Medicaid Estate Recovery in Oklahoma

Medicaid Estate Recovery in Oklahoma: key facts

Recovery scope

Payments for nursing facility services, home and community based services, related hospital and prescription drug services, physician services, and transportation, for care received on or after July 1, 1994.

Who is subject

Members who were 55 or older when the recoverable care was received. A lien may also be placed against the home of a member who is permanently institutionalized and cannot reasonably be expected to return home.

Recovery deferred

Estate recovery may be made only after the death of the member's spouse, and only when no surviving child age 20 or less and no surviving disabled child of any age is living in the home. A lien on the home cannot be filed or enforced while a surviving spouse, a child age 20 or less, a disabled child, a sibling with an equity interest who lived there for the year before the member's admission, or a son or daughter who lived there for two years and provided care that kept the member out of an institution, lawfully resides there.

Undue hardship waiver

A waiver may be granted where enforcing a lien or an estate recovery would deprive the member of medical care such that health or life would be endangered, or would deprive the member or financially dependent family members of food, clothing, shelter, or other necessities of life. Mere inconvenience or a restricted lifestyle does not qualify. Waiver decisions are made at the Oklahoma Human Services (OKDHS) State Office, Family Support Services Division, Health Related and Medical Services Section; a denial comes with written notice of the appeal process.

Long-Term Care Partnership exclusion

Where the member was covered by an Oklahoma Long-Term Care Partnership Program approved policy and assets or resources were disregarded in the eligibility determination, OHCA will not seek a lien or estate recovery for the amount of the assets or resources disregarded.

Funeral expenses come first on a homestead sale

If the homestead is sold to enforce an OHCA lien, up to $6,000 of the proceeds (less any prepaid burial or insurance policy or funeral account the member already owned) may be set aside in an irrevocable trust for the member's funeral expenses, and funeral expenses are satisfied before any reimbursement to OHCA (63 O.S. 5051.3(J)).

Paying off or clearing the lien

The member, the heirs, the personal representative, or assigns may discharge the lien at any time by paying its amount to OHCA. A recorded lien survives transfer of title by conveyance, sale, succession, inheritance or will, and it severs a joint tenancy (enforceable only to the extent of the member's ownership when assistance began).

Estate recovery contact

OHCA Third Party Liability Unit, Attention: Estate Recovery, 4345 N. Lincoln Blvd., Oklahoma City, OK 73105. Phone 405-522-7588, fax 405-522-7299, Estaterecovery@okhca.org.

Governing law: OAC 317:35-9-15; 63 O.S. 5051.3

Steps to take when someone dies

1. Determine whether the deceased received recoverable SoonerCare services on or after July 1, 1994, at age 55 or older, or was permanently institutionalized.
2. Contact the OHCA Third Party Liability Unit, Estate Recovery, at 405-522-7588 or Estaterecovery@okhca.org to confirm whether a claim or lien applies and to request the amount.
3. Check whether a lien was recorded against the member's homestead with the county clerk. The member's heirs, personal representative, or assigns may discharge the lien at any time by paying its amount to OHCA (63 O.S. 5051.3(G)).
4. Address the Medicaid recovery claim as a debt of the estate before distributing assets to heirs.
5. Apply for an undue-hardship waiver, or assert a deferral, if a qualifying survivor resides in the home or recovery would deprive the member or financially dependent family members of necessities of life. Waiver decisions are made at the Oklahoma Human Services State Office, Family Support Services Division, Health Related and Medical Services Section (OAC 317:35-9-15(b)(3)).

Frequently asked questions