3 Financial Eligibility

MDV 191431 (02/12/2019)
Life insurance death benefit not the same as face value, policies exempt

Tags: 3 Financial Eligibility, 3.2 Assets, 3.2.6 Liquid assets, 3.2.6.05 Life insurance, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Nicole Bjork

DHA Case No. MDV 191431 (Wis. Div. Hearings and Appeals Feb. 12, 2019) (DHS) ↓ Download PDF The cash value of life insurance is not counted if the total face value of all policies does not exceed $1,500. In this case, the petitioner owned two life insurance policies: one with a face value of $1,000 […] Read more

MGE 180617 (06/12/2017)
Life insurance labeled “Funeral Plan” was countable

Tags: 3 Financial Eligibility, 3.2 Assets, 3.2.4 Burial assets, 3.2.6 Liquid assets, 3.2.6.05 Life insurance, ALJ Mayumi M. Ishii

DHA Case No. MGE 180617 (Wis. Div. Hearings and Appeals Jun. 12, 2017) (DHS) ↓ Download PDF The cash surrender value of life insurance policies must generally be counted as a resource. In this case, the petitioner had a policy labeled “Funeral Plan” with a cash surrender value of $3,390.75. ALJ Mayumi Ishii concluded the […] Read more

FCP 159228 (03/12/2015)
Life insurance face value not increased by dividend additions

Tags: 3 Financial Eligibility, 3.2 Assets, 3.2.6 Liquid assets, 3.2.6.05 Life insurance, ALJ Kelly Cochrane

DHA Case No. FCP 159228 (Wis. Div. Hearings and Appeals Mar. 12, 2015) (DHS) ↓ Download PDF The cash value of life insurance is not counted if the total face value of all policies does not exceed $1,500. In this case, the petitioner owned a policy with an initial face value of $1,000 and dividend […] Read more

MDV 187317 (07/02/2018)
Life estate holder did not divest by paying share of mortgage, closing costs

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.25 Life estates, 3.3.25.1 Life estate—transfer of property for less than FMV, 3.3.25.3 Life estate—termination and payment of less than FMV, ALJ Nicole Bjork

DHA Case No. MDV 187317 (Wis. Div. Hearings and Appeals Jul. 2, 2018) (DHS) ↓ Download PDF Aperson who terminates her life interest in a property without receiving the value of the life estate has divested. In this case, the petitioner reserved her life estate before the look-back period but also signed a deferred loan […] Read more

MDV 139111 (05/04/2012)
Termination of life estate was divestment, not done exclusively for purpose other than to qualify

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.06 Transfers made for purpose other than to qualify for Medicaid, 3.3.25 Life estates, 3.3.25.3 Life estate—termination and payment of less than FMV, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Michael D. O’Brien

DHA Case No. MDV 139111 (Wis. Div. Hearings and Appeals May 4, 2012) (DHS) ↓ Download PDF A person who terminates her life interest in a property without receiving the value of the life estate has divested. In this case, the petitioner had executed an agreement that allowed her children to terminate her life estate […] Read more

MDV 135429 (11/09/2011)
Life estate valued under IRC was less than FMV

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.06 Transfers made for purpose other than to qualify for Medicaid, 3.3.25 Life estates, 3.3.25.3 Life estate—termination and payment of less than FMV, 5 Subprograms, 5.05 Home and Community-Based Waivers Long-Term Care, 5.05.1 Family Care, ALJ Brian C. Schneider

DHA Case No. MDV 135429 (Wis. Div. Hearings and Appeals Nov. 9, 2011) (DHS) ↓ Download PDF It is generally a divestment if a life estate holder is not paid fair market value when the property is sold. In this case, the petitioner and her family sold her property through a real estate lawyer, who […] Read more

MDV 47/87892 (01/07/2008)
Life estate ended upon admission to nursing home, was a divestment

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.25 Life estates, 3.3.25.1 Life estate—transfer of property for less than FMV, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Michael D. O’Brien

DHA Case No. MDV 47/87892 (Wis. Div. Hearings and Appeals Jan. 7, 2008) (DHS) ↓ Download PDF The transfer of a life estate without receiving fair market value in return is a divestment. In this case, the petitioner had transferred her property to her son but retained a right to occupy her property that terminated […] Read more

MDV 38/87937 (03/26/2008)
Life estate holder divested by paving a dirt driveway

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.03 Transfers for FMV, 3.3.15 Trusts, 3.3.15.1 Trusts for disabled individuals, 3.3.25 Life estates, 3.3.25.1 Life estate—transfer of property for less than FMV, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Joseph A. Nowick

DHA Case No. MDV 38/87937 (Wis. Div. of Hearings and Appeals Mar. 26, 2008) (DHS) ↓ Download PDF The holder of a life estate must generally make reasonable and necessary repairs, and payments for those repairs are not divestments. In this case, the petitioner owned a life estate and paid for insulation, window repairs, light […] Read more

MDV 67/60174 (02/03/2004)
Life estate not transferred automatically upon admission to nursing home

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.25 Life estates, 3.3.25.1 Life estate—transfer of property for less than FMV, 3.3.25.3 Life estate—termination and payment of less than FMV, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Peter D. Kafkas

DHA Case No. MDV 67/60174 (Wis. Div. Hearings and Appeals Feb. 3, 2004) (DHS) ↓ Download PDF A divestment is a transfer of assets for less than fair market value. In this case, the petitioner had a life estate in her home. The life estate was created before the look-back period and the petitioner did […] Read more

MDV 40/39925 (07/20/1999)
Life estate value must be considered in calculating divested amount

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.25 Life estates, 3.3.25.1 Life estate—transfer of property for less than FMV, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Kenneth D. Duren

DHA Case No. MDV 40/39925 (Wis. Div. Hearings and Appeals Jul. 20, 1999) (DHS) ↓ Download PDF When an individual transfers real estate but retains a life estate, the value of the life estate must be considered in determining the divested amount. In this case, the petitioner transferred her home with a fair market value […] Read more

MDV 40/18587 (12/16/1997)
Life estate holder did not divest by paying for property repairs

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.03 Transfers for FMV, 3.3.07 Payments to relatives, 3.3.25 Life estates, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Nancy J. Gagnon

DHA Case No. MDV 40/18587 (Wis. Div. of Hearings and Appeals Dec. 16, 1997) (DHS) ↓ Download PDF In general, a transfer for fair market value is not a divestment. In this case, the petitioner spent $52,074 on repairs to his home, in which he had retained a life estate, after he was institutionalized. The […] Read more

MDV 171354 (03/28/2016)
Contract required for services but not room and board

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.07 Payments to relatives, 3.3.07.1 For room and board, 3.3.07.2 For services, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Mayumi M. Ishii

DHA Case No. MDV 171354 (Wis. Div. Hearings and Appeals Mar. 28, 2016) (DHS) ↓ Download PDF Payments to relatives for care and services are not considered divestments if the services directly benefited the institutionalized person, compensation was reasonable, and, if the total exceeds 10% of the Community Spouse Asset Share, there is a preexisting […] Read more

MDV 156359 (05/09/2014)
Contract required only if payments to an individual exceed 10% CSAS

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.07 Payments to relatives, 3.3.07.2 For services, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Michael D. O’Brien

DHA Case No. MDV 156359 (Wis. Div. Hearings and Appeals May 9, 2014) (DHS) ↓ Download PDF Payments to relatives for care and services are not considered divestments if the services directly benefited the institutionalized person, compensation was reasonable, and, if the total exceeds 10% of the Community Spouse Asset Share, there is a preexisting […] Read more

MDV 138130 (06/27/2012)
Reimbursements, payments to POA agents not divestment

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.03 Transfers for FMV, 3.3.07 Payments to relatives, 3.3.07.2 For services, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Michael D. O’Brien

DHA Case No. MDV 138130 (Wis. Div. Hearings and Appeals Jun. 27, 2012) (DHS) ↓ Download PDF Transfers for fair market value are not divestments. In this case, the petitioner was a 96-year-old woman living in northern Wisconsin who had named her daughter as her financial agent. After she was admitted to a nursing home, […] Read more

MRA 223077 (07/22/2026)
CSIA increased, but expenses for savings, life ins., home security not necessary and basic

Tags: 3 Financial Eligibility, 3.4 Spousal impoverishment, 3.4.6 Community spouse income allocation, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ John P. Tedesco

DHA Case No. MRA 223077 (Wis. Div. Hearings and Appeals Jul. 22, 2026) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the petitioner’s community spouse had expenses […] Read more

Tag: 3 Financial Eligibility