Medicaid Estate Recovery in West Virginia
West Virginia Medicaid recovers the cost of nursing facility services, home and community-based services, and related hospital and prescription drug services from the estates of recipients who were 55 or older when they received the assistance.
Administering agency
West Virginia Department of Human Services, Bureau for Medical Services — Estate Recovery
Authority
W. Va. Code 9-5-11c
Medicaid Estate Recovery in West Virginia: key facts
- Recovery scope
- Nursing facility services, home and community-based services, and related hospital and prescription drug services paid by Medicaid.
- Who is subject
- Recipients who were 55 years of age or older at the time they received the welfare assistance.
- Recovery deferred
- While a surviving spouse is living, while there is a surviving child under 21, or while there is a surviving child who meets the Social Security Act's definition of blindness or permanent and total disability.
- Small estates exempt
- No recovery is imposed on an estate with a value of $5,000 or less at the time the estate is admitted to probate (BMS Provider Manual, Chapter 900, Section 900.7).
- Hardship waiver
- The department may waive a claim if it determines, under applicable federal law and rules, that the claim will cause substantial hardship to the surviving dependents of the deceased. The BMS manual sets out specific grounds, including an adult child who lived in the home for two years before the parent became a member and provided care that kept the parent out of a nursing facility, and an heir whose family business depends on the property.
- Hardship waiver deadline
- An application for an undue hardship waiver must be submitted to the Bureau within 45 days of the placement of the lien or the filing of the proof of claim. BMS then has 90 days from receipt to approve, deny, or advise that more time is needed.
Governing law: W. Va. Code 9-5-11c
Steps to take when someone dies
- Confirm whether the deceased received Medicaid-paid nursing facility, home and community-based, or related hospital or prescription drug services at age 55 or older.
- Check the value of the estate admitted to probate — West Virginia imposes no recovery on estates valued at $5,000 or less.
- Contact the Bureau for Medical Services at 304-342-1604 to find out whether a recovery claim applies and request the amount.
- Address any claim as a debt of the estate before distributing assets to heirs.
- Apply for an undue hardship waiver within 45 days of the lien placement or the filing of the proof of claim if recovery would cause substantial hardship to the surviving dependents.
West Virginia Department of Human Services, Bureau for Medical Services — Estate Recovery
Phone: 304-342-1604
Visit the agency website →Frequently asked questions
The Bureau for Medical Services may waive a claim if it determines, under applicable federal law and rules, that the claim will cause substantial hardship to the surviving dependents of the deceased. The application must be submitted within 45 days of the lien placement or the filing of the proof of claim, and BMS has 90 days from receipt to decide.
West Virginia recovers the cost of nursing facility services, home and community-based services, and related hospital and prescription drug services paid by Medicaid for recipients who were 55 or older at the time, under W. Va. Code 9-5-11c.
Recovery is deferred while a surviving spouse is living, while there is a surviving child under 21, or while there is a surviving child who meets the Social Security Act's definition of blindness or permanent and total disability.
Yes. Under Chapter 900 of the BMS Provider Manual, West Virginia imposes no recovery on an estate with a value of $5,000 or less at the time the estate is admitted to probate.
Sources
Data sourced from Medicaid Estate Recovery in West Virginia primary sources (5 pages reviewed). How we research.
Administering agency
West Virginia Department of Human Services, Bureau for Medical Services — Estate Recovery
Authority
W. Va. Code 9-5-11c