DHA Case No. 204650 (Wis. Div. of Hearings and Appeals May 3, 2022) (DHS) ↓ Download PDF
A resident alien is generally not eligible for public assistance benefits for five years after his or her date of entry. In this case, the petitioner had entered the country less than five years before applying for SeniorCare and none of the exceptions applied. ALJ Brian Schneider concluded the denial was correct.
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Pursuant to a petition filed March 8, 2022, under Wis. Stat., §49.45(5), to review a decision by the Division of Medicaid Services (DMS) to deny SeniorCare (SC), a hearing was held on April 27, 2022, by telephone.
The issue for determination is whether petitioner is an ineligible alien for SC purposes.
PARTIES IN INTEREST:
Department of Health Services
1 West Wilson Street, Room 651
Madison, WI 53703
By: Sara Warwick
Division of Medicaid Services
PO Box 309
Madison, WI 53701-0309
ADMINISTRATIVE LAW JUDGE:
Brian C. Schneider
Division of Hearings and Appeals
Findings of Fact
- Petitioner (CARES # —) is a 65-year-old resident of Dane County.
- Petitioner was born in — and emigrated to the United States from —. Her entry date on her Permanent Residence Card is listed as February 4, 2021. Her residency status is “ —.”
- Petitioner applied for SC on January 31, 2022, along with her husband, who is a U.S. citizen. SC was denied for petitioner by a notice dated February 28, 2022 because she has not been a U.S. resident for five years.
SC is a Wisconsin program providing prescription drug assistance for residents ages 65 and over. It is implemented under the Wisconsin Administrative Code, Chapter DS 109.
To be eligible, a person must be a Wisconsin resident, at least 65 years old, not eligible for regular Medical Assistance (MA), and be a U.S. national or an alien legally residing in the U.S. whose status qualifies her for MA. Wis. Admin. Code §DHS 109.11(1). Since 1996, a resident alien has not been eligible for public assistance benefits for five years after the date of entry into this country. See 8 U.S.C. §1613; note that this prohibition is a federal law, not a state policy. There are exceptions, and they are listed in the MA Handbook, §188.8.131.52, which is attached to the case summary provided by Ms. Warwick prior to the hearing. Petitioner does not meet any of the exceptions to the five-year limitation.
Her Permanent Residence card lists her status as “—.” The — status is a conditional one for an alien whose record of admission is created upon the conclusion of a — after entering as a —. The status fits petitioner’s situation. — (the entry date on the Residency card is based upon the date of application, not necessarily the date of actual arrival in the country). Crucially, her status is not as a refugee, asylee, or other specific status that would make her immediately eligible for the program.
I must conclude, therefore, that the denial of SC for petitioner was correct.
Conclusions of Law
Petitioner is ineligible for SC because she is a permanent alien resident who has not been in this country for five years.
THEREFORE, it is
That the petition for review is hereby dismissed.[Request for a rehearing and appeal to court instructions omitted.]