Medicaid Estate Recovery in Nebraska

Medicaid Estate Recovery in Nebraska: key facts

Who is subject

Recipients who were 55 years of age or older when the medical assistance was provided; and recipients who resided in a medical institution — a nursing facility, an intermediate care facility for persons with developmental disabilities, an assisted-living facility, or an inpatient hospital — whom the department determined could not reasonably have been expected to be discharged and resume living at home.

Recovery deferred

No recovery while a surviving spouse is living, or while there is a surviving child who is under 21 or who is blind or totally and permanently disabled under the Supplemental Security Income criteria.

What counts as the estate

Broader than probate. The estate includes any real estate, personal property, or other asset the recipient had any legal title or interest in at or immediately preceding death, plus assets passing by joint tenancy, tenancy in common, transfer on death deed, survivorship, remainder interest, retained life estate, living trust, or similar arrangement. Excluded: insurance proceeds and burial pre-need trust funds used for funeral, burial, or cremation expenses; life estate interests in real estate more than 60 months after a deed with a retained life estate was recorded; and pension rights or completed retirement plans exempt under federal law.

Hardship waiver

DHHS may waive or compromise its claim in whole or in part. Under 471 NAC 38-004.03 the qualifying circumstances are: an heir lived in the recipient's home for two years before the recipient entered a nursing home (or before the recipient received recoverable services) and provided unreimbursed care that delayed that entry or receipt; payment of the claim would make an heir eligible for public assistance; waiver would let an heir leave public assistance for a substantial period; or another situation DHHS determines case by case. The regulation calls the waiver "a rare and extraordinary remedy," and expecting an inheritance is not a valid basis. No waiver where assets were impermissibly divested or diverted to avoid recovery.

Hardship waiver deadline

A written application must reach DHHS within 30 days of the creditor claim-filing deadline, or within 90 days of the date of death if there is no probate proceeding. Any person who could be considered an heir under the Nebraska Probate Code may apply. DHHS issues a written decision within 90 days of receiving the application, with appeal information if it is denied in whole or in part.

How long DHHS has

DHHS may bring an action against the estate at any time before five years after the last of: the recipient's death; the death of the recipient's spouse; the youngest minor child reaching age 21; or a determination that a disabled adult child is no longer blind or totally and permanently disabled.

Clearance before distributing

A personal representative, successor trustee, or other person holding the decedent's assets may request a written certification from DHHS stating whether any medical assistance reimbursement is due as of a designated date. DHHS publishes a "Request for CERTIFICATION of No Recoverable Amount" form; attach a copy of the legal authority to act (trust provisions, court-issued letters, or a court order), and have the signature notarized if the certification goes to anyone other than the requester.

No estate-recovery liens

DHHS states it does not place liens on property for estate-recovery purposes — it stands as a creditor of the estate, like a doctor or hospital. Funeral expenses take priority over the DHHS claim and should be paid first. A death certificate is not required with the Asset Form.

Contact

Case-specific questions: 402-471-7727. General inquiries: 402-471-1614. Fax 402-742-1103. Email DHHS.MedicaidEstateRecovery@Nebraska.gov. Mail: DHHS Estate Recovery, P.O. Box 95026, Lincoln, NE 68509-9966. Estate Recovery accepts forms by email or U.S. mail.

Governing law: Neb. Rev. Stat. 68-919; 471 NAC 38

Steps to take when someone dies

1. Determine whether the deceased received Medicaid medical assistance at age 55 or older, or while residing in a medical institution without a reasonable expectation of returning home.
2. Expect DHHS to send an "Asset Form for Non-Probated Estates" and an explanatory letter to the decedent's contact person once it receives notice of the death. Return it with bank statements covering the date of death, the funeral statement, and any life insurance policies showing beneficiaries.
3. If the estate is probated, DHHS files a creditor's claim in the county court; address that claim as a debt of the estate before distributing assets.
4. Before distributing, request a written certification of no recoverable amount from DHHS using its Request for Certification form, with proof of your authority to act.
5. Apply in writing for an undue-hardship waiver within 30 days of the creditor claim-filing deadline, or within 90 days of death if there is no probate.

Frequently asked questions