Medicaid Estate Recovery in Alabama

Medicaid Estate Recovery in Alabama: key facts

Recovery scope

All approved Medicaid medical assistance except Medicare cost-sharing (42 U.S.C. 1396a(a)(10)(E)).

Who is subject

Recipients age 55 or older when assistance was received; recipients permanently institutionalized at any age.

Recovery deferred

While a surviving spouse is living, or while there is a surviving child under 21 or a blind or permanently and totally disabled child.

Hardship waiver

Available for an income-limited family farm or business that is the sole income-producing asset of heirs. Not available where long-term care insurance applied or assets were illegally divested to avoid recovery. Each heir must apply separately.

Hardship waiver deadline

A waiver application must be requested within 30 days of receiving the Agency's notice against the estate, or upon the sale, transfer, or conveyance of real property subject to a TEFRA lien.

Probate notice required

Code of Ala. 1975 § 43-2-697 (Act 2019-489) requires the personal representative — or the person filing a small estate case — to give notice of the estate to the Alabama Medicaid Agency by certified mail, return receipt requested, and to file an affidavit of that mailing with the probate court. The Agency must respond with a claim, a waiver of claim, or a statement that no amount is due no later than 30 days after it receives the notice; the claim is waived if it does not. Estate Notice Office: (334) 242-4097 or (334) 242-4098.

Distribution held

Sixth-preference debts may not be paid and no distribution may be made until proof of the Medicaid notice has been filed in the probate court and 30 days have passed since the Agency received it (§ 43-2-697(h)).

Governing law: Ala. Admin. Code r. 560-X-33-.05; Code of Ala. 1975, §§ 22-1-11, 22-6-8, 43-2-697

Steps to take when someone dies

1. Determine whether the deceased received Medicaid medical assistance at age 55 or older, or was permanently institutionalized.
2. Give the Estate Notice Office notice of the probate estate by certified mail, return receipt requested, and file the affidavit of mailing with the probate court, as Code of Ala. 1975 § 43-2-697 (Act 2019-489) requires of the personal representative or small-estate filer.
3. Contact the Alabama Medicaid Agency Estate Recovery Section at (334) 242-5727 to confirm whether a recovery claim applies and request the amount.
4. Address the claim as a debt of the estate before distributing assets to heirs.
5. Request an undue-hardship waiver within 30 days of the Agency's notice against the estate if the estate is an income-limited family farm or business that is the sole income-producing asset of heirs. Each heir applies separately.

Frequently asked questions