Medicaid Estate Recovery in District of Columbia: when someone dies
A 5-step process for DC Department of Health Care Finance (DHCF) after a death in District of Columbia.
Administering agency
DC Department of Health Care Finance (DHCF)
Authority
42 U.S.C. 1396p(b) (federal Medicaid estate-recovery requirement); DC Medicaid State Plan Attachment 4.17-A (estate defined by D.C. Official Code 20-101(1)). D.C. Code 4-214.01 is a separate District claim against the estates of Old Age Assistance and Aid to the Disabled recipients.
Steps to take
- Determine whether the deceased received DC Medicaid coverage at age 55 or older.
- Contact the DHCF Third Party Liability Division at 202-698-2000 to ask whether an estate-recovery claim applies and to request the claim amount in writing.
- Watch for a Notice of Proposed Recovery. It carries the District's lien on the estate and comes with the Exemption and Undue Hardship Waiver Applications.
- File the Exemption and/or Undue Hardship Waiver Application with DHCF within 30 calendar days of receiving the Notice of Proposed Recovery if an exemption or hardship applies.
- Treat any confirmed claim as a debt of the estate and address it before distributing assets to heirs.
Frequently asked questions
Yes. Under federal law and District regulations, the DC Department of Health Care Finance must request repayment from the estates of deceased Medicaid beneficiaries for services Medicaid paid for. A beneficiary who received Medicaid coverage at age 55 or older is covered by estate recovery. Medicare Part A and B premiums, deductibles, coinsurance, and copayments with dates of service on or after January 1, 2010 are excluded.
No lien is placed if an exemption applies: the surviving spouse lives in the home, a child under 21 lives in the home, or a blind or disabled child lives in the home. Where a lien is placed, the District may seek recovery only after that person no longer lives in the home and the home is sold. The District must also waive or reduce its claim in cases of undue hardship.
Contact the DHCF Health Care Operations Administration, Third Party Liability Division, at 202-698-2000 — the number DHCF publishes on its Medicaid Estate Recovery Fact Sheet. The DHCF main line is 202-442-5988.
Sources
Data sourced from Medicaid Estate Recovery in District of Columbia primary sources (5 pages reviewed). How we research.
Administering agency
DC Department of Health Care Finance (DHCF)
Authority
42 U.S.C. 1396p(b) (federal Medicaid estate-recovery requirement); DC Medicaid State Plan Attachment 4.17-A (estate defined by D.C. Official Code 20-101(1)). D.C. Code 4-214.01 is a separate District claim against the estates of Old Age Assistance and Aid to the Disabled recipients.