The Department of Vermont Health Access, part of the Agency of Human Services, recovers Medicaid long-term care costs from the estates of recipients who were 55 or older when they received covered services. Vermont layers a state homestead exemption on top of the federal rules, protecting the homestead when it passes to certain lower-income or caregiving lineal heirs or siblings.
Administering agency
Department of Vermont Health Access (DVHA) — Estate Recovery
Authority
33 V.S.A. § 1906a; 42 U.S.C. § 1396p
Governing law: 33 V.S.A. § 1906a; 42 U.S.C. § 1396p
Vermont recovers the cost of Medicaid-paid long-term care services received at age 55 or older — nursing facility care, home- and community-based waiver services, and related hospital and prescription drug costs — including amounts held in personal needs accounts. Recovery reaches the estates of people who died on or after January 1, 1994.
Recovery is deferred while a surviving spouse is living, and while there is a surviving child under 21 or a blind or permanently and totally disabled child of any age. These are federal protections under 42 U.S.C. § 1396p.
Under 33 V.S.A. § 1906a, no recovery is taken against a homestead passing to a lineal heir or sibling who has income below 300 percent of the federal poverty level, or who contributed significantly — financially or as a caregiver — to letting the decedent delay or avoid nursing home placement.
At any time before the probate estate closes, an heir may assert to DVHA that recovery against the homestead would be an undue hardship. Under Medicaid Covered Services Rule 7108.3.2, DVHA exempts the home if a sibling lived there continuously for at least one year immediately before the decedent began long-term care, a son or daughter lived there continuously for at least two years immediately before that date and provided care that let the decedent remain at home, or the homestead is worth less than $250,000 and passes to a sibling or lineal heir who has gross family income below 300 percent of the federal poverty level or provided significant services or financial support. Requests go in on DVHA 13 (homestead), DVHA 14 (caregiver), or DVHA 15 (household income below 300 percent of the federal poverty level). A denial carries appeal rights.
When someone dies
4-step process for Department of Vermont Health Access (DVHA) — Estate Recovery.
View details →Data sourced from Medicaid Estate Recovery in Vermont primary sources (7 pages reviewed). How we research.
Administering agency
Department of Vermont Health Access (DVHA) — Estate Recovery
Authority
33 V.S.A. § 1906a; 42 U.S.C. § 1396p