DHA Case No. MGE 208349 (Wis. Div. of Hearings and Appeals June 13, 2023) (DHS) ↓ Download PDF In general, applicants are responsible for verification—but agencies cannot deny eligibility when the applicant has no ability to get the required verification. In this case, the petitioner and his wife were both applying for Institutional MA through their […] Read more

DHA Case No. MGE 203793 (Wis. Div. of Hearings and Appeals December 23, 2021) (DHS) ↓ Download PDF Income is not counted as a resource in the month it is received. In this case, the petitioner had income of $3,660.10, but his checking account balance at the end of the month was only $983.80. The […] Read more

DHA Case No. MGE 194293 (Wis. Div. of Hearings and Appeals January 6, 2020) (DHS) ↓ Download PDF The amount a community spouse can keep depends on the couple’s total resources on the date of the asset assessment, which is often the date a functional screen was completed and the person was determined functionally eligible. […] Read more

DHA Case No. MGE 196806 (Wis. Div. of Hearings and Appeals January 9, 2020) (DHS) ↓ Download PDF An applicant must be under the asset limit as of the last day of the month for that month’s eligibility. In this case, the petitioner’s eligibility for August was denied because her bank statement showed a high […] Read more

DHA Case No. MAP 196477 (Wis. Div. of Hearings and Appeals January 13, 2020) (DHS) ↓ Download PDF To be eligible for the MAPP program, the individual’s countable assets must be below $15,000. Assets titled solely in a spouse’s name do not count for MAPP. In this case, the Department disenrolled the petitioner, apparently counting […] Read more

DHA Case No. MGE 196927 (Wis. Div. of Hearings and Appeals January 28, 2020) (DHS) ↓ Download PDF The Department must give applicants adequate notice when requesting verification. In this case, the agency requested verification of a third-party discretionary trust but gave only 9 days to provide it and was not specific about the kind […] Read more

DHA Case No. MGE 197380 (Wis. Div. of Hearings and Appeals March 2, 2020) (DHS) ↓ Download PDF In general, a Medicaid application must be processed within 30 days (plus 10 days if needed to provide verification) and the applicant has the burden of providing the needed verification. This case, however, was “highly unusual” for […] Read more

DHA Case No. MGE 197888 (Wis. Div. of Hearings and Appeals March 20, 2020) (DHS) ↓ Download PDF In general, applicants are responsible for verification—but agencies cannot deny eligibility when the applicant has no ability to get the required verification. In this case, the petitioner listed an old timeshare on the Medicaid application but lacked […] Read more

DHA Case No. MGE 208717 (Wis. Div. of Hearings and Appeals July 20, 2023) (DHS) ↓ Download PDF The Medicaid Eligibility Handbook contains two competing rules: revocable annuities are countable and available assets, but IRAs belonging to a community spouse are disregarded. In this case, the community spouse owned two Individual Retirement Annuities. The agency argued these […] Read more

DHA Case No. MGE 166562 (Wis. Div. of Hearings and Appeals August 21, 2015) (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

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

DHA Case No. MGE 198180 (Wis. Div. of Hearings and Appeals May 8, 2020) (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

DHA Case No. CWA 198273 (Wis. Div. of Hearings and Appeals August 3, 2020) (DHS) ↓ Download PDF This brief decision is a straightforward application of the name-on-the-check rule. A Medicaid-compliant annuity that pays only to the community spouse is not income available to the insititutionalized spouse. Preliminary Recitals Pursuant to a petition filed on […] Read more

DHA Case No. MGE 200475 (Wis. Div. of Hearings and Appeals February 8, 2021) (DHS) ↓ Download PDF Eligibility for MA begins the first of the month in which the applicant meets all program requirements. In this case, the petitioner planned for a divestment penalty with a Medicaid-compliant annuity, but the final annuity payment occurred […] Read more