Medicaid Estate Recovery in Washington

What is recovered

For services received on or after January 1, 2014, recovery covers nursing facility services, home and community-based services (including COPES, CFC, IFS, PACE, and Medicaid Personal Care), and related hospital and prescription drug costs.¹

For dates of service beginning January 1, 2010, a client who was eligible for both Medicaid and a Medicare savings program leaves no estate liability for any sum paid to cover medical assistance cost-sharing benefits.¹

Who is subject to recovery

Medicaid long-term services and supports are recoverable when they were paid for a client age 55 or older.^{2, 3}

State-only funded long-term care services and related charges are recoverable from estates of recipients of any age.^{2, 1}

Exemptions and protected assets

The state's rule on services subject to recovery excepts adult protective services, offender reentry community safety program services, supplemental security payments authorized by developmental disabilities community services, volunteer chore services, and guardianship and conservatorship assistance program services.¹

For dates of service beginning July 1, 2017, long-term services and supports authorized under the medicaid transformation project, including medicaid alternative care and tailored supports for older adults, are exempt from estate recovery.¹

When recovery is deferred or barred

The state's rule bars recovery from the estate so long as there is a surviving spouse, or a surviving child who is age 20 or younger or who is blind or disabled.⁴

An heir granted a delay must reside on the property, not sell, transfer, or encumber it, keep property taxes and utilities current, and insure it with the state of Washington named as primary payee.⁵

Undue-hardship waiver

The state's undue hardship rule lets an heir ask the state to delay recovery for undue hardship.⁵

Undue hardship exists only when the property subject to recovery is an heir's sole income-producing asset, when recovery would deprive an heir of shelter and the heir cannot afford alternative shelter, or when the client is survived by a state-registered domestic partner.⁵

Liens on real property

A surviving spouse or a minor, blind, or disabled child may continue to live in or rent out the home, and may sell, borrow against, or refinance it.⁶

The state must remove the lien when it receives proof that a bona fide sale or transfer of the real property is complete.⁶

Governing law: RCW 41.05A.090; RCW 43.20B.080; WAC 182-527-2738 (recovery bar); WAC 182-527-2740 (age); WAC 182-527-2742 (services); WAC 182-527-2750 (undue hardship)

Health Care Authority (HCA)

Runs Apple Health (Washington Medicaid)²

1. 1.WAC 182-527-2742, services subject to recovery
2. 2.Office of Financial Recovery, Estate Recovery (Washington DSHS)
3. 3.WAC 182-527-2740, age
4. 4.WAC 182-527-2738, general right to recover and surviving spouse or child bar
5. 5.WAC 182-527-2750, delay of recovery for undue hardship
6. 6.Estate Recovery Information (DSHS 22-1634, Rev. 11/15)