), a hearing was held on June 25, 2025, by telephone.
The issue for determination is whether the agency erred in its denial of petitioner’s application for MA.
There appeared at that time the following persons:
PARTIES IN INTEREST:
Petitioner:
—
Respondent:
Department of Health Services
1 West Wilson Street, Room 651
Madison, WI 53703
By: K. Bruett
Marinette County Health & Human Services
Entrance B
1925 Ella Court
Marinette, WI 54143
ADMINISTRATIVE LAW JUDGE:
John Tedesco
Division of Hearings and Appeals
Findings of Fact
- Petitioner (CARES # —) is a resident of Marinette County.
- Petitioner applied for MA.
- She provided a verification of a savings account with a balance in excess of $69,000. That account is not a joint account but is an individual account at —.
Discussion
Medical assistance is supposed to pay for “health care services for qualified persons whose financial resources are inadequate to provide for their health care needs.” Wis. Admin. Code, § DHS 101.01. Generally, a person cannot be eligible if her assets exceed $2,000 or, if married, her and her spouse’s combined assets exceeded $3,000. Wis. Admin. Code, § DHS 103.06(1)(a); Wis. Stat. §§ 49.46(1) and 49.47(4).
In this case, petitioner applied for MA and provided a bank account statement showing a balance far in excess of $2,000. The agency denied eligibility by notice dated 3/24/25.
In her hearing request, — (on behalf of petitioner) stated that the majority of the funds were his and not assets of petitioner. Petitioner included with the hearing request a printed bank statement showing a balance as of 3/6/25 in the amount of $69,738.83. Petitioner’s name is the only name on the statement despite the assertion by — that this is a “joint” bank account. The documents also include a typed and unsigned statement stating that the deposits belong to —.
At hearing, petitioner was represented by —. He argued that the funds belong to him as the checks that were deposited were made out to him. But, the funds have now been deposited in an individual account of petitioner. The facts surrounding the deposit are not at issue here. The only question before me is whether, on this record, the agency made an error in denying MA to a person with nearly $70,000 in a bank account that is available to her. The agency did not.
Conclusions of Law
The agency correctly denied MA eligibility to petitioner due to her assets exceeding the eligibility limit.
THEREFORE, it is
Ordered
That this appeal is dismissed.
[Request for a rehearing and appeal to court instructions omitted.]
If you found this decision useful, sign up for my email newsletter. You’ll get summaries of newly published decisions and a PDF of useful information on estate recovery.