Medicaid Estate Recovery in Georgia
Georgia recovers the cost of long-term care from the estates of deceased Medicaid members who were 55 or older when they received it, and from members of any age who were in a nursing facility, intermediate care facility, or other medical institution. Recovery applies to services received on or after May 3, 2006, and the Commissioner waives any claim against the first $25,000 of the estate for deaths on or after July 1, 2018.
Medicaid Recovery
Georgia
medicaid.georgia.gov/programs/third-party-liability/medicaid-estate-recovery→Administering agency
Georgia Department of Community Health — State Medicaid Estate Recovery Program
Authority
Ga. Comp. R. & Regs. 111-3-8 (Estate Recovery); O.C.G.A. 49-4-147.1
Medicaid Estate Recovery in Georgia: key facts
- Recovery scope
- Nursing facility services, personal care services, home and community-based services, hospital services, and prescription drug services provided as long-term care.
- Who is subject
- Members age 55 or older when they received the covered services, and members of any age who were an inpatient in a nursing facility, an intermediate care facility for individuals with intellectual disability, or another medical institution.
- Recovery deferred
- No action is taken while a surviving spouse, a child under 21, or a blind or permanently and totally disabled child is living. A lien is not enforced while a qualifying sibling or caregiving child continues to occupy the home.
- Estate value exemption
- For deaths on or after July 1, 2018, the Commissioner waives any claim against the first $25,000 of the estate (Rule 111-3-8-.04). An estate with a gross value of $25,000 or less is exempt from recovery entirely, and undue hardship does not have to be asserted (Rule 111-3-8-.08).
Governing law: Ga. Comp. R. & Regs. 111-3-8 (Estate Recovery); O.C.G.A. 49-4-147.1
Steps to take when someone dies
- Determine whether the deceased received Medicaid long-term care at age 55 or older, or was an inpatient in a nursing facility, intermediate care facility, or other medical institution at any age.
- Contact the State Medicaid Estate Recovery Program at the Department of Community Health to confirm whether a claim applies and request the amount.
- Address any claim as a debt of the estate before distributing assets to heirs, after the first $25,000 exemption for qualifying deaths.
- Request an undue-hardship waiver in writing within 30 days of the notice if recovery would take an income-producing farm that is an heir's sole income source with annual gross income of $25,000 or less, or would make the applicant eligible for needs-based public assistance (Rule 111-3-8-.08). The waiver must be shown by clear and convincing evidence, and the Department decides within 30 days.
Georgia Department of Community Health — State Medicaid Estate Recovery Program
Phone: 770-916-0328
Visit the agency website →Frequently asked questions
Yes. For deaths on or after July 1, 2018, the Commissioner waives any claim against the first $25,000 of the estate, and an estate with a gross value of $25,000 or less is exempt from recovery entirely. Heirs may also request an undue-hardship waiver by showing clear and convincing evidence of hardship.
Georgia recovers the cost of long-term care — nursing facility services, personal care, home and community-based services, hospital services, and prescription drug services — from the estates of members who were 55 or older when they received it, and from members of any age who were an inpatient in a nursing facility, intermediate care facility, or other medical institution.
Recovery is deferred while a surviving spouse, a child under 21, or a blind or permanently and totally disabled child is living. A lien on the home is not enforced while a qualifying sibling with an equity interest, or a caregiving child who lived there continuously, still occupies it.
Sources
Data sourced from Medicaid Estate Recovery in Georgia primary sources (6 pages reviewed). How we research.
Medicaid Recovery
Georgia
medicaid.georgia.gov/programs/third-party-liability/medicaid-estate-recovery→Administering agency
Georgia Department of Community Health — State Medicaid Estate Recovery Program
Authority
Ga. Comp. R. & Regs. 111-3-8 (Estate Recovery); O.C.G.A. 49-4-147.1