Medicaid Estate Recovery in California

What is recovered

For deaths on or after January 1, 2017, recovery is limited to payments for nursing facility services, home and community-based services, and related hospital and prescription drug services.¹

What counts as the estate

For deaths on or after January 1, 2017, recovery is limited to assets in the probate estate.¹

Who is subject to recovery

Beneficiaries who received Medi-Cal at age 55 or older, and individuals who were permanently institutionalized.¹

When recovery is deferred or barred

Under Welfare and Institutions Code 14009.5, the department does not claim when there is a surviving spouse or surviving registered domestic partner, a surviving child under 21, or a surviving child who is blind or disabled.^{2, 1}

Undue-hardship waiver

Under Welfare and Institutions Code 14009.5, DHCS waives its claim, in whole or in part, where enforcement would result in substantial hardship.²

DHCS requires a substantial-hardship waiver request within 60 days of the date on the DHCS estate recovery claim letter.¹

Exemptions and protected assets

Under Welfare and Institutions Code 14009.5, DHCS waives its claim when the estate is a homestead of modest value: a home worth 50 percent or less of the average home price in its county at the date of death.²

How the state files its claim

Probate Code 215 requires the estate attorney, or where there is none, the beneficiary, the personal representative or the person in possession of the decedent's property, to give the Director of Health Care Services notice of the death within 90 days, with a copy of the death certificate.³

DHCS takes the notice through its online Notice of Death form, which it names the fastest route, or by mail to the Estate Recovery Program.¹

Governing law: Cal. Welf. & Inst. Code 14009.5

Notice of death to the Director of DHCS, with a copy of the death certificate

within 90 days of the date of death^{3, 1}

Substantial-hardship waiver request

within 60 days of the date on the DHCS estate recovery claim letter¹

1. 1.Estate Recovery Program (California Department of Health Care Services)
2. 2.Cal. Welf. & Inst. Code 14009.5
3. 3.Cal. Prob. Code 215