Medicaid Estate Recovery in Missouri

What is recovered

The MO HealthNet Division recovers the cost of MO HealthNet benefits from the estate of a deceased participant.¹

What counts as the estate

Estate assets such as homes, savings, and retirement accounts, plus remaining personal-funds and surplus burial-plan balances at the facility.¹

Who is subject to recovery

Estates of MO HealthNet participants. The state does not seek repayment for benefits received before the participant was age 55.¹

Liens on real property

A TEFRA lien may be placed on the property owned by a participant age 55 or older who is receiving long-term care in a nursing facility.¹

Section 208.215.13 directs the department or MO HealthNet Division to enforce TEFRA liens on permanently institutionalized individuals, as authorized by federal law and regulation.²

When recovery is deferred or barred

MO HealthNet will not pursue estate recovery while there is a surviving spouse, a surviving child under age 21, or a surviving child of any age who is blind or disabled.¹

How the state files its claim

Section 473.398 requires the personal representative to file a release from the MO HealthNet Division with the probate clerk before closing the probate estate of a decedent enrolled in MO HealthNet at death, unless the division waives it.³

MO HealthNet returns the completed Estate Notice form indicating whether it will assert or waive an estate recovery claim and, if asserted, the amount.¹

If the decedent was a MO HealthNet participant, a release letter is sent only after the estate recovery claim is paid.¹

Governing law: Mo. Rev. Stat. 473.398, 208.215

Clerk of the court exercising probate jurisdiction

Receives the MO HealthNet release before the probate estate is closed³

1. 1.MO HealthNet Cost Recovery
2. 2.Mo. Rev. Stat. 208.215
3. 3.Mo. Rev. Stat. 473.398
4. 4.MO HealthNet Estate Notice (form 2575-009), March 2025