Medicaid Estate Recovery in Alaska

What is recovered

The estate claim under AS 47.07.055(e) covers services received at age 55 or older as an inpatient in a nursing facility, intermediate care facility, or other medical institution, and home- and community-based waiver services. It does not cover all Medicaid medical assistance.¹

Routine Medicaid medical costs of a recipient who was never institutionalized are not recovered.^{2, 1}

Who is subject to recovery

For the estate claim, the estate of a recipient who was age 55 or older when the long-term care services were received.¹

For the lifetime lien, a recipient of any age who was an inpatient in a nursing facility, intermediate care facility, or other medical institution, was required to spend all but a minimal amount of income on medical expenses, and was determined after notice and hearing to be unable to return home.¹

When recovery is deferred or barred

A claim may be made only after the death of the recipient's surviving spouse, if any, and only when there is no surviving child under age 21 and no surviving child who is blind or totally and permanently disabled.¹

Recovery on a home lien is barred while a qualifying sibling, or a son or daughter who lived there for the two years before institutionalization and provided care that kept the recipient out of an institution, still lawfully resides there.¹

Liens on real property

AS 47.07.055(a) authorizes a claim for the medical assistance secured by a lien filed on the recipient's real property during their lifetime, recovered when the property is sold.¹

No lien may be filed on the home while it is lawfully occupied by the recipient's spouse, a child under 21, a blind or disabled child, or a sibling who has an equity interest and lived there for the year before admission.¹

Undue-hardship waiver

42 U.S.C. 1396p(b)(3) requires every state, Alaska included, to have a procedure for waiving estate recovery where recovery would work an undue hardship.³

A hardship waiver request goes to the Division of Health Care Services Recovery Unit.^{4, 5}

How the state files its claim

AS 47.07.055(g) makes a Medicaid recovery claim a debt with preference under state law for purposes of the probate claim-payment order (AS 13.16.470).¹

Governing law: Alaska Stat. 47.07.055

• The criteria for an undue-hardship waiver
• A standalone estate-recovery hardship form

1. 1.Alaska Stat. 47.07.055
2. 2.Division of Health Care Services (Alaska Department of Health)
3. 3.42 U.S.C. 1396p
4. 4.Alaska Medicaid Recipient Handbook (rev. April 16, 2025)
5. 5.Department Contacts (Alaska Department of Health)