Medicaid Estate Recovery in Alaska

Medicaid Estate Recovery in Alaska: key facts

Recovery scope

Two limbs. The estate claim (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. Separately, 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 on sale. Not all Medicaid medical assistance.

Who is subject

For the estate claim, the estate of a recipient who was age 55 or older when the long-term care services were received. 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 not reasonably expected to be discharged and return home.

Recovery deferred

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. 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; and recovery on a home lien is further 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.

Hardship waiver

Federal law requires every state, Alaska included, to have a procedure for waiving estate recovery where recovery would work an undue hardship. Alaska does not publish a standalone hardship form or criteria page — the request goes to the Division of Health Care Services Recovery Unit (907-334-2400).

Priority in probate

A Medicaid recovery claim is a debt with preference under state law for purposes of the probate claim-payment order (AS 13.16.470).

Governing law: Alaska Stat. 47.07.055

Steps to take when someone dies

1. Determine whether the deceased received Medicaid long-term care services — nursing facility, intermediate care facility, other medical institution, or home- and community-based waiver care — at age 55 or older, or was permanently institutionalized at any age and owned real property that may carry a Medicaid lien.
2. Contact the Division of Health Care Services Recovery Unit at 907-334-2400 to confirm whether a recovery claim or lien applies and request the amount.
3. Address any valid claim as a debt of the estate before distributing assets to heirs; the claim carries preference in the probate payment order (AS 13.16.470).
4. Ask the Recovery Unit for an undue-hardship waiver if recovery would work a hardship; every state must have a waiver procedure under 42 U.S.C. 1396p(b)(3).

Frequently asked questions