DHA Case No. BCS 210493 (Wis. Div. of Hearings and Appeals January 9, 2024) (DHS) ↓ Download PDF BadgerCare Plus eligibility is based on income and, unlike EBD Medicaid programs, taxable withdrawals from IRAs are counted as income. In this case, the petitioner was 63 and his only income was monthly withdrawals of $3,200 from […] Read more

DHA Case No. MED 53/97033 (Wis. Div. of Hearings and Appeals December 8, 2008) (DHS) ↓ Download PDF Home maintenance expenses only reduce the patient liability of an institutionalized recipient if a physician certifies the recipient is likely to return home within six months. In this case, the physician certified that the petitioner was not […] Read more

DHA Case No. MRA 70/105086 (Wis. Div. of Hearings and Appeals July 30, 2009) (DHS) ↓ Download PDF In general, an asset is counted if it is available—if the owner can access it and use it for support and maintenance. In this case, the agency counted as available a $7,233 check paid to and cashed […] Read more

DHA Case No. MED 292938 (Wis. Div. of Hearings and Appeals September 3, 2008) (DHS) ↓ Download PDF Gifts received by a Medicaid recipient must be reported within ten days. In this case, the petitioner was disabled with cancer. Her community held a fundraiser and gave her almost $30,000, which she failed to report. Although […] Read more

DHA Case No. MGE 211422 (Wis. Div. of Hearings and Appeals February 1, 2024) (DHS) ↓ Download PDF A life-insurance funded burial contract (LIFBC or “burial insurance”) can be funded with more than $4,500 and still be exempt for Medicaid eligibility; but an irrevocable funeral trust can only make up to $4,500 truly irrevocable and […] Read more

DHA Case No. MGE 210403 (Wis. Div. of Hearings and Appeals December 8, 2023) (DHS) ↓ Download PDF The assets in an irrevocable trust funded with the petitioner’s property are potentially available if there are any circumstances allowing payment from the trust to the petitioner. In this case, the petitioner established a Hedlund-type trust in 1996 […] Read more

DHA Case No. MGE 209343 (Wis. Div. of Hearings and Appeals October 2, 2023) (DHS) ↓ Download PDF The balance of a land contract is counted as an available asset unless its terms prohibit transfer or no one is willing to purchase it. In this case, the petitioner was selling non-homestead real estate under a […] Read more

DHA Case No. MGE 209206 (Wis. Div. of Hearings and Appeals November 8, 2023) (DHS) ↓ Download PDF DHA Case No. CWA 209207 (Wis. Div. of Hearings and Appeals November 8, 2023) (DHS) ↓ Download PDF The principal or income of an irrevocable trust funded with a Medicaid applicant’s resources is countable if there are […] Read more

DHA Case No. MDV 209022 (Wis. Div. of Hearings and Appeals August 25, 2023) (DHS) ↓ Download PDF An appeal of a divestment penalty must be filed within 45 days; an appeal of a hardship waiver denial must also be filed within 45 days. In this case, the agency imposed a divestment penalty when the […] Read more

DHA Case No. MGE 210503 (Wis. Div. of Hearings and Appeals December 19, 2023) (DHS) ↓ Download PDF After enrollment in a long-term care Medicaid program, the institutionalized spouse must spend down or transfer resources to the community spouse to get below $2,000 by the first renewal. In this case, the petitioner failed to do […] Read more

DHA Case No. MGE 210128 (Wis. Div. of Hearings and Appeals November 22, 2023) (DHS) ↓ Download PDF An asset is not available if the member lacks the ability to provide legal access to it. In this case, the petitioner had a life insurance policy with a cash value greater than $2,000; he also had […] Read more

DHA Case No. MDV 209376 (Wis. Div. of Hearings and Appeals October 27, 2023) (DHS) ↓ Download PDF Institutional MA eligibility can be backdated up to three months prior to the the month of application. In this case, the petitioner requested an asset assessment in January 2023 but didn’t apply until May. ALJ Peter McCombs […] Read more

DHA Case No. MGE 210319 (Wis. Div. of Hearings and Appeals October 20, 2023) (DHS) ↓ Download PDF In general, all available assets are counted and counted assets are not reduced by outstanding debt. In this case, the petitioner had excess assets at her renewal and an overpayment claim that was pending but not yet […] Read more

DHA Case No. MGE 210257 (Wis. Div. of Hearings and Appeals December 7, 2023) (DHS) ↓ Download PDF An appeal must be filed within 45 days of a Medicaid application denial for the Division of Hearings and Appeals to have jurisdiction. In this case, the deadline to appeal the initial denial of the Medicaid application […] Read more