Medicaid Estate Recovery in Oregon
Oregon Health Plan is the state Medicaid program, run by the Oregon Health Authority. After a member dies, the Estate Administration Unit of the Oregon Department of Human Services recovers Medicaid benefits paid during the member's long-term care from age 55 onward.
Administering agency
Oregon Department of Human Services — Estate Administration Unit (Oregon Health Plan)
Authority
ORS 416.350; OAR 461-135-0832 to 461-135-0847
Medicaid Estate Recovery in Oregon: key facts
- Recovery scope
- Medicaid benefits paid since age 55 during the member's long-term care — nursing facility, assisted living, residential and adult foster care, in-home care, and related fee-for-service and managed-care costs.
- Who is subject
- Oregon Health Plan members who received long-term care services at age 55 or older. ORS 416.350(2) also reaches medical assistance paid for a person of any age who was a permanently institutionalized inpatient in a nursing facility, an intermediate care facility for persons with intellectual disabilities, or another medical institution.
- Recovery deferred
- No claim is made until after the surviving spouse dies, and no claim is made while there is a surviving child under 21 or a child of any age who is blind or permanently and totally disabled (ORS 416.350).
- Hardship waiver
- A beneficiary, heir, or family member claiming the deceased person's assets may request an undue-hardship waiver in writing within 45 days of the date ODHS sent the hardship-waiver notice to that person or to the probate court (later requests only for good cause). ODHS may consider whether enforcing the claim would make the applicant eligible for assistance or homeless, and issues a written decision within 90 days of receiving the application.
- Waiver does not pause recovery
- Filing a hardship-waiver request or a hearing request does not stop ODHS from pursuing its estate recovery claim in the meantime. If the waiver is ultimately granted, ODHS returns any funds it collected.
Governing law: ORS 416.350; OAR 461-135-0832 to 461-135-0847
Steps to take when someone dies
- Determine whether the deceased received Oregon Health Plan long-term care services at age 55 or older.
- Contact the ODHS Estate Administration Unit to confirm whether a recovery claim applies and request the amount.
- Address the claim as a debt of the estate before distributing assets to heirs.
- Submit a written undue-hardship waiver request within 45 days of the date ODHS sent the hardship-waiver notice to you or to the probate court, if recovery would cause hardship to a person receiving the deceased's property (OAR 461-135-0844).
Oregon Department of Human Services — Estate Administration Unit (Oregon Health Plan)
Phone: 800-826-5675
Visit the agency website →Frequently asked questions
Under ORS 416.350, no claim is made until after a surviving spouse dies, and no claim is made while there is a surviving child under 21 or a child of any age who is blind or permanently and totally disabled. For a Native American or Alaska Native tribal member, OAR 461-135-0837 exempts trust land and other tribal resources and items with unique religious, spiritual, traditional, or cultural significance.
The Estate Administration Unit of the Oregon Department of Human Services handles recovery for the Oregon Health Plan. It files claims with personal representatives and the probate court when an estate is administered. Reach the unit at 800-826-5675.
No. Oregon recovers Medicaid benefits paid during the member's long-term care from age 55 onward — nursing facility, assisted living, residential and adult foster care, in-home care, and related costs — rather than every Medicaid service ever received.
Sources
Data sourced from Medicaid Estate Recovery in Oregon primary sources (6 pages reviewed). How we research.
Administering agency
Oregon Department of Human Services — Estate Administration Unit (Oregon Health Plan)
Authority
ORS 416.350; OAR 461-135-0832 to 461-135-0847