WISCONSIN MEDICAID FOR THE ELDERLY, BLIND, OR DISABLED APPLICATION PACKET
F-10101
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Estate Recovery
If you are enrolled in Medicaid, Wisconsin State
law, with limited exceptions, requires the recovery
of certain Medicaid benefits from your estate. The
Estate Recovery Program Handbook, P-13032
provides you with information on estate recovery.
You may get a copy of the brochure online
(dhs.wi.gov/library/collection/P-13032), from your
local agency or by contacting Member Services at
800-362-3002. Certain benefits you get in the
community after age 55 and all Medicaid benefits
you get while residing in a nursing home or while
you are an inpatient in a hospital for 30 days or
more, are recoverable. Also, if you reside in a
nursing home or are institutionalized in a hospital,
and are not expected to return home to live, a lien
may be placed on your home. A lien may not be
placed on your home if you, your spouse or certain
other family members reside in the home.
Rights and Responsibilities
Rights
State and Federal laws guarantee rights for
members, which include:
• The right to be treated with respect by state and
county employees.
• The right to confidentiality of all information
given to agencies to determine eligibility. (This
does not prohibit the use of such records for
program administration.)
• The right of access to agency’s records and files
relating to your case, except information obtained
by the agency under a promise of confidentiality.
• The right to remain eligible for Medicaid benefits
even if temporarily absent from the state, if you
remain a Wisconsin resident.
• The right to a speedy determination of eligibility
status and prior notice of proposed changes in
such status.
• The right to emergency medical care.
• The right to request reasonable accommodation
to participate in the program for a disability-
related reason, or the right to request interpreters
or translators to participate in the program.
• The right to appeal any action taken concerning
your Medicaid application or ongoing benefits
that you do not agree with by requesting a fair
hearing.
Fair Hearing
You may appeal to the Division of Hearings and
Appeals or your agency if:
• Your application for Medicaid was denied in
error.
• Your application was not processed within 30
days from the date the agency received it.
• You disagree with the agency’s decision to
discontinue, terminate, suspend, or reduce your
benefit.
• Your request for prior authorization for a
medical service was denied.
You may request a fair hearing by writing to:
Wisconsin Department of Administration
Division of Hearings and Appeals
PO Box 7875
Madison, WI 53707-7875
The Request for Fair Hearing form can be found at
dhs.wi.gov/forwardhealth/resources.htm.
If you choose to write a letter instead of using the
form, you must include:
• Your name.
• Your mailing address.
• A brief description of the problem.
• The name of the agency.
• Your CARES case number.
• Your signature.
An appeal must be made no later than 45 days after
the date of the action.
You may also contact the agency where you applied
and ask for help filing a Fair Hearing request. Refer
to the ForwardHealth Enrollment and Benefits
Handbook, P-00079, to learn more about the fair
hearing process. You will get a handbook when the
agency gets your application or you can find the
handbook at dhs.wi.gov/library/collection/P-00079.
If you have questions about the fair hearing process,
you can call the Division of Hearings and Appeals at
608-266-7709.