Medicaid Estate Recovery in Illinois

Medicaid Estate Recovery in Illinois: key facts

Recovery scope

Cash and medical assistance paid under the AABD program. The state never asks for more than it paid for services, and for deaths on or after July 1, 2022 the first $25,000 of estate value is protected.

Who is subject

Recipients of AABD cash and medical assistance (all cash assistance, plus medical assistance paid after age 55); recipients of AABD medical assistance only (medical assistance paid after their 55th birthday); and recipients of AABD medical assistance only who resided in a long-term care facility, had been in a medical institution more than 120 days, and had a lien filed on their real property — for them a claim covers all medical assistance paid, regardless of age.

Recovery deferred

No claim is satisfied while there is a surviving spouse, a child under 21, or a child of any age who is blind or permanently and totally disabled under Social Security requirements.

Hardship waiver

HFS waives its claim, in whole or in part, where recovery would cause an heir or legatee undue hardship. The codified ground is that recovery would cause the heir or beneficiary to become or remain eligible for a public benefit program such as SSI, TANF or SNAP (89 Ill. Adm. Code 102.210(g)). HFS publishes two further criteria: estate property that has been the site of a family business for at least 12 months before the death, is the heirs' primary income-producing asset and produces 50% or more of their livelihood; or heirs who could discontinue public or medical assistance if the state did not recover. A separate application is required for each person, returned with supporting documents within 60 calendar days of the date stated on the Notice of Intent to File a Claim Against the Estate.

Governing law: 305 ILCS 5/5-13; $25,000 exemption 89 Ill. Adm. Code 102.210(h); hardship waiver 89 Ill. Adm. Code 102.210(g)

Steps to take when someone dies

1. Determine whether the deceased received AABD cash or medical assistance after age 55, or resided in a long-term care facility after a medical-institution stay of more than 120 days with a lien filed on their real property.
2. Respond to the Notice of Intent to File a Claim Against the Estate that HFS sends to the estate representative or heirs, providing the information requested.
3. Treat an estate recovery claim as a debt of the estate; funeral, legal, and mortgage costs are paid before the claim.
4. Request a hardship waiver within 60 calendar days of the notice if recovery would cause an heir or legatee undue hardship, returning the application with supporting documents.

Frequently asked questions