Medicaid Estate Recovery in Vermont
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
Medicaid Estate Recovery in Vermont: key facts
- Who is subject
- Vermont seeks recovery from the estates of individuals who died on or after January 1, 1994 and were 55 or older when they received Medicaid-paid long-term care services — nursing facility services, home- and community-based waiver services, and related hospital and prescription drug services. Recovery includes amounts held in personal needs accounts (Medicaid Covered Services Rule 7108.3).
- Recovery deferred
- While a surviving spouse is living, or while there is a surviving child under 21 or a blind or permanently and totally disabled child of any age.
- Vermont homestead exemption
- No recovery against a homestead passing to a lineal heir or sibling whose income is below 300 percent of the federal poverty level, or who contributed significantly (monetarily or otherwise) to letting the decedent delay or avoid nursing home placement (33 V.S.A. § 1906a).
- Undue hardship exemption for the homestead
- At any time before the probate estate closes, an heir may assert undue hardship. DVHA exempts the home under Medicaid Covered Services Rule 7108.3.2 when a sibling lived in the home continuously for at least one year immediately before the decedent began long-term care, or a son or daughter lived there continuously for at least two years immediately before that date and provided care that allowed the decedent to remain at home, or the homestead is worth less than $250,000, passes to a sibling or lineal heir, and that heir has gross family income below 300 percent of the federal poverty level or provided significant services or financial support that let the decedent avoid or delay long-term care by at least six months. Where the homestead exceeds $250,000, the first $250,000 of fair market value is exempt and the excess equity remains subject to recovery. Requests are made on DVHA 13 (homestead), which must accompany either DVHA 14 (caregiver) or DVHA 15 (household income below 300 percent of the federal poverty level); DVHA requires an affidavit for the sibling and son-or-daughter residence conditions.
- Administering agency
- Department of Vermont Health Access (DVHA), Agency of Human Services.
Governing law: 33 V.S.A. § 1906a; 42 U.S.C. § 1396p
Steps to take when someone dies
- Determine whether the deceased died on or after January 1, 1994 and received Medicaid-paid long-term care services — nursing facility, home- and community-based waiver, or related hospital and prescription drug services — at age 55 or older.
- Contact DVHA Estate Recovery to confirm whether a recovery claim applies to the estate and request the amount.
- Address the claim as a debt of the estate before distributing assets to heirs.
- If the homestead is passing to a lineal heir or sibling who meets the income or caregiving standard in 33 V.S.A. § 1906a, raise the homestead exemption with DVHA in writing.
Department of Vermont Health Access (DVHA) — Estate Recovery
Phone: 802-879-5900
Visit the agency website →Frequently asked questions
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), which DVHA requires alongside either DVHA 14 (caregiver) or DVHA 15 (household income below 300 percent of the federal poverty level); the sibling and son-or-daughter residence conditions also require an affidavit. A denial carries appeal rights.
Sources
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