Shocking Revelation: Your State May Come After Your Estate to Get Reimbursement for Medicaid Payments After You Die

Craig Huey Government, Congress, and Politics, Healthcare, Obamacare 3 Comments

Many Americans who signed up for health insurance under Obamacare were placed into their state’s Medicaid program because of their income.

Perhaps you were one of them … or perhaps you know someone who was.

Receiving free healthcare under expanded Medicaid programs is one reason why so many people like Obamacare … and don’t want to see it repealed.

But there’s something those folks who were placed into their state’s expanded Medicaid program weren’t told…

State Medicaid programs are required by law to recover certain Medicaid benefits paid on behalf of a Medicaid enrollee … after the enrollee dies.

Yes … you read that right.

For Medicaid recipients aged 55 or older, states must seek reimbursement from the enrollee’s estate for payments made for:

  • Nursing facility services
  • Home and community-based services
  • Related hospital and prescription drug payments

States also have the option to seek reimbursement for all other Medicaid services provided – with the exception of a specific type of Medicare cost-sharing.

Currently, the following 10 states seek reimbursement of all Medicaid payments made to enrollees aged 55 and older:

  • California
  • Colorado
  • Iowa
  • Massachusetts
  • Nevada
  • New Jersey
  • New York
  • North Dakota
  • Ohio
  • Rhode Island

If you live in one of these states and have a life insurance policy – or if you own a home – the state can recover their Medicaid payments from those assets after you and your spouse die … even if you put them into a trust.

There are 3 restrictions to states’ ability to raid a deceased Medicaid recipient’s estate. States may not recover Medicaid payments from the estate of a deceased enrollee who is:

  1. Survived by a spouse
  2. Survived by a child under age 21
  3. Survived by a blind or disabled child of any age

States are also required to have procedures in place for waiving estate recovery when doing so would cause “an undue hardship.”

Of course, the burden of proving “undue hardship” is on the heirs of the deceased Medicaid recipient.

To learn more about how your state can use estate recovery rules and liens against real estate and other property to recover Medicaid payments, go to this web site. Click here.

What do you think? Email me at

Here are the rest of this week’s articles:

Comments 3

  1. Hi Craig! I had Medi-cal for a while and I received notices letting me know that this would be the case. I even took my name off of a title deed to a house my daughter and I owned because I was so afraid of this. Now I’m on Medicare because I’m 65, but I believe I got a letter from Medi-cal shortly before I went off of it that said they had changed this law and it was no longer the case that they would go after a person’s estate. I don’t know if Medi-cal and Medicaid have the same rules but I just thought I would put this out there. This was a law that really caused me to live in fear for a few years. It’s preposterous!

    1. Thank you for your comment, Kathy. Perhaps California has either (a) changed it’s own state law and decided to contradict federal law, or (b) adopted a policy of not following federal law, while not actually changing California law. Either way, estate recovery of nursing home and other specific Medicaid payments is still a federal law, so if California burns through its budget surplus and starts running a deficit, Sacramento will be looking for new sources of tax revenue. They could start collecting again at a moment’s notice … without notifying unsuspecting Medicaid recipients in advance.

      1. Thank you for your reply. As I said in my first comment, this was effective during the time I had Medi-Cal so I don’t know if that is separate from Medicaid. However, I didn’t realize this was a federal law. So sad. I hope that this will change in the near future!

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