State of Wisconsin
Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

17.12 Promissory Notes

17.12.1 Promissory Notes Prior to January 1, 2009

It is divestment if an institutionalized person signs a promissory note prior to January 1, 2009, that has at least one of the following:

17.12.2 Promissory Notes on or After January 1, 2009

The purchase of a promissory note, loan, land contract, or mortgage, on or after January 1, 2009, is a divestment unless such note, loan, land contract, or mortgage meets all of the following criteria:

 

If all of the criteria above are not met, the purchase of the promissory note, land contract, loan, or mortgage is a divestment. The divested amount is the value of the outstanding balance due on the promissory note, loan, land contract, or mortgage as of the date of application for Medicaid LTC services.

 

Example 1: On February 1, 2009, Mary gave her adult daughter $50,000 in exchange for a promissory note, which was expected to be paid back in full during her life expectancy. The terms of the note required Mary’s daughter to repay the loan within a 48-month period by making payments of $100 per month for the first 47 months and a $45,300 payment in the 48th month. Twelve months later, on February 1, 2010, Mary enters a nursing home and applies for Medicaid. She is otherwise eligible for Medicaid but acknowledges the promissory note transaction that occurred during her look-back period.

 

Since the terms of the promissory note contained a provision for a balloon payment, the purchase of the promissory note is a divestment. As of the date of Mary’s application for Medicaid LTC services (February 1, 2010), Mary’s daughter has repaid her mother only $1,200, and the outstanding balance on the note is $48,800. Mary’s divested amount is $48,800 which will be used to calculate a penalty period beginning February 1, 2010.

 

Example 2: John purchased a $60,000 promissory note from his brother Al on April 1, 2009. At that time, John was 80 years old, with a life expectancy of 7.62 years. The terms of the note required equal monthly payments over a 10-year period. Since John’s life expectancy was less than the repayment term, the note is not actuarially sound. Several years later, John enters a nursing home and applies for Medicaid. The outstanding balance on the promissory note on the date of John’s application for Medicaid LTC services is $40,000. The divested amount that will be used in calculating John’s divestment penalty period is $40,000.

17.12.2.1 Promissory Notes on or After July 14, 2015

Beginning with promissory notes created on or after July 14, 2015, notes that cannot be considered assets because they are non-negotiable, non-assignable, or have no market value may be considered divestments. The divestment will be effective either at the time the note was created or at the time it was made non-negotiable, whichever is later.

 

Example 3: Jean gave her adult son $50,000 in exchange for a promissory note, which was expected to be paid back in full during her life expectancy with regular monthly payments. Later that year, Jean entered a nursing home and applied for Medicaid. Since the terms of the promissory note were actuarially sound (meeting all the conditions in Section 17.12.2 Promissory Notes on or After January 1, 2009), the transfer was not considered a divestment. As of the date of Jean’s application for Medicaid LTC services, her son had repaid her only $1,200, and the outstanding balance on the note was $48,800. The promissory note would be considered an available asset for Jean with an assumed value of $48,800.

 

 

 

This page last updated in Release Number: 16-01

Release Date: 06/10/2016

Effective Date: 06/10/2016


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