3 Financial Eligibility

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. MGE 197217 (Wis. Div. of Hearings and Appeals May 21, 2020) (DHS) ↓ Download PDF The usual maximum for the Community Spouse Income Allocation (CSIA) can be increased by an ALJ if needed to pay for “necessary and basic” expenses. In this case, ALJ John Tedesco increased the CSIA to $4,078, largely […] Read more

DHA Case No. MDV 198612 (Wis. Div. of Hearings and Appeals June 24, 2020) (DHS) ↓ Download PDF Any transfer of resources for less than fair market value is generally a divestment, but there is an exception if the resource was transferred “exclusively for some other purpose than to become eligible for MA.” In this […] Read more

DHA Case No. MDV 198638 (Wis. Div. of Hearings and Appeals June 29, 2020) (DHS) ↓ Download PDF A divestment penalty for a Medicaid applicant begins on the date the person applies and is “otherwise eligible” but for the divestment; it begins for a member the first of the month after the member receives timely notice. In this case, […] 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. FCP 177944 (Wis. Div. of Hearings and Appeals December 13, 2016) (DHS) ↓ Download PDF It is a divestment when a life estate is terminated and the life estate holder is not paid her proportional share. In this case, the petitioner’s life estate was divested when she sold her home and her […] Read more

DHA Case No. MDV 183502 (Wis. Div. of Hearings and Appeals December 6, 2017) (DHS) ↓ Download PDF Adivestment occurs upon the transfer of a non-exempt resource for less than fair market value. In this simple case, the petitioner sold the home in which she had a life estate and paid a prorated portion of […] Read more

DHA Case No. MDV 199054 (Wis. Div. of Hearings and Appeals August 25, 2020) (DHS) ↓ Download PDF A divestment occurs upon the transfer of a non-exempt resource for less than fair market value. In this case, the petitioner sold the home in which she had a life estate for $3,200 less than the tax […] Read more

DHA Case No. MDV 199112 (Wis. Div. of Hearings and Appeals September 21, 2020) (DHS) ↓ Download PDF Divestment occurs at the time of a transfer for less than fair market value. In this case, the petitioner executed an agreement with her daughter in 2012 whereby her daughter made monthly payments and received incremental interests […] Read more

DHA Case No. MDV 199858 (Wis. Div. of Hearings and Appeals December 4, 2020) (DHS) ↓ Download PDF Divestment is a transfer of non-exempt resources for less than fair market value. This case involved two potential divestments when the petitioner’s house was sold to her daughter and daughter’s boyfriend: (1) the boyfriend was paid $40,534.37 […] Read more

DHA Case No. MDV 200210 (Wis. Div. of Hearings and Appeals January 21, 2021) (DHS) ↓ Download PDF An appeal must be filed within 45 days of an agency action for the ALJ to have jurisdiction to review it. In this case, the petitioner established an irrevocable trust, divested, and applied for Medicaid in May […] 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