Updated August 27, 2026. Quick answer: Wisconsin sums months, not averages them: “Add together the excess income of the months in the deductible period. The result is the Medicaid deductible.” And for an institutionalised person it gives an instruction that is easy to get backwards: “Calculate the deductible by comparing his or her monthly income for each of the 6 months to the SSI-related medically needy income limit, not the institutional income limit.”
What Wisconsin requires
| What the state sets out | What it says |
|---|---|
| Wisconsin’s name for it | deductible (Medicaid Eligibility Handbook 24.5) |
| Handbook release read | “Release 26-03 August 12, 2026” |
| Months under the limit | “If a given month’s income is less than or equal to the medically needy limit, ignore it.” |
| Months over the limit | “If a given month’s income is more than the medically needy limit, find the excess income by subtracting the income limit from the net income of that month.” |
| The total | “Add together the excess income of the months in the deductible period. The result is the Medicaid deductible.” |
| Which limit applies in an institution | “Calculate the deductible by comparing his or her monthly income for each of the 6 months to the SSI-related medically needy income limit, not the institutional income limit.” |
| The alternative to a deductible | “To be certified for the months he or she is eligible, and accept the ineligibility of the other months in which he or she has excess income, or” |
How it works in practice
- A low month does not offset a high one. Months at or below the limit are ignored rather than credited, so the deductible is the sum of the overages and nothing reduces it.
- The institutional instruction is the differentiator: the comparison uses “the SSI-related medically needy income limit, not the institutional income limit”. Using the institutional figure would produce a different, wrong number.
- There is a choice, and it is not always the deductible. A person eligible in some backdated months can accept ineligibility in the others instead of meeting a six-month deductible.
The mechanism itself — why an income cap exists and what the trust must contain — is explained on the income-cap and Miller trust page. This page is the record for Wisconsin.
What this page does not settle
- The handbook release read for this page is 26-03, dated August 12, 2026. Wisconsin revises this handbook frequently, and the section number is stable while the figures behind it move.
- This page reads one source: Wisconsin Medicaid Eligibility Handbook, Section 24.5 Calculating the Deductible. It is the state’s own publication on this rule, but no state puts its whole treatment of excess income in a single document, and a detail that decides your case may sit in one this page did not read.
- A spend-down fixes an income problem and nothing else. The resource test, the level-of-care test and the transfer-of-assets look-back are separate hurdles, each decided on your own file, and meeting this rule does not clear any of them.
- Every quotation here was read against the source on August 27, 2026. States revise these rules, and a figure or a section number can move without the page around it changing. Open the source before you rely on a detail.
Eligibility is decided by the state agency on the whole file, not by one rule on one page. Nothing here is legal advice, and no one should move, retitle or assign income on the strength of a web page.
Sources
The source above was retrieved and read against the state text on August 27, 2026. Every quotation on this page was checked against those bytes.
This page covers what happens to income above the eligibility standard. What Wisconsin actually uses as that standard, and the state document it comes from, is on Medicaid nursing home income limit in Wisconsin ($2,982/Month).
Related: Wisconsin’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
Related: Wisconsin’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.