Medicaid Estate Recovery in Montana
Montana files a claim against a deceased Medicaid recipient's estate for the medical assistance Medicaid paid on their behalf. Recovery applies to recipients who were 55 or older when they received assistance and to residents of an institution such as the Montana State Hospital. Recipients eligible under Medicaid Expansion are not subject to recovery except for Medicaid-paid long-term care such as nursing home and home and community-based services.
Administering agency
Montana Department of Public Health and Human Services — Estate Recovery (Third Party Liability Unit)
Authority
Mont. Code Ann. 53-6-167; 53-6-180; 53-6-189; Mont. Admin. r. 37.82.431
Medicaid Estate Recovery in Montana: key facts
- Who is subject
- Recipients age 55 or older when assistance was received, and residents of an institution such as the Montana State Hospital. Medicaid Expansion enrollees are not subject to recovery except for Medicaid-paid long-term care such as nursing home and home and community-based services.
- What is recovered
- The amount Medicaid paid on the recipient's behalf, claimed against the estate after death. Medicare cost-sharing paid through a Medicare Savings Program is not subject to recovery.
- Recovery deferred
- While there is a surviving spouse, a surviving child under 21, or a surviving child who is blind or permanently and totally disabled. The State may still recover from a surviving spouse's estate if the spouse dies within three years of the recipient.
- Hardship waiver
- The Department may waive recovery, wholly or in part, where it would cause undue hardship under Mont. Admin. r. 37.82.431 — for example a business or farm that is the heir's sole income source, or property needed for the necessities of life. Not available where assets were diverted to avoid recovery.
- Program contact
- Estate Recovery Program: (406) 444-9440, option 1, or hhsestatelien@mt.gov. Lien Recovery Program: (406) 444-9440, option 3. Mail: Third Party Liability Unit, P.O. Box 202953, Helena MT 59620-2953.
Governing law: Mont. Code Ann. 53-6-167; 53-6-180; 53-6-189; Mont. Admin. r. 37.82.431
Steps to take when someone dies
- Determine whether the deceased received Medicaid at age 55 or older, or was a resident of an institution such as the Montana State Hospital.
- Contact the DPHHS Estate Recovery / Third Party Liability Unit to confirm whether a claim applies and request the amount.
- Address the claim as a debt of the estate before distributing assets to heirs.
- Apply for an undue-hardship waiver through DPHHS if recovery would cause hardship, for example:
- A business or farm that is the heir's sole income-producing asset
- A home where an heir age 65 or older, blind, or disabled has lived for at least a year
- Property an heir needs for the necessities of life with no other assets available
Montana Department of Public Health and Human Services — Estate Recovery (Third Party Liability Unit)
Phone: 1-800-694-3084
Visit the agency website →Frequently asked questions
Montana files a recovery claim against the estate of a Medicaid recipient who was 55 or older when they received assistance, and against residents of an institution such as the Montana State Hospital. Recipients eligible under Medicaid Expansion are not subject to recovery except for Medicaid-paid long-term care such as nursing home and home and community-based services.
Under Mont. Code Ann. 53-6-167(9)(b), the Department may not recover while there is a surviving spouse of the recipient or a surviving child who is under 21, blind, or permanently and totally disabled. DPHHS's Medicaid Lien and Estate Recovery brochure adds that the State can recover from the estate of the surviving spouse if the spouse dies within three years of the recipient.
Yes. Under Mont. Admin. r. 37.82.431, DPHHS may waive recovery, wholly or in part, where it would cause undue hardship — such as a business or farm that is the heir's sole income source, or property needed for food, shelter, clothing, or medical care. The waiver is not available where assets were diverted to avoid recovery.
Sources
Data sourced from Medicaid Estate Recovery in Montana primary sources (6 pages reviewed). How we research.
Administering agency
Montana Department of Public Health and Human Services — Estate Recovery (Third Party Liability Unit)
Authority
Mont. Code Ann. 53-6-167; 53-6-180; 53-6-189; Mont. Admin. r. 37.82.431