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State of Wisconsin |
Release 25-02 |
There is no asset test for SeniorCare. In general, cash that is received as a result of converting an asset from one form to another is not income. This includes withdrawals from savings and/or checking accounts, CDs, or money market accounts. However, special provisions apply to retirement benefits (see Section 33.6.7 Gross Retirement Income) and Cobell buy-out payments (see Section 16.7.11.2 Lump Sum Payments Under the Settlement of the Cobell v. Salazar Class-Action Trust Case). Income generated from any assets that the SeniorCare participant may have is considered budgetable income and must be reported on the application or renewal application.
| Example 1 |
Eric has a savings account with $5,000 in it. Eric’s savings account is considered an asset, but the interest that he anticipates earning is countable income. Eric anticipates withdrawing $1,000 from his savings account during the coming year. This amount does not count as income. It is an asset that has been converted to cash. Only the interest Eric anticipates receiving from the savings account is countable income. Any withdrawals from his savings account are considered the conversion of an asset and are not counted as income. |
Income for SeniorCare is based on what the FTG expects to receive in the next 12 month period, beginning with the month of application. The incomes for the applicant and his or her spouse are counted together if they live together. Applicants can use the previous year’s information from tax returns or other sources as a guide when estimating what to report on their application. Applicants are asked to round income amounts to the nearest whole dollar when entering their good faith estimates on their SeniorCare application or renewal application.
Social Security income will always be verified. For all other income types, if reported amounts seem unreasonable or questionable, further verification may be obtained from the applicant or other available sources, such as a data exchange.
The income of a spouse who is in the SeniorCare FTG is included in the estimate of the annual, budgetable income even if he or she does not apply or is nonfinancially ineligible. However, the spouse’s income is not counted if one of the exceptions noted in Section 33.4 Fiscal Test Group applies.
Annual income is determined prospectively from the month of application through the next 12 calendar months. Income exempted for Medicaid eligibility is also exempted for SeniorCare (see Section 15.3 Exempt and Disregarded Income), including EITC and income tax refunds (see Section 15.5.7 Income Tax Refunds).
Budgetable income consists of projected gross annual income, except for self-employment income, which uses net income (see Section 33.6.6 Self-Employment Earnings).
In the following income related sections, policy is defined according to the categories on the SeniorCare Application form, F-10076. All income listed in the following sections should be prospectively budgeted for a 12-month period beginning with the month of application.
When calculating anticipated gross annual Social Security income, add any deductions for Medicare Part B or D and court-ordered guardianship fees, alimony, and/or child support must be added to the net payment amount.
Exception: If a SeniorCare applicant is receiving Medicare premium assistance (see Section 32.1 Medicare Savings Programs), his or her monthly payment already includes the Medicare Part B premium.
The applicant should contact the SSA at 1-800-772-1213 if he or she does not know his or her Medicare premium amount.
When the applicant is a surviving spouse receiving benefits under his or her spouse’s Social Security number, the amount should be considered the applicant’s income and reported under the applicant’s income column of the application.
Social Security income is verified through the Social Security Administration data exchange.
Budgetable gross earnings consist of all gross earned income, except for self-employment income, which uses net income (see Section 33.6.6 Self-Employment Earnings). Gross earnings include the following:
The SeniorCare applicant must report the estimated gross amount of all interest and dividends that they expect to receive in the next 12 months, beginning with the month of application. Sources of interest and dividends include, but are not limited to, the following:
Payments do not need to be directly received. If they are rolled back into the asset, they still must be reported.
Irrevocable interest that a SeniorCare applicant receives for an irrevocable burial trust is not budgetable income.
| Note | Unlike Medicaid, income that is received irregularly and infrequently and is under $20 per month should be reported as budgetable income for SeniorCare applicants. |
Budgetable income consists of all anticipated capital gains that would be reportable as capital gains to the IRS for tax purposes. All anticipated losses should be subtracted from the gross capital gains amount, and the net capital gain amount should be reported if it is greater than zero. Negative amounts should not be reported and will not be used to offset other types of income.
The principal or initial investment in the capital asset that the person receives in cash when he or she sells the asset is not considered income. That portion is considered a conversion of an asset from one form to another.
All anticipated payments (including interest, dividends, and withdrawals from principal) from a trust to the applicant are counted as income.
Irrevocable interest that a SeniorCare applicant receives for an irrevocable burial trust is not budgetable income.
| Note | Unlike Medicaid, withdrawals from principal are counted for SeniorCare as income in the month received. |
Each person who is a holder in a joint savings account is assigned an equal share of the interest earned. The applicant or applicant’s spouse should report only his or her share of the interest.
If the applicant and his or her spouse are not living together and hold a joint savings account, the applicant should only report his or her share of the interest
SeniorCare will budget net self-employment income, which is calculated by deducting allowable business expenses, losses, and depreciation from gross self-employment income (see Section 15.6 Self-Employment Income).
If the net self-employment earnings are anticipated to be a loss, the amount should be reported as zero.
Negative amounts should not be reported. Any reported losses will be budgeted as zero and will not be used to offset other income.
If rental income is reported to the IRS as self-employment income and is subject to the federal self-employment tax for rental income (usually real estate agents or individuals in a business where extensive services are provided to the renters), depreciation should also be deducted from the gross rental income. Refer to Section 15.6.4 Self-Employed Income Sources for more information about rental income for self-employed members.
Refer to Section 33.6.8.3 Rental Income if rental income is not reported as self-employment income.
Examples of retirement income that should be counted for SeniorCare include:
Retirement benefits include work-related plans for providing income when employment ends (e.g., pension, disability, or retirement plans administered by an employer or union). Other examples are funds held in an IRA and plans for self-employed individuals, sometimes referred to as Keogh plans.
The funds in retirement accounts, including IRAs, Keogh plans, etc., are assets and are therefore not counted for SeniorCare. However, periodic payments, withdrawals, and distributions the individual expects to receive from their retirement account or annuity in the next 12 months are counted as income. The only exception is when the individual has never previously made withdrawals from the account and he or she withdraws the full amount at one time. This is not considered a periodic payment and is not countable income.
| Note |
Rolling over an IRA (transferring the funds from one IRA to another) is the conversion of an asset from one form to another. Any potential income from an IRA rollover is countable income for SeniorCare. |
| Example 2 |
Mike owns a $2,000 IRA and plans to withdraw all of it this year. Mike has not withdrawn any money from this IRA in the past. If Mike withdraws the full $2,000 at one time, the $2,000 continues to be considered an asset. This is a conversion from one form of an asset to another. If Mike were planning to make a one-time withdrawal of $1,000 from the $2,000 IRA in the next 12 months, the $1,000 would be considered income. He should report this income on his SeniorCare application and it should be budgeted. If Mike were planning to withdraw $100 monthly from his IRA in the next 12 months, the $100 he plans to receive monthly from the IRA is counted as income. He should report this income on his SeniorCare application and it should be budgeted. |
Examples of other income are:
A SeniorCare applicant whose spouse is a Medicaid member living outside the home (e.g., in a nursing home) must report the spousal income allocation amount (see Section 18.6 Spousal Impoverishment Income Allocation) as income.
| Example 3 | Betty is a Medicaid member and in a nursing home. She is allowed to allocate up to $1,000 to her spouse, Carl, according to the notice she receives. Betty only actually has $650 available, and of that, $55 is set aside as her personal needs allowance. The $595 per month that she allocates to Carl would be counted as unearned income for Carl. He would report $7,140 as “Other Income” on his SeniorCare application. |
A SeniorCare applicant whose spouse is a Medicaid member living in the home (e.g., a community waivers participant) should not report income that is allocated to him or her. The allocated amount must be included in the income estimate for the Medicaid member spouse because he or she is living in the home.
A SeniorCare applicant must report anticipated farm subsidy payments. A SeniorCare applicant must also report payments from CREP, a program where the landowner is paid to install conservation practices for a period of 10–15 years.
All expected rental income will be budgeted for SeniorCare. Annual operating expenses should be deducted from the annual amount of gross rental income. Operating expenses include ordinary and necessary expenses, such as insurance, utilities, taxes, advertising for tenants, and repairs. Repairs include expenses, such as repainting, fixing gutters or floors, plastering, and replacing broken windows.
Refer to Section 33.6.6.1 Rental Income if rental income is reported to the IRS as self-employment income.
Veterans benefit payments should be reported as income.
Don’t count as income any portion of a veterans benefit that is an aid & attendance (A&A) or housebound allowance or is intended to help the beneficiary pay for their unreimbursed medical expenses (see Section 15.3.26 VA Allowances).
An applicant should check with the Department of Veterans Affairs (VA) at 1-800-827-1000 to determine what (if any) amount of their veterans benefit is considered an A&A or housebound allowance or is for unreimbursed medical expenses.
Reimbursement from the VA for medical costs does not count as income.
The applicant should not report income anticipated from any of the following:
This page last updated in Release Number: 25-02
Release Date: 04/09/2025
Effective Date: 04/09/2025
The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10030