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
5.09 Medicare Savings Programs
DHA Case No. MGE 209372 (Wis. Div. of Hearings and Appeals August 11, 2023) (DHS) ↓ Download PDF In general, a member must have at least ten days to provide required verification during a renewal. In this case, the agency sent a notice on July 3 requesting verification by July 10. Although he should have […] Read more
DHA Case No. MQB 209768 (Wis. Div. of Hearings and Appeals November 14, 2023) (DHS) ↓ Download PDF QMB benefits normally begin on the first of the month after the month the person is determined eligible. In this case, the petitioner became eligible for Medicare in June but did not finish verification until July 5, […] Read more
DHA Case No. MQB 209568 (Wis. Div. of Hearings and Appeals October 2, 2023) (DHS) ↓ Download PDF With the Public Health Emergency unwinding, members may voluntarily complete an early renewal, but Income Maintenance agencies must inform members that their eligibility may be impacted by doing an early renewal. In this case, the member’s renewal […] Read more
DHA Case No. MQB 207807 (Wis. Div. of Hearings and Appeals July 7, 2023) (DHS) ↓ Download PDF QMB benefits cannot normally be backdated (compare MQB 207494), but an ALJ can order backdating following a fair hearing. In this case, the Social Security Administration conceded that its own error caused a 3-month delay in verification […] Read more
DHA Case No. MQB 207494 (Wis. Div. of Hearings and Appeals May 1, 2023) (DHS) ↓ Download PDF For the Qualified Medicare Beneficiary (QMB) program, benefits cannot begin until the month after the application is processed. In this straightforward case, the petitioner applied but did not complete verification until November 14. ALJ John Tedesco concluded […] Read more
DHA Case No. MOP 197486 (Wis. Div. of Hearings and Appeals February 27, 2020) (DHS) ↓ Download PDF To establish an overpayment, the Department has the burden of proof by the preponderance of the evidence. In this case, the issue was whether the petitioner’s husband lived with her or not (if so, her household income […] Read more
DHA Case No. MQB 170244 (Wis. Div. of Hearings and Appeals February 8, 2016) (DHS) ↓ Download PDF In general, an irrevocable trust established by either spouse is a countable, available asset if there are any circumstances under which the applicant could receive money from the trust. But this policy does not apply to a […] Read more