Medicaid Estate Recovery in Nebraska

Who is subject to recovery

Neb. Rev. Stat. 68-919(1) reaches recipients who were 55 years of age or older when the medical assistance was provided.¹

It also reaches 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 DHHS determined could not reasonably have been expected to be discharged and resume living at home.¹

When recovery is deferred or barred

Under Neb. Rev. Stat. 68-919(2)(a), no recovery is made 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.¹

What counts as the estate

Neb. Rev. Stat. 68-919(4)(b) reaches more than probate: any real estate, personal property or other asset the recipient had any legal title or interest in at or immediately preceding death.¹

The estate also includes assets passing by joint tenancy, tenancy in common, transfer on death deed, survivorship, remainder interest, retained life estate, living trust, or a similar arrangement.¹

Exemptions and protected assets

Excluded from the estate: 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.¹

Undue-hardship waiver

Neb. Rev. Stat. 68-919(6) lets DHHS waive or compromise its claim, in whole or in part, where enforcement would not be in the best interests of the state or would result in undue hardship.¹

Under 471 NAC 38-004.03 an heir qualifies who lived in the recipient's home for two years before the recipient entered a nursing home (or received recoverable services) and provided unreimbursed care that delayed that entry or receipt.²

The rule also qualifies an heir whom payment would make eligible for public assistance, or whom a waiver would let leave public assistance for a substantial period, and any other situation DHHS determines case by case. No waiver is granted where assets were impermissibly divested or diverted to avoid recovery.²

How the state files its claim

Under Neb. Rev. Stat. 68-919(4)(d), DHHS may bring an action against the estate at any time before five years after the last of: the recipient's death; the spouse's death; the youngest minor child reaching age 21; or a determination that a disabled adult child is no longer blind or totally and permanently disabled.¹

Under Neb. Rev. Stat. 68-919(4)(c), 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.¹

DHHS says funeral expenses take priority over its claim and should be paid first.³

Liens on real property

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.^{3, 4}

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

Written undue-hardship waiver application, when the estate is probated

within 30 days of the creditor claim-filing deadline²

Written waiver application, by any person who could be an heir under the Nebraska Probate Code, with no probate

within 90 days of the date of death²

DHHS action for recovery against the estate

five years after the last of the four events in Neb. Rev. Stat. 68-919(4)(d)¹

Nebraska county court

Probate of the estate, where DHHS files its creditor's claim³

1. 1.Neb. Rev. Stat. 68-919
2. 2.471 NAC 38, Estate Recovery, 07-01-2019
3. 3.Medicaid Estate Recovery (Nebraska Department of Health and Human Services)
4. 4.Medicaid Estate Recovery brochure (MLTC-PAM-22 (FAM)), Rev. 9/2024
5. 5.Medicaid Estate Recovery Asset Form
6. 6.Request for Certification of No Recoverable Amount