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In January of 2009, I worked with a Wisconsin elder law attorney who had a Medicaid case involving a husband and wife.  In order to eliminate the spend-down amount, Ithe community spouse purchased a Medicaid Compliant Annuity from Employees Life Company (Mutual). 

With the spend-down amount eliminated, a Medicaid application was submitted.  The application was supplemented with three refusal letters, from companies that stated that they could not purchase the Medicaid Compliant Annuity.  After reviewing the Medicaid application, the Dane County Department of Health Services denied eligibility on the premise that J.G. Wentworth could purchase the Medicaid Compliant Annuity.  Thus, it was an available resource.

The matter went to a fair hearing, wherein the Administrative Law Judge determined J.G. Wentworth's offer to purchase the MCA was not reliable evidence, in that the offer was conditional - not a firm offer.  The Administrative Law Judge concluded:

1. That the annuity purchased by the community spouse is not a countable asset based upon the applicable law and policy at that purchase.
2. That the county agency incorrectly determined that the annuity was a countable asset in testing the institutionalized spouse's asset eligibility for institutional MA.
3. The count agency incorrectly denied the institutionalized spouse's Medicaid application due to assets above the program asset eligibility limits.

It is my opinion that this is a great win for Wisconsin!

Review the case decision here.