Tag: 3 Financial Eligibility

DHA Case No. MRA 159882 (Wis. Div. Hearings and Appeals Oct. 27, 2014) (DHS) ↓ Download PDF An asset is not available if the owner documents that it will not be available for 30 days or more and a process has been started to gain access. In this case, the petitioner owned a tax-sheltered annuity […] Read more

DHA Case No. MDV 143690 (Wis. Div. Hearings and Appeals Nov. 23, 2012) (DHS) ↓ Download PDF A divestment occurs when a Medicaid applicant transfers resources and receives less than fair market value in return; exempt business assets must be used in a business “for the self-support of the individual.” In this case, the petitioner […] Read more

DHA Case No. MED 36/91877 (Wis. Div. Hearings and Appeals Jun. 4, 2008) (DHS) ↓ Download PDF An institutionalized person’s home is exempt if the person expresses an intent to return there. In this case, the petitioner was admitted to a nursing home and a doctor opined that she “cannot realistically expect to return home,” […] Read more

DHA Case No. MDV 5/105182 (Wis. Div. Hearings and Appeals 2009) (DHS) ↓ Download PDF Agift that occurred during the lookback period and was made by either the institutionalized person or his or her spouse is a divestment. In this case, the petitioner’s husband amended their revocable trust to transfer their home to a new […] Read more

DHA Case No. MDV 59/60290 (Wis. Div. Hearings and Appeals Jan. 20, 2004) (DHS) ↓ Download PDF A gift that occurred during the lookback period and was made by either the institutionalized person or his or her spouse is a divestment. In this case, the petitioner’s husband disinherited her and then died a year before […] Read more

DHA Case No. MAP 219778 (Wis. Div. Hearings and Appeals Dec. 23, 2025) (DHS) ↓ Download PDF Medical Assistance policy requires applicants and recipients to verify self-employment income. In this case, the petitioner was enrolled in MAPP and a Medicare savings program when she applied for FoodShare and reported rental income from billboards she owned. […] Read more

DHA Case No. MDV 220070 (Wis. Div. Hearings and Appeals Dec. 10, 2025) (DHS) ↓ Download PDF The action of avoiding the receipt of income that a Medicaid member is entitled to is a divestment. In this case, the petitioner revocably renounced a VA survivor’s pension, which was $948 normal pension and $567 Aid and […] Read more

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. MDV 220057 (Wis. Div. Hearings and Appeals Nov. 10, 2025) (DHS) ↓ Download PDF A divestment does not affect eligibility if the resource was “transferred exclusively for some purpose other than to become eligible for MA.” In this case, the petitioner gave $5,000 to each of her three daughters (to one for […] Read more

DHA Case No. MAP 219997 (Wis. Div. Hearings and Appeals Oct. 31, 2025) (DHS) ↓ Download PDF An employer-sponsored retirement plan is not counted as an available asset if the individual is still working and would have to quit their job to obtain funds. In this case, the petitioner had a 401(k) with a balance […] 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 218210 (Wis. Div. Hearings and Appeals Aug. 6, 2025) (DHS) ↓ Download PDF 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 […] 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