Medicaid Estate Recovery in Washington
Apple Health (Washington Medicaid) is run by the Health Care Authority, and estate recovery is collected by the DSHS Office of Financial Recovery. For services received on or after January 1, 2014, recovery is limited to long-term services and supports — nursing facility care, home and community-based services, and related hospital and prescription drug costs — provided to a recipient aged 55 or older.
OverviewWhen someone dies
Administering agency
DSHS Office of Financial Recovery (OFR) — Estate Recovery Unit
Phone1-800-562-6114
WebsiteVisit website →
Authority
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)
Verified Jul 2026
Medicaid Estate Recovery in Washington: key facts
- Recovery scope (services received on or after Jan 1, 2014)
- Nursing facility services, home and community-based services (including COPES, CFC, IFS, PACE, and Medicaid Personal Care), and related hospital and prescription drug costs paid for a client age 55 or older.
- State-funded long-term care
- State-only long-term care services and related charges are recoverable from estates of recipients of any age.
- Recovery barred
- The state cannot recover 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 (WAC 182-527-2738(3)).
- Medicaid transformation services exempt
- 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.
- Hardship deferral
- An heir may ask the state to delay recovery for undue hardship. 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 (WAC 182-527-2750).
- Conditions on a granted deferral
- 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 (WAC 182-527-2750(4)).
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)
Frequently asked questions
For services received on or after January 1, 2014, Washington recovers only long-term services and supports — nursing facility care, home and community-based services, and related hospital and prescription drug costs — provided to a client age 55 or older. Beginning January 1, 2010, Medicare savings programs and Medicare premiums are exempt from estate recovery when no other recoverable services were provided.
The state cannot recover 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 (WAC 182-527-2738(3)). 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; the state must remove its lien on proof that a bona fide sale or transfer is complete.
Yes. Under WAC 182-527-2750, an heir may ask the state to delay recovery for undue hardship. Undue hardship exists only when the property is the heir's sole income-producing asset, when recovery would deprive an heir of shelter they cannot afford to replace, or when the client is survived by a state-registered domestic partner. Request a deferral from the DSHS Office of Financial Recovery at 1-800-562-6114. An heir granted a delay must live on the property, keep it insured with the state named as primary payee, and may not sell, transfer, or encumber it.
When someone dies
Steps after a death in Washington
5-step process for DSHS Office of Financial Recovery (OFR) — Estate Recovery Unit.
View details →
Sources
Data sourced from Medicaid Estate Recovery in Washington primary sources (8 pages reviewed). How we research.
Administering agency
DSHS Office of Financial Recovery (OFR) — Estate Recovery Unit
Phone1-800-562-6114
WebsiteVisit website →
Authority
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)
Verified Jul 2026