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. 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. 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 216362 (Wis. Div. Hearings and Appeals Mar. 4, 2025) (DHS) ↓ Download PDF An individual is financially eligible for EBD Medicaid if the total value of all non-exempt liquid assets does not exceed $2,000 at the end of the month. In this case, the petitioner owned countable assets of $2,015.27 as […] Read more

DHA Case No. MGE 213928 (Wis. Div. Hearings and Appeals Jan. 17, 2025) (DHS) ↓ Download PDF The cash surrender value of life insurance is generally a countable asset (unless the total face value of all policies does not exceed $1,500). In this case, the petitioner applied for MA and listed two life insurance policies […] Read more

DHA Case No. FCP 218679 (Wis. Div. Hearings and Appeals Sep. 2, 2025) (DHS) ↓ Download PDF As stated in the recent DMS Ops Memo 25-07, the state must maintain Medicaid coverage while completing regularly scheduled renewals as long as the renewal is received before the end of the month the renewal is due. In […] Read more

DHA Case No. MGE 218599 (Wis. Div. Hearings and Appeals Aug. 15, 2025) (DHS) ↓ Download PDF An individual is financially eligible for EBD Medicaid if the total value of all countable and available resources does not exceed $2,000 at the end of the month in question. Income received that month and checks delivered but […] Read more

DHA Case No. MGE 216988 (Wis. Div. Hearings and Appeals Jul. 14, 2025) (DHS) ↓ Download PDF The transfer of resources for less than fair market value is a divestment resulting in a penalty period. The penalty (for Institutional MA) begins the first date the applicant applied and would have been otherwise eligible. In this […] Read more

DHA Case No. MGE 217517 (Wis. Div. Hearings and Appeals Jun. 12, 2025) (DHS) ↓ Download PDF An asset is unavailable if the member lacks the ability to provide legal access to the assets. In this case, the petitioner’s bank refused to give access to his guardian until the guardian was appointed representative payee by […] Read more

DHA Case No. MGE 215302 (Wis. Div. Hearings and Appeals Jun. 2, 2025) (DHS) ↓ Download PDF The agency is required to verify income, assets, and divestments, both at application and at renewals. The applicant or member has the primary responsibility to provide verification and resolve questionable information. In this case, the petitioner’s authorized representatives […] 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. MGE 216363 (Wis. Div. Hearings and Appeals Feb. 28, 2025) (DHS) ↓ Download PDF A Medicaid applicant must be below the asset limit on the last day of the month to be eligible that month. In this case, the petitioner’s application was denied due to the cash value of a life insurance […] Read more

DHA Case No. MGE 215913 (Wis. Div. Hearings and Appeals Feb. 14, 2025) (DHS) ↓ Download PDF In Wisconsin, an irrevocable burial trust is exempt only up to $4,500. In this case, the petitioner had $11,663.82 in irrevocable burial trusts. ALJ Nicole Bjork concluded only $4,500 and the cost of a casket ($1,910) could be […] Read more