Medicaid Estate Recovery in California

Medicaid Estate Recovery in California: key facts

Recovery scope (deaths on or after Jan. 1, 2017)

Limited to assets in the probate estate, and limited to payments for nursing facility services, home and community-based services, and related hospital and prescription drug services.

Who is subject

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

No recovery while protected survivors exist

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.

Notice of death (90 days)

The person handling the affairs of a deceased Medi-Cal beneficiary must give the Director of DHCS notice of the death, with a copy of the death certificate, no later than 90 days after the date of death (Cal. Prob. Code 215). DHCS takes the notice through its online Notice of Death form or by mail to the Estate Recovery Program, MS 4720, P.O. Box 997425, Sacramento, CA 95899-7425.

Hardship waiver

DHCS waives its claim where enforcement would cause substantial hardship, and waives it when the estate is a homestead of modest value (a home worth 50 percent or less of the average home price in its county). A waiver request is submitted within 60 days of the date on the DHCS estate recovery claim letter.

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

Steps to take when someone dies

1. Determine whether the deceased received Medi-Cal at age 55 or older, or was permanently institutionalized.
2. Give the Director of DHCS notice of the death with a copy of the death certificate within 90 days of the date of death, using the online Notice of Death form or the Estate Recovery Program mailing address.
3. Confirm whether there is a surviving spouse or registered domestic partner, a child under 21, or a blind or disabled child, in which case no claim is made.
4. Contact DHCS Estate Recovery to confirm whether a claim applies and request the amount before distributing probate assets.
5. Submit a substantial-hardship waiver request to DHCS within 60 days of the date on the claim letter if enforcement would cause hardship.

Frequently asked questions