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 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 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. 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

DHA Case No. MGE 199939 (Wis. Div. of Hearings and Appeals April 19, 2021) (DHS) ↓ Download PDF Non-homestead real estate is countable unless it is listed for sale with a realtor. In this unusual case, the petitioner owned some land with a mobile home, but realtors refused to list it because of its condition […] Read more

DHA Case No. MGE 201671 (Wis. Div. of Hearings and Appeals June 15, 2021) (DHS) ↓ Download PDF A Medicaid member must have adequate notice of any change in his or her patient liability. In this case, the petitioner elected online notices and a notice of patient liability was posted to her ACCESS account. Her […] Read more

DHA Case No. MGE 201844 (Wis. Div. of Hearings and Appeals July 12, 2021) (DHS) ↓ Download PDF In determining patient liability, the Medicaid Eligibility Handbook allows a limited number of deductions from income. In this case, the petitioner could not afford to pay both his patient liability and his bankruptcy settlement. ALJ Kelly Cochrane could find […] Read more

DHA Case No. MGE 203510 (Wis. Div. of Hearings and Appeals March 9, 2022) (DHS) ↓ Download PDF Income is not available if the individual lacks the legal ability to make it available for support and maintenance. In this case, the petitioner was on hospice and totally incapacitated, had no POA or guardian, her marital […] Read more

DHA Case No. MGE 201120 (Wis. Div. of Hearings and Appeals April 29, 2021) (DHS) ↓ Download PDF When a Medicaid applicant is the grantor of a trust—even an irrevocable trust—it is countable and available “if there are any circumstances under which payment from the trust could be made to or for the benefit of […] Read more

DHA Case No. MGE 198872 (Wis. Div. of Hearings and Appeals August 12, 2020) (DHS) ↓ Download PDF The Medicaid Eligibility Handbook allows business property to be exempted—regardless of value or rate of return—if the individual is “actively involved in the business operation on a day-to-day basis.” Rental property is not exempt unless the owner is in […] Read more

DHA Case No. MGE 208281 (Wis. Div. of Hearings and Appeals May 30, 2023) (DHS) ↓ Download PDF The Medicaid Eligibility Handbook contains two main ways to exempt “property essential to self-support.” The property is (1) exempt (regardless of value or rate of return) if used in a business in which the individual is actively […] Read more

DHA Case No. MRA 178406 (Wis. Div. of Hearings and Appeals January 13, 2017) (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 an Individual Retirement Annuity, funded by […] Read more

DHA Case No. MED-40/46891 (Wis. Div. of Hearings and Appeals March 29, 2001) (DHS)  ↓ Download PDF In a spousal impoverishment case, the Wisconsin administrative code provides that funds “expressly set aside” for burial expenses are not countable. In this case, the petitioner’s attorney told the county agency, in writing, that $3,000 in a certain […] Read more

DHA Case No. MDV 206205 (Wis. Div. of Hearings and Appeals December 2, 2022) (DHS)  ↓ Download PDF Issue 1: “Irrevocable assignment” The Medicaid Eligibility Handbook provides that an asset is available when the owner can dispose of it, has a legal right to its value, has the legal ability to make it available, and can make […] Read more