Medicaid Estate Recovery in New York
New York recovers Medicaid medical assistance from the estate of a deceased recipient who was age 55 or older when it was paid, or who was permanently institutionalized. Since December 6, 2011, recovery reaches only the probate estate — assets passing outside probate are no longer counted.
Administering agency
New York State Office of the Medicaid Inspector General (OMIG) — Estate Recovery
Authority
N.Y. Soc. Serv. Law 369; 18 NYCRR 360-7.11
Medicaid Estate Recovery in New York: key facts
- Who is subject
- Recipients who were age 55 or older when Medicaid was paid, or who were permanently institutionalized in a nursing or other medical facility.
- Recovery scope
- The probate estate only. N.Y. Soc. Serv. Law 369(6) defines "estate" as property passing under the terms of a valid will or by intestacy, and the expanded regulatory definition that reached non-probate assets (joint property, life estates, living trusts) expired December 6, 2011 (GIS 11 MA/028).
- Recovery deferred
- While there is a surviving spouse, a surviving child under 21, or a surviving child of any age who is certified blind or disabled.
- Undue hardship waiver
- May be waived where the asset is the sole income-producing asset of the beneficiary (such as a limited-income family farm or business), or is real property of modest value (no higher than 50 percent of the county average selling price) that is the beneficiary's primary residence.
Governing law: N.Y. Soc. Serv. Law 369; 18 NYCRR 360-7.11
Steps to take when someone dies
- Determine whether the deceased received Medicaid at age 55 or older, or was permanently institutionalized.
- Watch for a Notice of Intent to File a Claim and an Estate Questionnaire from OMIG or its vendor (Health Management Systems, Inc., a Gainwell Technologies company), addressed to the estate representative or beneficiary.
- Complete and return the Estate Questionnaire, noting any deferral, exemption, or undue hardship and attaching probate documents and the death certificate.
- Address the Medicaid claim as a preferred creditor of the estate — paid after funeral expenses, administrative costs, and federal liens — before distributing assets to heirs.
New York State Office of the Medicaid Inspector General (OMIG) — Estate Recovery
Phone: 518-474-6852
Visit the agency website →Frequently asked questions
No. OMIG's claim is against the estate and pertains only to assets in the deceased recipient's name. Beneficiaries and estate representatives are not responsible for paying the claim out of their own funds.
No. New York recovers only from the probate estate. The expanded estate definition that reached jointly held property, life estates, and living trusts expired December 6, 2011, and districts must not include assets passing outside probate.
Recovery is deferred while there is a surviving spouse, a surviving child under 21, or a surviving child of any age who is certified blind or disabled. Medicaid recovers correctly paid benefits only after these deferral circumstances no longer apply.
Sources
Data sourced from Medicaid Estate Recovery in New York primary sources (7 pages reviewed). How we research.
Administering agency
New York State Office of the Medicaid Inspector General (OMIG) — Estate Recovery
Authority
N.Y. Soc. Serv. Law 369; 18 NYCRR 360-7.11