Medicaid Estate Recovery in Texas

What is recovered

Covered Medicaid long-term care services received at age 55 or older: nursing facility services, intermediate care facility services, home and community-based services, and related hospital and prescription drug costs.¹

Who is subject to recovery

1 Tex. Admin. Code § 373.103(a) allows a claim when the recipient was 55 or older when the services were received and first applied for covered Medicaid long-term care services on or after March 1, 2005, when the program began.^{2, 1}

What counts as the estate

Recovery is limited to the probate estate.¹

When recovery is deferred or barred

The state does not ask for money when there is a surviving spouse, a child under 21, a child of any age who is blind or permanently and totally disabled under Social Security requirements, or an unmarried adult child who lived full-time in the recipient's home for at least one year before the death.^{1, 2}

When the state does not pursue a claim

1 Tex. Admin. Code § 373.215 treats a claim as not cost-effective, and the state does not ask for money, when the estate is worth $10,000 or less, the Medicaid cost is $3,000 or less, or the cost of selling the property is more than the property is worth.^{2, 1}

Undue-hardship waiver

MERP may waive its claim in whole or in part when recovery would cause an undue hardship for a legatee or heir, and heirs apply with Form 5006 and proof of the hardship. The state does not grant a hardship waiver unless heirs request it and supply the requested proof.¹

HHSC published the 2025 heir income limit for the homestead waiver as $46,950 for one person and $63,450 for a family of two, and adjusts these figures each year.¹

1 Tex. Admin. Code § 373.209(d) exempts the first $100,000 of the homestead's tax appraisal district value when one or more siblings or direct descendants inheriting it have gross family income below 300 percent of the federal poverty level.²

Under the same rule, appraised value above $100,000 remains subject to recovery, and when only some heirs qualify, only their share of the homestead is exempt.²

How the state files its claim

MERP provides the undue hardship waiver request form with its Notice of Intent to File a Claim.²

Governing law: 1 Tex. Admin. Code §§ 373.103, 373.207, 373.209, 373.215

Undue-hardship waiver request

within 60 days of the date of the MERP Notice of Intent to File a Claim²

Health Management Systems, Inc. (HMS)

The Texas Medicaid Estate Recovery Contractor, which administers the program for HHSC^{4, 1}

Phone: 1-800-641-9356

Fax: 1-214-560-3918

Mailing address: PO Box 166889, Irving, TX 75016-6889

Stellarware Corporation

Takes over Texas MERP operations effective Sept. 1, 2026¹

1. 1.Your Guide to the Medicaid Estate Recovery Program (Texas Health and Human Services)
2. 2.1 Tex. Admin. Code Chapter 373, Medicaid Estate Recovery Program
3. 3.Form 5006, Application for Hardship Waiver (Texas Health and Human Services)
4. 4.Medicaid Estate Recovery Program FAQs (Texas Health and Human Services)