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. But there were state-sized gaps in what that group could provide. Anything specific to Wisconsin I had to figure out for myself. Thankfully, there were resources like the State Bar of Wisconsin’s Advising Older Clients and the Wisconsin chapter of NAELA’s yearly winter workshop. But even these, valuable as they were, had many gaps. For example, Advising Older Clients contains only one chapter on Medicaid, which does not cover the most important planning strategies or how to execute them. The yearly Essentials Program at the winter workshop was certainly a helpful orientation, but lacked the time to dive deep on any particular strategy.
Without the benefit of joining an established elder law firm and learning directly from an experienced elder law attorney, what I needed was one resource to bring all the knowledge I needed together in a practical way. I needed to know not just federal and state law, but Wisconsin-specific strategies and how to execute them. I needed to know not just what state policy was, but how it actually plays out in different ways across our state and what problems Wisconsinites face when applying for Medicaid. I needed to know what the steps in a Medicaid planning case are, how to guide clients through them, and how to answer the many questions my clients would ask.
To this day, little has changed. Unless you are fortunate enough to learn directly from an experienced elder law attorney, you’ll have to hunt and gather the morsels of knowledge you need like scattered truffles. And because that takes so much time and effort, you might very well decide to give up on it altogether.
But the fact is that Wisconsin needs more elder law attorneys. Our population will only get older in the coming decades and need more and more long-term care. Qualifying and applying for Medicaid is a confusing, anxious, and threatening process for most Wisconsinites. 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 on short notice. Medicaid has a reputation of being complex and difficult to navigate, even for lawyers. I’ll not deny it. But I believe that problem can be solved with good, creative research and writing. With the right guide, anyone can learn Medicaid planning in just a few months while representing their first Medicaid clients.
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. 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.
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.