Wisconsin Medicaid Divisor Staying Put. For Now.

Ruder Ware

Every year before July 1st, Wisconsin publishes an updated Medicaid divisor to be in effect starting on July 1st of that year until June 30th of the next year.  This year, Wisconsin has not yet updated its Medicaid divisor due to COVID-19 pandemic.  At this point in time, there is no official guidance as to when the divisor will be updated.

The Medicaid divisor is the average statewide daily rate of nursing home care for a resident who is privately paying for his or her care.  The current Medicaid divisor, which was announced last year prior to July 1st, 2019, is still $287.29.

The Medicaid divisor is used to determine the length of a penalty period in the event gifts are made within the five-year look-back period.  For example, if someone applies for Wisconsin Medicaid benefits to help pay for nursing home care or assisted living care and made gifts of $28,000, the penalty period would be 97 days (or just over three months) ($28,000 in gifts divided by $287.29 Medicaid divisor equals 97.63 days).  This means that the Medicaid applicant would not be able to receive Medicaid benefits to help pay for nursing home care for a (penalty) period of 97 days.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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