Medicaid Estate Recovery in Colorado
Colorado recovers Health First Colorado (Medicaid) costs from the estates of recipients who were 55 or older when they received nursing facility, home and community-based, or related hospital and prescription drug services, and — for recipients who were institutionalized when they received medical assistance — all medical assistance paid on their behalf.
Administering agency
Colorado Department of Health Care Policy and Financing — Estate Recovery
Authority
Colo. Rev. Stat. 25.5-4-302; 10 CCR 2505-10, Section 8.063
Medicaid Estate Recovery in Colorado: key facts
- Recovery scope
- For recipients 55 or older when assistance was received: nursing facility services, home and community-based services, and related hospital and prescription drug services. Colorado does not make the broader optional recoveries federal law permits for this group. For recipients who were institutionalized when they received medical assistance: all medical assistance paid on their behalf.
- Who is subject
- Recipients age 55 or older when they received medical assistance; recipients who were institutionalized at the time they received medical assistance.
- No recovery
- The Department does not recover from the estate if there is a surviving spouse of the recipient, or a child of the recipient under age 21, or a blind or disabled dependent of the recipient.
- Home sale protection
- Recovery from the sale of the recipient's home is barred where a sibling lawfully resided there for at least one year immediately before the recipient was admitted to the institution, or a son or daughter lawfully resided there for at least two years immediately before that admission and provided care that permitted the recipient to live at home rather than in an institution — in each case having continuously lived in the home since. The Department may still recover from other assets in the estate.
- Cost-effectiveness limit
- The Department may limit recovery to cases that are cost-effective — where the medical assistance likely to be recovered is greater than the likely cost of the recovery.
Governing law: Colo. Rev. Stat. 25.5-4-302; 10 CCR 2505-10, Section 8.063
Steps to take when someone dies
- Determine whether the deceased received Health First Colorado medical assistance at age 55 or older, or was institutionalized when they received it.
- Contact the Department of Health Care Policy and Financing to confirm whether an estate recovery claim applies and request the amount.
- Address the claim as a debt of the estate before distributing assets to heirs.
- Ask the Department to compromise, settle, or waive recovery for good cause if heirs would become eligible for assistance without the estate proceeds, if the inheritance would let them leave assistance, or if the home is part of a business, working farm, or ranch that is the heirs' means of livelihood.
Colorado Department of Health Care Policy and Financing — Estate Recovery
Phone: 303-866-2993
Visit the agency website →Frequently asked questions
Yes. Colo. Rev. Stat. 25.5-4-302(4) lets the Department compromise, settle, or waive recovery upon good cause shown, and 10 CCR 2505-10, Section 8.063.18 defines good cause: the heirs would become eligible for assistance without the estate proceeds; the inheritance would let the heirs discontinue assistance; or the home is part of a business, including a working farm or ranch, and recovery would cost the heirs their means of livelihood.
For recipients 55 or older, Colorado recovers the costs of nursing facility services, home and community-based services, and related hospital and prescription drug services. For recipients who were institutionalized when they received medical assistance, Colorado recovers all medical assistance paid on their behalf.
Under 10 CCR 2505-10, Section 8.063.15, the Department does not recover medical assistance from the estate if there is a surviving spouse of the recipient, or a child of the recipient under age 21, or a blind or disabled dependent of the recipient.
Sources
Data sourced from Medicaid Estate Recovery in Colorado primary sources (4 pages reviewed). How we research.
Administering agency
Colorado Department of Health Care Policy and Financing — Estate Recovery
Authority
Colo. Rev. Stat. 25.5-4-302; 10 CCR 2505-10, Section 8.063