DHA Case No. FCP 219890 (Wis. Div. Hearings and Appeals Nov. 13, 2025) (DHS) ↓ Download PDF Income received less often than monthly is generally prorated and counted, but the MEH directs: “do not count the prorated income until it is received.” In this case, the petitioner received a yearly annuity payment in January and […] Read more

DHA Case No. MQB 218814 (Wis. Div. Hearings and Appeals Sep. 12, 2025) (DHS) ↓ Download PDF Rental income is generally countable income for MA eligibility. In this case, the petitioner’s SLMB+ benefits ended when his caregiver moved in and began paying $650/mo. towards his mortgage payment. Although the petitioner claimed the payment was made […] Read more

DHA Case No. MGE 218833 (Wis. Div. Hearings and Appeals Sep. 5, 2025) (DHS) ↓ Download PDF For a single person in the Institutional MA program, the items that may be subtracted from income in determining patient liability are limited. In this case, the petitioner asked that his $70/month life insurance premiums be deducted, noting […] Read more

DHA Case No. MGE 217939 (Wis. Div. Hearings and Appeals Jul. 3, 2025) (DHS) ↓ Download PDF Aparticipant in Institutional MA may have their patient liability reduced to allow them to pay medical or remedial expenses. In this case, the petitioner owed $22,504 in unpaid patient liability due to his brother/POA’s mismanagement, or perhaps theft […] Read more

DHA Case No. MGE 216220 (Wis. Div. Hearings and Appeals May 27, 2025) (DHS) ↓ Download PDF A participant in Institutional MA may have their patient liability reduced to allow them to pay medical or remedial expenses. In this case, the petitioner was given a medical/remedial expense deduction to pay an outstanding nursing home bill, […] Read more

DHA Case No. BCS 216544 (Wis. Div. Hearings and Appeals Mar. 14, 2025) (DHS) ↓ Download PDF Certain payments to live-in care providers under the Family Care and IRIS programs do not counts as income for BadgerCare Plus eligibility. In this case, the petitioner argued his $2,797 monthly income should not be counted under these […] Read more

DHA Case No. MGE 216305 (Wis. Div. Hearings and Appeals Mar. 24, 2025) (DHS) ↓ Download PDF Income received in a month is not counted as an asset unless and until it is retained into the following month. In this case, the petitioner applied in September and requested backdating to June and July. She submitted […] Read more

DHA Case No. MAP 216062 (Wis. Div. Hearings and Appeals Feb. 4, 2025) (DHS) ↓ Download PDF The agency may not require one particular type of verification when various types are adequate and available. In this case, the petitioner owned a newly incorporated business with no previous tax filings. Instead of submitting a self-employment income […] Read more

DHA Case No. MGE 214684 (Wis. Div. Hearings and Appeals Jan. 2, 2025) (DHS) ↓ Download PDF Royalties are considered unearned self-employment income for MA purposes. The monthly countable income is calculated by prorating the previous tax year’s net income over twelve months. In this case, the petitioner complained that the fluctuating amounts received meant […] Read more

DHA Case No. MGE 217838 (Wis. Div. Hearings and Appeals Jul. 15, 2025) (DHS) ↓ Download PDF Court-ordered support payments are deducted from income for an “institutionalized person,” according to the Medicaid Eligibility Handbook (MEH). In this case, the petitioner paid $4,059 per month in court-ordered spousal support, had monthly income of $12,089.20 ($8,045.98 from a […] Read more

DHA Case No. BCS 215161 (Wis. Div. Hearings and Appeals Dec. 18, 2024) (DHS) ↓ Download PDF To be eligible for BadgerCare Plus, a person must meet certain financial and non-financial requirements, including verification of income for self-employment. In this case, the petitioner verified her self-employment income with a partial, unsigned copy of her tax […] Read more

DHA Case No. MGE 173712 (Wis. Div. Hearings and Appeals Sep. 7, 2016) (DHS) ↓ Download PDF To be income-eligible for Institutional MA, an applicant must qualify as either categorically needy (having a very low income) or medically needy, having income less than her monthly need—of which the cost of the nursing home is a […] Read more

DHA Case No. BCS 211404 (Wis. Div. Hearings and Appeals Feb. 8, 2024) (DHS) ↓ Download PDF BadgerCare Plus counts all available income, even if the member chooses not to receive it. In this case, the petitioner chose to stop receiving long-term disability benefits of nearly $2,000 per month in an attempt to maintain her […] Read more

DHA Case No. BCS 213610 (Wis. Div. Hearings and Appeals Sep. 23, 2024) (DHS) ↓ Download PDF To determine self-employment income, Wisconsin Medicaid programs generally use the previous year’s federal tax return; but if the business had a “significant change in circumstances,” the agency must use anticipated earnings instead. In this case, the petitioner was […] Read more