The Complete Guide for Wisconsin Lawyers
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When I started practicing elder law about ten years ago, I learned the basics from a national group that provided training, drafting software, and business coaching. I also took advantage of resources like the State Bar of Wisconsin’s Advising Older Clients and the Wisconsin chapter of NAELA’s yearly winter workshop and e-list. But these resources, valuable as they were, often failed to answer my specific questions.
I needed one resource to collect and organize all the knowledge I required. That knowledge included not just federal and state law, but Wisconsin-specific strategies and how to execute them. I needed to know state policy and how it actually plays out across our state. I needed to know how to guide a client through planning and applying for Medicaid.
To this day, little has changed. Unless you are fortunate enough to learn directly from an experienced elder law attorney, you’ll have to figure out a lot of this on your own. Because that is time-consuming and risky, many Wisconsin lawyers won’t touch Medicaid with a ten-foot pole.
That’s a shame. Wisconsin needs more elder law attorneys. Our population will only get older in the coming decades, requiring ever more long-term care. Qualifying and applying for Medicaid is a confusing, anxious, and threatening process for the people of Wisconsin. They need lawyers who can navigate it on their terms.
That’s why I’m writing Essential Medicaid Planning—to make it possible for any Wisconsin lawyer to competently handle a Medicaid case. Medicaid has a reputation of being complex and difficult to navigate, even for lawyers. But I believe that problem can be solved with good, creative research and writing. With the right guide, anyone can competently handle their first Medicaid cases.
Essential Medicaid Planning is inspired by the Essentials program at the yearly WINAELA Winter Workshop. That program is a crash course in Medicaid planning that covers the essential topics: eligibility, income, resources, spousal impoverishment, divestment, applications, and estate recovery. It is probably the best place for a new Wisconsin elder law attorney to start. But the program can only do so much in three hours, and it only happens once a year. What if it could be expanded, delving deeper into each essential topic? What if it were organized, indexed, searchable, and easily accessibile throughout the year? That is what I hope to accomplish in Essential Medicaid Planning.
I recently wrote a column about the need for better resources for the Elder Law and Special Needs Journal of Wisconsin. To learn more about why I’m writing Essential Medicaid Planning, click the button below:
Read: On the Need for Better Resources
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To get access to Essential Medicaid Planning, subscribe to ELWPro.
Essential Medicaid Planning is a book in progress that will be published on this site. My goal is to publish a new segment and deliver a new live webinar every few weeks, finishing the first edition by January 28, 2027. The book will include:
- Eight chapters on how to actually plan for Medicaid in Wisconsin, including asset protection, irrevocable trusts, divestment planning, spousal impoverishment planning, estate recovery, the application process, and more;
- The checklists, procedures, and forms you’ll need as you work on your first Medicaid cases;
- Calculators for important planning numbers, like patient liability, cost share, and divestment planning; and
- One-hour CLE webinars on the topic of each segment as it is published, available live and on-demand (10.0 CLE total, pending approval).
While I am launching ELWPro and Essential Medicaid Planning, the subscription will have introductory pricing of $25/month for the first year (through the end of 2027).
Contents
Links will be added as each chapter is published.
Chapter 1—Getting Started in Medicaid Planning
Who this guide is for. What it promises to do. Why elder law. Who am I, why trust me. How Medicaid goes wrong for clients and their lawyers. Two main problems: ignorance of the law and inaccuracy about facts. Delay, time, deadlines. Sources of law. Process overview. Resources needed to get started. Getting clients, first contacts, consults. Hiring, engagement agreements, fees.
Part I: Understanding the Medicaid Rules
Chapter 2—Nonfinancial Eligibility
US citizen or qualifying immigrant. Wisconsin residency. Elderly/blind/disabled. Functional eligibility: need for LTC and target groups. Client FAQs.
Chapter 3—Financial Eligibility
Income eligibility. Resource limit. Countable resources. Exempt resources. Available vs. unavailable resources. Spousal impoverishment: snapshot date, CSRA, CSIA, exempt assets. Client FAQs.
3.1—Income
3.2—Resources
Chapter 4—Divestment
Definition. FMV. 5-year lookback (and look-forward). Exceptions: no intent, sufficient resources for 5 years, pattern of gifting, spouse, disabled child, SNT, paying relatives, caretaker child, testamentary trusts, annuities, promissory notes, etc. Planning around. Solving divestment problems. Undue hardship. Client FAQs.
Chapter 5—Estate Recovery
What is estate recovery. Who is subject to estate recovery. What is recoverable, what is not. Probate recovery, nonprobate recovery, liens. Allowed expenses, priority of claims. Marital property and recovery from spouse’s estate. Exceptions and undue hardship. Client FAQs.
Part II: Planning and Applying for Medicaid
Chapter 6—Strategies
Spending down. Last day of the month rule. Checks not yet cashed. Available vs. unavailable assets. Simple options: LIFBC, debt, car, home improvements, personal items, $1500 life insurance, upcoming expenses, medical bills, legal & professional help, listing RE for sale. Advanced options: planned divestments (gifts, IRRs, caretaker child, special needs child), MCA or promissory note, paying family for services, paying family for room and board, Wispact, SNT. Options to increase CS income and assets. Client FAQs.
6.1—Simple Spend-down Strategies
6.2—Divestment Strategies
6.3—Spousal Impoverishment Strategies
Chapter 7—Applications
Documentation. Complete list of needed verification. How to get documents. How to handle as POA or guardian. Common problems. Filling out the application form. Required signatures. Auth Reps. Consortia. How to submit app and follow-up documentation. 30-day time limit (+10 days). Time for verification. Common problems. Mistakes in processing. Appeals. Client FAQs.
Chapter 8—Enrolling and Maintaining Eligibility
Approval & enrollment. Begin dates / backdating. Cost share / patient liability. Medical/remedial expenses. SNF refunds. Spousal transfer period. 1-year renewal. Change reporting. Client FAQs.
Index
Other Resources
These are other resources and guides I’ve published for subscribers.
Estate Recovery Panel Takeaways—A web version of my notes from the “Best Practices for Working with Medicaid Estate Recovery” session during the 2023 Legal Issues of the Aging seminar. Bookmark this in your browser for quick reference.
Requires an ELW Free subscription
Fair Hearing Appeals: Basic Outline—A simple outline of the law and process for a fair hearing appeal of a Medicaid denial.
Requires an ELW Free subscription
Qualified Disability Trust Basics—A basic summary of the QDT requirements and benefits. Bookmark this in your browser for quick reference.
Requires an ELW Pro subscription
The Medical or Remedial Expense Deduction—A guide to understanding and using the medical or remedial expense deduction, including legal references, forms, and notable fair hearing decisions. A one-hour CLE webinar accompanies this guide and is available on-demand.
Requires an ELW Pro subscription
The Most Notable Fair Hearing Decisions of 2025—A review of the most interesting and useful fair hearing decisions decided in 2025. Includes a one-hour CLE webinar available on demand.
Requires an ELW Pro subscription
Increasing the Monthly Maintenance Needs Allowance—A guide to fair hearing appeals for the purpose of increasing the community spouse’s income allowance based on high “necessary and basic” expenses. This guide includes legal references, forms, notable fair hearing decisions, and worksheets. A one-hour CLE webinar accompanies this guide and is available on-demand.
Requires an ELW Pro subscription
There’s more to come. To get updates, subscribe to my email newsletter. You’ll also get summaries of newly published fair hearing decisions and access to Estate Recovery Panel Takeaways.