Estate Recovery and Liens

For individuals age 55 or older, states are required to seek recovery of payments from
the individual's estate for nursing facility services, home and community-based services, and
related hospital and prescription drug services. States have the option to recover payments for
all other Medicaid services provided to these individuals, except Medicare cost-sharing paid on
behalf of Medicare Savings Program beneficiaries.

Under certain conditions, money remaining in a trust arer a Medicaid enrollee has passed away
may be used to reimburse Medicaid. States may not recover from the estate of a deceased
Medicaid enrollee who is survived by a spouse, child under age 21, or blind or disabled child of
any age. States are also required to establish procedures for waiving estate recovery when
recovery would cause an undue hardship.

States may impose liens for Medicaid benefits incorrectly paid pursuant to a court judgment.
States may also impose liens on real property during the lifetime of a Medicaid enrollee who is
permanently institutionalized, except when one of the following individuals resides in the home:
the spouse, child under age 21, blind or disabled child of any age, or sibling who has an equity
interest in the home. The states must remove the lien when the Medicaid enrollee is discharged
from the facility and returns home.
https://www.medicaid.gov/