While it is possible for a state to attempt recovery following the death of the surviving spouse, not all states do. Questions regarding probate estates should be directed to the Estate Notice Office. Depending on where you live, your estate could be subject to MERP even if you never accessed long-term care as a Medicaid enrollee. For Medicaid Estate Recovery purposes, an estate consists of the assets and property owned by the Medicaid recipient at the time of his or her death. What defines undue hardship varies based on the state, but examples include the following. Federal law requires states to have an estate recovery program. Box 166889 Irving, Texas 75016-6889 Fax: 214-560-3918 . It also required estate recovery for persons under 55 years of age who were permanently institutionalized (i.e., in a nursing home). 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. 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. Heirs are not asked to spend their own money to pay the estate claim. The NOI will include information on the program, a list of questions for you to complete and return, and an undue hardship waiver request form. Fact Sheet: Nursing HomesA Guide for Medicaid. Alabama Medicaid State Plan - Liens and Recoveries Omnibus Budget Reconciliation Act of 1993 (OBRA '93) The child caregiver exception allows a Medicaid applicant to transfer their home to their healthy adult child. To be clear, unless planning strategies have been implemented, ones home is often not safe from Medicaid estate recovery. Generally speaking, a life insurance policy is safe from estate recovery if a beneficiary is named other than ones estate. State Medicaid programs must recover certain Medicaid benefits paid on behalf of a Medicaid enrollee. Yes, a Medicaid long-term care recipient does not have to be receiving services at the time of death in order for MERP to file a claim. Estate Recovery Department of Health & Human Services General Information (402) 471-1614 Case-Specific Information (402) 471-7727 Email Address DHHS.MedicaidEstateRecovery@Nebraska.gov Mailing Address DHHS Estate Recovery P.O. Non-probate assets that were transferred out of the probate estate before May 1, 2002. An official website of the State of Georgia. Elizabeth Davis, RN, is a health insurance expert and patient liaison. B-2610 Types of MEPD Groups Subject to MERP. Real property, including property conveyed to the recipients survivor through joint tenancy with right of survivorship. A probate estate does not include assets that pass directly to a beneficiary outside of the probate process. With the passing of the Tax Equity and Fiscal Responsibility Act (TEFRA) in 1982, states were given the option to use liens to prevent Medicaid beneficiaries from transferring their home to a loved one shortly before they die as a means to avoid estate recovery. 5. Elizabeth Davis, RN, is a health insurance expert and patient liaison. The State should notify Medicaid recipients about the estate recovery program during their initial application for Medicaid eligibility and annual re-determination process. Assets in a revocable trust if the assets were transferred into the trustafter May 1, 2002. The Medicaid Estate Recovery Program (MERP) allows Medicaid to recover the money it spent on your care from your estate. In most cases, ones home is the last remaining asset of any real value from which Medicaid can seek reimbursement. All funds collected via MERP go back into a states Medicaid program and are used to pay for Medicaid services for other beneficiaries. The federal government has general guidelines for MERP, but specifics vary from state to state. The home is the primary home of the survivor Legal. Medi-Cal Personal Injury Program. The undue hardship waiver (undue hardship exception) enables a state to waive estate recovery if it would cause undue hardship for the beneficiaries / survivors of a deceased Medicaid recipients estate. VI. Since federal and state taxpayers fund Medicaid, the goal of MERP is to lower Medicaid costs. Our records indicate the above named decedent received medical assistance benefits under the Medicaid program. If you live in one of the 29 states that have a Partnership for Long-Term Care program, you can protect some of your assets from MERP by purchasing a private long-term care policy. The federal government has a resource page that includes websites for state long-term care programs and information. MEDICAID ESTATE RECOVERY PROGRAM [R.C. Financial Assistance for Long Term Care. This would include, but is not limited to. For example, in some states, a ladybird deed, a type of life estate deed, can be utilized to protect ones home. Heres how you know. If you have any questions about the claim against the estate or how to complete this form, contact HMS toll-free at 1-800-641-9356. This office may be reached at (334) 242-5727 or by emailing estaterecovery@medicaid.alabama.gov. The family would then have to pay out-of-pocket for long term care costs during disqualification. Specifically, the text of the legislation that implemented MERP clarifies that costs can be recovered for "nursing facility services, home and community-based services, services in an institution for mental diseases, home and community care, and community-supported living arrangements" (in other words, long-term care services, rather than basic medical care) for people who were 55 or older when the care was provided. Mailing address: PO Box 30435, Lansing, MI 48909 How to Protect Your Spouse If You're on Medicaid, Here's What To Do If You'll Lose Medicaid Coverage When the Pandemic Emergency Ends, 3 Insurance Changes That May Impact Your Coverage This Year. Contact Information: Toll-Free Number: 1-844-TPL-MDCH (844-875-6324) Fax: 517-346-9806. Ohio's Medicaid program and other creditors are paid before any assets are distributed to heirs or other . Raleigh, NC 27699-2001 Email: MDHHS-EstateRecovery@michigan.gov. The .gov means its official. To ensure that the checks are successfully processed, Family and Social Services Administration, Program of All-Inclusive Care for the Elderly, Determining Disability Status for Indiana Health Coverage Programs, Termination of Provider Participation in Medicaid and CHIP, http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXIX-sec1396p.pdf, http://iga.in.gov/legislative/laws/2020/ic/titles/012/#12-15-9, http://www.in.gov/legislative/iac/T04050/A00020.PDF, Report Can the state still take it? These payments must have been provided on or after August 15, 1994, the effective date of the Act. 919-855-4850, Section V-(a) Human Resources - Division of Health Benefits, Section VII Procurement and Contract Services, Special Assistance Administrative Letters, Special Assistance In Home Program Admin Letters, Special Assistance In Home Program Change Notices, Special Assistance In Home Case Management Manual, Subsidized Child Care Reimbursement System, Subsidized Child Care Reimbursement System Administrative Letters, Subsidized Child Care Reimbursement System Change Notice, Mental Health, Developmental Disabilities and Substance Abuse Services, EIS-4000 CODES APPENDIX TABLE OF CONTENTS, EIS-4000 CODES APPENDIX B - MEDICAID CODES, EIS-4000 CODES APPENDIX E - TRANSITIONAL CODES, Independent Living Older Blind Policies and Procedures Manual, Independent Living Services Program Manual, Vocational Rehabilitation Policies and Procedures Manual, Services for the Deaf and Hard of Hearing, Formulaires en Franais - Forms in French, Cov ntaub ntawv nyob rau hauv Hmong - Forms in Hmong, Cc biu mu bng ting Vit - Forms in Vietnamese, Enterprise Program Integrity Control System (EPICS), Food Stamp Information System (FSIS) Users, Performance Management/Reporting & Evaluation, https://policies.ncdhhs.gov/divisional/health-benefits-nc-medicaid/adult-medicaid/policies-manuals/ma-2285-estate-recovery, How To Navigate DHHS Policies and Manuals, MA-1100 SSI Medicaid-County DSS Responsibility, MA-2100 CATEGORICALLY NEEDY-NO MONEY PAYMENT, MA-2120: MEDICALLY NEEDY REGULATIONS{ XE "MEDICALLY NEEDY REGULATIONS", MA-2245 UNDUE HARDSHIP WAIVER FOR TRANSFER OF ASSETS, MA-2275 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE), MA-2305 EVALUATING COUNTY/DDS PERFORMANCE, MA-2306 APPLICATION PROCESSING - CORRECTIVE ACTION PROCEDURES, MA-2312 MEDICARE PRESCRIPTION DRUG BENEFIT, MA-2395 CORRECTIVE ACTION AND RESPONSIBILITY FOR ERRORS, MA-2425 COMMUNITY CARE OF NORTH CAROLINA (CCNC)/CAROLINA ACCESS (CA), MA-2430: AUTOMATED INQUIRY AND MATCH PROCEDURES, MA-2505 CITIZENSHIP/IDENTITY SSA DATA MATCH, MA-2900 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES, MA-2130 QUALIFIED MEDICARE BENEFICIARIES - Q, MA-2140 QUALIFIED MEDICARE BENEFICIARIES - B, MA-2231 COMMUNITY SPOUSE RESOURCE PROTECTION, MA-2242 HOME EQUITY VALUE & ELIGIBILITY FOR INSTITUTIONAL SERVICES, MA-2260 FINANCIAL ELIGIBILITY REGULATIONS-PLA, MA-2270 LONG TERM CARE NEED AND BUDGETING, MA-2910 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT), MA-2180 HEALTH COVERAGE FOR WORKERS WITH DISABILITIES, MA-2280 COMMUNITY ALTERNATIVES PROGRAM (CAP), MA-2252 NON-MAGI MEDICAID INCOME/RESERVE LIMITS, MA-2507 TRIBAL MEMBERSHIP AND AMERICAN INDIAN HEALTH SERVICE. As an example, some states attempt reimbursement of costs for other Medicaid services outside of long term care. Medicaids estate recovery follows the Medicaid recipients death, and it is through his / her remaining estate (typically ones home) that the Medicaid agency attempts repayment. Talking with an elder law attorney can help you ensure that you're protecting your assets to the best of your ability, while also receiving the medical coverage for which you're eligible. How Medicaid Takes Its Money Back After You Die. In addition, all states have an undue hardship exception, which is covered in detail below. In some states, this can happen if you received Medicaid-funded services before the age of 55 if you were permanently institutionalized, or any Medicaid-funded services after age 55. 1396p], Alabama Medicaid Administrative Code - Chapter 33. It is possible for Medicaid to initiate estate recovery after the child turns 21. Ones estate might include cash, checking and savings accounts, stocks and bonds, remaining funds in a qualified income trust and / or irrevocable funeral trust, a vehicle, and any other items of value. General inquiries can be sent via U.S. Mail to the address above used for payment, by telephone at 877-267-0013, and by email at EstateRecovery@fssa.in.gov. HMSTexas MERP P.O. Texas Health & Human Services Commission. Estate recovery is a program, required by federal law, whereby Medicaid members with qualified assets reimburse the taxpayers for long term care and home and . The proceeds of a life insurance policy that names a beneficiary. You are asked for a signature to show the state explained MERP to you or your representative. This means that in most cases, if the child does not turn 21 within a year of the Medicaid recipients passing, the state cannot attempt estate recovery. The Medicaid Estate Recovery Program (MERP) allows Medicaid to recover the money it spent on your care from your estate. How can I find out how much the State of Indiana is seeking to recover? States also have the option to attempt recovery from assets that do not go through probate. he Estate Recovery Program allows the Commonwealth to recover Medical Assistance payments made on behalf of an individual who received long-termcare Medical Assistance [including nursing facility, Home and Community Based Services (HCBS) and related services]from the time they turned 55 until their passing. State and federal government websites often end in .gov. To ensure that the checks are successfully processed, DO NOT USE light colored ink when issuing the check. These exceptions allow ownership of the home to be transferred by a living Medicaid beneficiary without violating Medicaids look back rule and causing Medicaid ineligibility. Ultimately, the ideal time to contact a professional planner is well in advance of the need for long term care Medicaid. The State must notify affected survivors about the initiation of estate recovery and give them an opportunity to claim an exemption based on hardship. Medicaid's estate recovery program, abbreviated as MERP or MER, is a program through which a state's Medicaid agency seeks reimbursement of all long term care costs for which it paid for a Medicaid beneficiary. Health Insurance Options If Youre Retiring Before Age 65. Completing the CAPTCHA proves you are a human and gives you temporary access to the web property. Quality Assurance Fee Program. If you're enrolled in Medicaid, or if you have a loved one who is, it's worth understanding how your state handles Medicaid estate recovery. The process for applying for an undue hardship exception should be included with the notice of intent of estate recovery. All states try to recover Medicaid money spent on long-term care such as nursing homes. Check with your state Medicaid office to understand how MERP is enacted within your state and what costs are subject to recoupment. In a nutshell, the home is exempt from Medicaids asset limit prior to sale, but if it is sold, it turns an exempt asset into a countable asset (cash). A Medicaid recipients house and real estate may be subject to estate recovery. Applications can also be downloaded from the FSSA website (see below for link). Medicaid expansion and what it means for you. And if the Medicaid beneficiary was truly without any assets at all, the estate recovery program won't be able to recover anything, as they cannot attempt to recover the money from the beneficiary's heirs (they can use the estate recovery process to recoup assets that may have passed to a surviving spouse, but only after that spouse has passed away as well). Federal Estate Recovery . Learn more here. The sibling exemption allows the transfer of a Medicaid applicants home to a sibling. Yes. If you don't sign the form, you can still get services. 2001 Mail Service Center Funds remaining in a funeral trust after the funeral has been paid for in full. The Estate Recovery Program can provide the amount of the States claim upon request. Estate Recovery Program? This office may be reached at (334) 242-4097 or (334) 242-4098 or by emailing eno.liens@medicaid.alabama.gov. A Medicaid agency cannot collect more from ones estate than the amount in which it paid. But just because you don't sign the form does not make your estate exempt from recovery. Documents Effective Date: 8/2020 8001.pdf (227.69 KB) 8001-S.PDF (118.53 KB) The Estate Notice Office was created to respond to notices at the commencement of a probate proceeding. Aging Care. The estate assets are expected to be used to pay the debts of the estate. American Council on Aging. Box 8486 Harrisburg, PA 17105-9976 (800) 528-3708 Phone (717) 772-6553 Fax RA-PWESTATERECOVERY@pa.gov If you are a Funeral Director or Nursing Home facility choosing to return excess funds, for individuals over 55, click here for more information. Funds remaining in a Qualified Income Trust, also known as a Miller Trust, as of the date of death. Local agencies cannot collect from an MA member . This site is for information purposes; it is not a substitute for professional legal advice. The states must remove the lien when the Medicaid enrollee is discharged from the facility and returns home. input. Although the idea of Medicaid taking money that otherwise would have gone to your heirs is distasteful, it becomes more palatable when you look at the reasons behind the MERP. States can also implement estate recovery for any Medicaid spending incurred (not just long-term-care costs) after enrollees turn 55. The sum due from an annuity contract purchased before May 1, 2005. Some states also attempt to recover money spent on other healthcare expenses. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Are there exceptions to Medicaid Estate Recovery? Copyright 2023 State of Indiana - All rights reserved. Accessibility Issues. The NOI will be mailed to the decedent's estate representative, guardian, power of attorney or family members who have acted on behalf of the recipient, if their name and address are known. Medicaid planners can also provide assistance to a family member of a deceased Medicaid recipient who would like to pursue an undue hardship exception. 2138 - Medicare and Medicaid budget reconciliation act of 1993. Keystone State. In addition to the pre-death lien discussed above, some states may put a lien on the home following a Medicaid recipients death. If it can recover part or all of the money spent on your health care, it saves taxpayers money. Through the MERP program, DADS will send a Notice of Intent to File a Claim within 30 days of the date MERP learns of the death. The State of Indiana is not barred by any time limitations when filing a claim against a probated estate. Last modified date: 3/23/2021 2:17 AM. States cant make recoveries if you have a living child who is under 21 years old, blind, or disabled. It's important to understand that while the ACA expanded the population of people age 55 to 64 who are enrolled in Medicaidand whose assets are not taken into consideration when their Medicaid eligibility is determinedit did not change anything about the MERP. In some states, this can happen if you received Medicaid-funded services before the age of 55 if you were permanently institutionalized, or any Medicaid-funded services after age 55. 1917. 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