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State of Wisconsin |
Release 24-03 |
The following types of income are not included in the countable income when determining eligibility for BadgerCare Plus.
Do not count payments received from the Agent Orange Settlement Fund or any other fund established in settling In Re "Agent Orange" Product Liability Litigation, M.D.L. No. 381 (E.D.N.Y.). This is retroactive to January 1, 1989. Do not count these payments for as long as they are identified separately.
Do not count combat zone pay that goes to the household that is in excess of the military person's pre-deployment pay. The exclusion lasts while the military person is deployed to the combat area.
If the amount of military pay from the deployed absent family member is equal to or less than the amount the household was receiving prior to deployment, count all of the income to the household. Any portion of the military pay that exceeds the amount the household was receiving prior to deployment to a designated combat zone should not be counted when determining the household’s income.
| Example 1 |
John's wife Bonnie and their daughter have an open BadgerCare Plus case. John is in the military stationed overseas; his monthly income is $1,000. John sends his wife $1,000 every month. When John is deployed to a combat zone his pay is increased to $1,300 a month, which is deposited into a joint account. Because the $300 is combat zone pay, it is not counted in the determination. The pre-combat pay of $1,000 is budgeted as unearned income for BadgerCare Plus. |
Do not count income received for the following purposes:
| Note |
Military pay can be verified using the Leave and Earnings Statement received by active-duty personnel. |
Payments received from a state-established fund to aid victims of a crime.
Payments made by federal, state, county, tribal, or local government agencies or disaster assistance organizations.
See Section 2.8 Modified Adjusted Gross Income Counting Rules for information about counting income for people younger than 18 years old.
Payments that are made in the form of matching funds to buy a home, start a business, or to complete post-secondary education.
Count all jury duty payments as earned income for the month in which it is received if the payments are not turned over to the individual’s employer. Amounts received separately as reimbursements or allowances for travel to and from the courthouse, meals, and lodging during jury duty are not countable.
Received from the following:
Made under PL 103-286 to victims of Nazi persecution.
Payments to persons to compensate injury or death due to exposure to radiation from nuclear testing ($50,000) and uranium mining ($100,000). The federal Department of Justice reviews the claims and makes the payments. If the affected person is dead, payments are made to their surviving spouse, children, parents, or grandparents. This is retroactive to October 15, 1990. Do not count these payments for as long as they are identified separately.
The Refugee Cash Assistance program is administered by W-2 agencies and is made available for refugees who do not qualify for W-2.
Refugee "Reception and Placement" payments made to refugees during the first 30 days after their arrival in the U.S. Reception and Placement payments are made by voluntary resettlement agencies and may be a direct payment to the refugee individual/family or to a vendor.
Reimbursements for out-of-pocket expenses that an assistance group member has incurred and/or paid. However, reimbursements for normal household living expenses (for example, rent, clothing, or food eaten at home) are counted.
Examples of reimbursements that are not counted:
The reimbursement payment should not be more than the person’s actual out-of-pocket expenses. If it is more, count the excess amount as unearned income.
Under Wis. Stat. § 32.19, relocation payments are available to displaced persons. The following are examples of costs that the relocation payments are intended to cover moving expenses and replacement housing and property transfer expenses. Do not count the amounts paid by any governmental agency or organization listed in Wis. Stat. § 32.02. Do not count Title II, Uniform Relocation Assistance and Real Property Acquisition Policies Act payments. Its purpose is to treat people displaced by federal and federally aided programs fairly so that they do not suffer disproportionate injuries as a result of programs designed for the public's benefit.
Do not count Experimental Housing Allowance Program payments. Its purpose is to study housing supply. Test areas, which include Brown County, were selected throughout the United States, and contracts were entered into prior to January 1, 1975. A sample of families was selected to receive monthly housing allowance payments.
Repayments of money the member has received from an economic support program and must give back because of a program error or violation. Since they are not entitled to the money, they must repay it; therefore, it should not be counted as income to the member.
Do not count the following repayments:
| Example 2 |
Richard receives $50 a month from the VA and $250 from Social Security. The income from the two sources is added together to equal $300. If the VA overpays Richard by $200, he can only pay back the $50 a month he receives from the VA. If he repays more, for instance, $75 a month, only $50 should be disregarded. |
Income received from any of the following:
(PL 104-204) Payments to any child of a Vietnam veteran for any disability resulting from the child's spina bifida.
Susan Walker Payments received from the class action settlement of Susan Walker vs. Bayer Corporation. These payments are to hemophiliacs who contracted the HIV virus from contaminated blood products.
Work study income and any income from an internship or assistantship should be counted as earned income. Grants, scholarships, fellowships, and any additional financial assistance provided by public or private organizations that exceed the cost of tuition, books, and mandatory fees are counted as unearned income and should be prorated over the period of time they are intended to cover. Student loans are not counted as income regardless of what the loan is used to pay for.
| Example 3 |
Mary was awarded a scholarship for $3,500 in July that is intended to cover her fall semester (September through December). Her tuition and course related expenses are $3,250 for the semester. The $250 that exceeds the amount of tuition and course-related expenses will be prorated over the four-month period from September through December at $62.50 in unearned income each month ($250/4 months = $62.50/month). |
The following types of grants, scholarships, and fellowships are counted as income:
The following educational aid types are not counted as income:
| Note |
These income types will not be considered when determining if grants, scholarships, and fellowships exceed the cost of tuition, books, and mandatory fees. |
The following expense types will be used to offset income from grants, scholarships, fellowships, and other financial aid:
The following expense types will not be allowed to offset income from grants, scholarships, or other financial aid:
Paid to high school students to encourage low-income students to further their education.
Income that is unpredictable, irregular, and has no appreciable effect on ongoing need.
Do not count any veterans' benefits paid under any law, regulation, or administrative practice administered by the VA. The following amounts paid to veterans or their families are not countable:
Do not count VA allowances for unusual medical expenses that are received by a veteran, their surviving spouse, or dependent. Do not count aid and attendance and housebound allowances received by veterans, spouses of disabled veterans, and surviving spouses. For institutionalized and community waiver cases, do not count these allowances in eligibility and post-eligibility determinations, except for residents of the State Veterans Home at King.
(PL 100-383) restitution payments made to individual Japanese Americans (or their survivors) and Aleuts who were interned or relocated during World War II.
Income paid to any adult or minor participating in the Workforce Investment Act, including:
Payments for W-2 Transition, Custodial Parent of an Infant, At Risk Pregnancy, Case Management Follow-up Plus (CMF+) and Community Service Jobs. Do not disregard payments for Trial Employment Match Program or Transform Milwaukee Jobs.
SSI is not counted income for BadgerCare Plus. The following is a brief list of the potential codes for SSI.
Count lump sum payments (if the payment is otherwise a countable income type) in the month received. Lump sum payments are not counted outside of the month received.
Money received as a property settlement is always an asset, regardless of whether it is paid in one payment or installments. It is never income.
Subsidized guardianship payments are not counted for BadgerCare Plus.
Child Support payments are not taxable and are not counted under MAGI rules (see Process Help, Section 62.2.6 Entering Child Support Income on an Unearned Income Page). If a household is receiving family support, divide the payment by the number of members in the household. The amount of the payment allocated to the child(ren) is considered child support and is disregarded. To determine whether the amount of the payment allocated to the adult(s) should be counted (see Section 16.2 Income types not counted, #40 Alimony/Spousal Support).
| Example 4 |
Morgan receives $500 a month in family support for herself and her three children, Kyra (age 15), Kevin (age nine), and Katie (age seven). $500/4 people = $125 per person. Disregard the amount allocated to the children ($125 x 3 children = $375). |
If a household is receiving family support, divide the payment by the number of members in the household. The amount of the payment allocated to the child(ren) is considered child support and is disregarded (see Section 16.2 Income Types Not Counted, #38 Child Support). The amount of the payment allocated to the adult(s) is considered alimony/spousal support. To determine whether alimony/spousal support is counted as income (see Section 16.2 Income Types Not Counted, #40 Alimony/Spousal Support).
Do not count alimony/spousal support if it meets one of the following criteria:
Alimony/spousal support must be counted if the date that the separation or divorce agreement was finalized or modified cannot be verified.
A gift is something a person receives, is not repayment for goods or services the person provided and is not given because of a legal obligation on the giver’s part. To be a gift, something must be given irrevocably (that is, the donor relinquishes all control).
Do not count the value of a gift as income. This includes funds received through crowdfunding accounts, such as GoFundMe and Kickstarter. Funds received through a crowdfunding account would be considered a gift. These funds are not taxable and are not counted.
| Example 5 |
Marco’s grandmother gave him $1,600 to help pay for his classes at a local technical college. Do not count this $1,600 as income. |
Money a person receives that is not repayment for goods or services the person provided and is not given because of a legal obligation on the giver’s part. Money from another person is not a loan.
Do not count money from another person as income (see Section 16.2 Income Types Not Counted, #43 Inheritances, Bequests, and Devises for policies regarding money received from another person through an inheritance, bequest, or devise).
| Example 6 |
Mimi receives $500 each month from her parents. She is not expected to pay back this money. The $500 is not counted as income for BadgerCare Plus eligibility. |
| Note |
If money received from another person is in exchange for goods or services (such as an informal arrangement in which someone rents a room in their house) and if the payment is regular and predictable, it should be counted. See Section 16.4.3.1 Income Sources for information on counting rental income. |
| Example 7 |
Jeremy pays Micah $300 each month to live in a room in Micah’s house. Micah and Jeremy do not have a formal lease agreement, but the payment is regular and predictable. Count the $300 per month as income for BadgerCare Plus eligibility. |
An inheritance is property received from someone who is deceased without a valid will. A bequest is personal property received from someone who is deceased, as directed by that decedent’s will. A devise is real property received from someone who is deceased, as directed by that decedent’s will.
Inheritances, bequests, and devises are generally not taxable, and, as a result, the value of the inheritance, bequest, or devise is generally not counted as income.
However, there are a few forms of inheritances or bequests that may be taxable. For example, distributions from an inherited pension are usually taxable to the beneficiary if the distributions would have been taxable if the deceased were still living.
In addition, income generated from an inheritance, bequest, or devise is usually taxable.
For inheritances, bequests, and devises that are taxable, the income should be counted only in the month it was received if it was received as a lump sum. If the payments are regular and predictable, they should be prorated (unless they are received monthly) and counted accordingly.
| Example 8 |
Roger’s aunt passed away, and Roger inherited her rental house. It is worth $100,000. The house is occupied by tenants who pay $800 a month in rent. At the time of the deed transfer, the tenants owed $3,200 in back rent. The value of the $100,000 property is not taxable, but if the tenants pay Roger the $3,200 in back rent, that income is taxable and would be counted in the month it was received. If they pay Roger $800 a month on an ongoing basis, this income would also be taxable and would be counted based on rules regarding rental income. |
| Note |
Income from the sale of inherited property is taxable if the property is sold for more than the fair market value on either the date of the decedent’s death or on the alternate valuation date. In Example 9, if Roger were to sell the rental house for $150,000, the $50,000 gain would be taxable. If Roger receives income from the sale in a lump sum, this income would only be counted in the month it was received. |
| Example 9 |
Darcy inherited her husband’s $150,000 life insurance policy. In most cases, life insurance policies are not taxable when they are inherited, so the $150,000 should not be counted as income. However, Darcy receives an ongoing interest payment of $1,200 a month from the policy. This amount is taxable and would be counted as unearned income. |
Income generated by an inheritance, bequest, or devise includes situations in which someone is the beneficiary of a trust or estate, and the trust or estate holds assets that are generating income. If the trust or estate distributes income to the beneficiary, the beneficiary is responsible for paying taxes on that income.
| Example 10 |
Keisha is the beneficiary of a trust. Land was given to the trust, and it generates interest that is distributed to Keisha as the beneficiary. Count this interest as unearned income. |
Do not count workers’ compensation benefits. This includes workers’ compensation benefits received as a settlement.
Some refugee resettlement agencies have grants available for refugees for their second, third, and fourth month after arrival in the U.S. These are cash grants and can vary in the amount issued. Do not count this income.
If a BadgerCare Plus applicant or member receives a loan and it is available for current living expenses, do not count it as income, even if there is a repayment agreement.
Certain payments received by live-in care providers who provide care to someone enrolled in an HCBW program are not counted for BadgerCare Plus under MAGI budgeting rules. A live-in care provider lives in the same home as the person for whom they are providing care. This means the same house, apartment, duplex unit, or other residential unit. A provider who lives in a separate unit from the person receiving care within a multi-unit building is not a live-in care provider.
| Example 11 | Ameera provides care to her father, Raheem. Ameera lives in one unit of a duplex. Raheem lives in the other unit of the duplex. Ameera is not a live-in care provider because they do not live together in the same unit. |
Live-in care providers are typically paid as employees, but some may be self-employed. They may be related to or not related to the person receiving care. In order to not be counted, payments to live-in care providers must meet all of the following criteria:
If the payments received by the live-in care provider meet all of these criteria, they are not counted when determining eligibility for BadgerCare Plus. If the payments received by the live-in care provider do not meet all of these criteria, the payments must be treated like other countable earnings or self-employment income. (See Section 16.4.4.2 Live-In Care Providers for verification of payments to live-in care providers and the Verifying Tax-Exempt Income for Live-in Care Providers Form (F-02193)).
ABLE accounts are tax-sheltered money market savings accounts specifically designed for people with disabilities. Anyone may contribute to these accounts for the disabled beneficiary.
While Wisconsin does not offer residents a state-specific ABLE program, Wisconsin residents may open these accounts in any state where an ABLE program is offered. If an applicant or member has an ABLE account, treat the money in the account as follows:
| Note | Someone using their earned or unearned income to contribute to an ABLE account does not make the income exempt for purposes of Medicaid eligibility. Income received by the designated beneficiary and deposited into their ABLE account is still income to the designated beneficiary. For example, an applicant can have contributions automatically deducted from their paycheck and deposited into an ABLE account. In this case, the income used to make the ABLE account contribution is included in the Medicaid eligibility determination as income, even though the ABLE account is an exempt asset. |
ABLE account funds remaining after a member’s death are subject to estate recovery.
| Note |
If a third party contributes to someone else’s ABLE account and then later applies for long-term care Medicaid, the contributed funds may be considered divestment. |
When spouses are filing taxes separately and one spouse enrolled in Institutional Medicaid and allocates income to the spouse still living in the community, do not count this income when determining BadgerCare Plus eligibility for the spouse living in the community.
| Example 11 |
Jenny resides in a nursing home and is enrolled in Institutional Medicaid. Her husband, Kevin, lives in the community and is applying for BadgerCare Plus. Jenny and Kevin file taxes separately. Jenny has income from Social Security and a pension. She allocates $1,100 of her monthly income to Kevin as the community spouse. Do not count this allocation when determining Kevin’s BadgerCare Plus eligibility. |
There is no uniform policy for how to count payment types related to the COVID-19 pandemic. Some payment types are counted as income for BadgerCare Plus and some payment types are not counted as income for BadgerCare Plus. The criteria used to evaluate whether a payment type is counted as income include:
The payment types that do not count as income for BadgerCare Plus include but are not limited to:
See Section 16.5 Other Income, #23 Certain Payment Types Related to the COVID-19 Pandemic for countable types of pandemic-related unemployment compensation benefits.
Advance payments of the federal EITC and the Child Tax Credit are disregarded as income, whether they are received regularly or as a lump sum.
Guaranteed income from a privately funded, non-profit organization is excluded. This includes but is not limited to payments from the Madison Forward Fund and The Bridge Project in Milwaukee.
Canceled debt is not counted as income.
This page last updated in Release Number: 24-03
Release Date: 12/18/2024
Effective Date: 12/18/2024
The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 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-10171