Medicaid Estate Recovery

How states recover Medicaid long-term care costs from a deceased recipient's estate

Medicaid Estate Recovery

51 state programs

medicaid.gov/medicaid/eligibility-policy/estate-recovery

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Each state's Medicaid agency or estate recovery unit

Select a state for its administering office, key facts, and steps.

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Medicaid Estate Recovery

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Verified Jul 2026

Medicaid estate recovery is the process by which a state recovers what it paid for certain Medicaid benefits from the estate of a deceased recipient. Federal law (42 U.S.C. 1396p(b)) requires every state to recover for long-term care and related services provided to people age 55 or older, and for anyone who was permanently institutionalized. Recovery is made after death against the deceased recipient's estate, so it is a claim the executor or administrator handles during estate settlement. The scope of recoverable assets, available exemptions, and the administering agency are set by each state.

Medicaid estate recovery in your state

Each state administers its own program. Select a state for its administering office, key facts, and the steps that apply there.

Handling Medicaid estate recovery after a death

The state's claim is addressed during estate settlement, before assets are distributed.

A state Medicaid agency files its claim against the estate after the recipient dies. The executor or administrator identifies whether the deceased received Medicaid long-term care, notifies the state Medicaid or estate recovery unit as required during probate, and addresses the claim before distributing assets to heirs. Recovery is deferred by federal law while a surviving spouse is living, or while there is a surviving child under 21 or a child of any age who is blind or has a disability. States provide a process to request a hardship waiver.

Timeline: During estate administration (state claim windows vary)

1
Determine whether the deceased received Medicaid-funded long-term care (nursing facility, home and community-based services, or related hospital and prescription drug services) at age 55 or older, or was permanently institutionalized.
2
Contact the state Medicaid agency or its estate recovery unit to confirm whether a recovery claim applies and to request a statement of the amount.
3
Identify whether recovery is deferred or an exemption applies:
  • Recovery is deferred while a surviving spouse is alive
  • Recovery is deferred while there is a surviving child under 21, or a child of any age who is blind or has a disability
  • Many states defer or waive recovery for an undue-hardship case (for example, an heir's primary residence or income-producing asset)
4
Address the state's claim as a debt of the estate before distributing assets to heirs.
5
Request a hardship waiver through the state process if an exemption may apply.

Required Documents

  • Death certificate
  • Letters testamentary or letters of administration
  • The deceased's Medicaid identification or case number, if known
  • An inventory of estate assets

Timeline

Resolved during estate administration

Frequently asked questions

The executor or administrator of the estate handles the claim. The state Medicaid agency files a claim against the estate, and the claim is treated as a debt of the estate that is addressed before assets are distributed to heirs.

Federal law defers recovery while a surviving spouse is living, or while there is a surviving child under 21 or a child of any age who is blind or has a disability. States also provide an undue-hardship waiver process. The specific exemptions and how to request a waiver are set by each state.

Medicaid estate recovery is the process by which a state recovers what it paid for certain Medicaid benefits from the estate of a deceased recipient. Federal law requires states to recover for long-term care and related services provided to recipients age 55 or older, and for anyone who was permanently institutionalized.

Yes. Federal law at 42 U.S.C. 1396p(b) requires every state to operate a Medicaid estate recovery program. States decide which assets are recoverable beyond the probate estate, what exemptions apply, and which agency administers the program.

At a minimum, states recover for nursing facility services, home and community-based services, and related hospital and prescription drug services provided to a recipient age 55 or older. Some states recover for all Medicaid benefits paid on behalf of those recipients.

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Sources

Data sourced from Medicaid Estate Recovery primary sources (3 pages reviewed). How we research.