Medicaid Estate Recovery in Arizona

Medicaid Estate Recovery in Arizona: key facts

Recovery scope

ALTCS long-term care services — nursing home, assisted living, adult group home, and home- and community-based services — not all Medicaid coverage.

Who is subject

Members who received ALTCS benefits at age 55 or older, on or after January 1, 1994. Costs for benefits provided before the member turned 55 are not included in the claim.

Assets reached

Only property that is subject to a small estate affidavit or probate. A home is reached if it was solely owned, owned jointly without right of survivorship, or owned jointly with right of survivorship where the joint owner is already deceased. An annuity is reached if it too passes through a small estate affidavit or probate.

Personal representative notice

A member's personal representative must notify AHCCCS of the estate or property within three months after the death if the member was at least 55 (A.R.S. § 36-2935(B)).

Statutory exemptions (recovery delayed)

AHCCCS delays recovery where there is a surviving spouse, a surviving child under age 21, or a surviving child of any age who is blind or disabled under SSA/SSI criteria. Proof of the exemption must be provided.

Undue hardship waiver

An heir who lived in the home for at least the 12 months before the death, still lives there, plans to stay, and owns no other real property may qualify for a waiver (Ariz. Admin. Code R9-28-911). The application goes to the recovery contractor HMS within 30 days of the Notification of the AHCCCS Claim, and AHCCCS decides within 60 days.

Governing law: A.R.S. § 36-2935; Ariz. Admin. Code R9-22-1006, R9-28-901, R9-28-911, R9-28-912; 42 U.S.C. 1396p

Steps to take when someone dies

1. Determine whether the deceased received ALTCS long-term care benefits at age 55 or older on or after January 1, 1994.
2. Notify AHCCCS of the estate or property within three months of the death if the member was at least 55 and AHCCCS has not already filed a statement of claim (A.R.S. § 36-2935(B)).
3. Identify which assets pass through probate or a small estate affidavit, since the claim reaches only that property.
4. Complete the Estate Questionnaire that HMS — the AHCCCS recovery contractor — sends, which is what identifies a statutory exemption (surviving spouse, child under 21, or blind or disabled child).
5. Pay the AHCCCS claim from estate assets as a debt due to the State (A.R.S. § 14-3805) before distributing to heirs, or file an application for an undue hardship waiver or partial recovery with HMS within 30 days of the Notification of the AHCCCS Claim Against the Estate.

Frequently asked questions