Medicaid Estate Recovery in Florida
Accepting Florida Medicaid medical assistance creates a debt to the Agency for Health Care Administration for everything paid for the recipient after the recipient reached 55 years of age. The Agency recovers by filing a statement of claim against the deceased recipient's probate estate, through its Third Party Liability Recovery Program.
Administering agency
Florida Agency for Health Care Administration (AHCA) — Medicaid Third Party Liability Recovery Program
Authority
Fla. Stat. 409.9101 (Medicaid Estate Recovery Act)
Medicaid Estate Recovery in Florida: key facts
- Who is subject
- Recipients who received Medicaid medical assistance after reaching age 55. Payment of benefits to a person under the age of 55 does not create a debt.
- Recovery barred
- The debt is not enforced if the recipient is survived by a spouse, by a child under 21, or by a child who is blind or permanently and totally disabled.
- Homestead protection
- No debt under the Act is enforced against property determined to be exempt from the claims of creditors under the Florida Constitution or laws of this state, which is how constitutional homestead is protected.
- Undue hardship waiver
- The personal representative or any heir may ask the Agency to waive recovery for hardship. A hardship does not exist solely because recovery will prevent heirs from receiving an anticipated inheritance. Criteria the Agency considers include an heir who lived in the decedent's residence for the 12 months before death and owns no other residence, an heir who would be deprived of food, clothing, shelter, or medical care, an heir who gave full-time care that delayed the recipient's entry into a nursing home, and a sale cost equal to or greater than the value of the property.
- No transfer of real property
- Where there are no liquid assets, nonexempt property that is not protected homestead is sold to satisfy the claim. Real property is never transferred to the Agency.
Governing law: Fla. Stat. 409.9101 (Medicaid Estate Recovery Act)
Steps to take when someone dies
- Determine whether the deceased received Florida Medicaid medical assistance after reaching age 55.
- Send notice of the death and the probate proceeding to the Florida Medicaid TPL Recovery Program, as required by Fla. Stat. 409.910, 409.9101, and 733.2121.
- Request the recovery claim amount and treat the claim, once filed in the probate proceeding, as a debt of the estate before distributing assets to heirs.
- Ask the Agency to waive recovery for hardship, or assert the homestead or another creditor exemption, where it applies.
Florida Agency for Health Care Administration (AHCA) — Medicaid Third Party Liability Recovery Program
Phone: 1-877-357-3268
Visit the agency website →Frequently asked questions
Under Fla. Stat. 409.9101, accepting Medicaid medical assistance creates a debt to the Agency for the total amount paid for the recipient after the recipient reached 55 years of age. Payment of benefits to a person under 55 does not create a debt. The Agency recovers by filing a statement of claim in the probate proceeding.
No debt under the Medicaid Estate Recovery Act is enforced against property determined to be exempt from the claims of creditors under the Florida Constitution or state law. Florida's constitutional homestead protection is applied in that determination.
The debt is not enforced if the recipient is survived by a spouse, by a child under 21, or by a child who is blind or permanently and totally disabled. Separately, the personal representative or any heir may request a hardship waiver; a hardship does not exist solely because recovery prevents heirs from receiving an anticipated inheritance.
Sources
Data sourced from Medicaid Estate Recovery in Florida primary sources (2 pages reviewed). How we research.
Administering agency
Florida Agency for Health Care Administration (AHCA) — Medicaid Third Party Liability Recovery Program
Authority
Fla. Stat. 409.9101 (Medicaid Estate Recovery Act)