The Medicaid Estate Recovery Program (MERP) is a federal and state mandate that allows states to seek repayment for certain Medicaid benefits (primarily long-term care services and nursing facility services) from a deceased Medicaid recipient’s estate. MERP typically applies to beneficiaries who are over the age of 55 or who have been subject to institutionalization in a nursing home.
Relevant Medicaid Services
MERP applies to Medicaid programs like nursing facility services, home care and community-based services, and related hospital/prescription drugs.
Eligible Assets
When a Medicaid beneficiary passes away, the state can file a claim against their estate. Estate assets may include:
Probate Estate Assets: Assets owned solely in the name of the beneficiary that go through the probate process.
Non-Probate Assets: Depending on state laws, jointly owned property, living trusts, life insurance policies, and other assets may also be subject to recovery.
Limits: If the value of the estate is negligible, there is nothing the state can collect, and they cannot go after living heirs or family members for repayment.
Protections and Exemptions
The state is legally barred from seizing assets or placing a lien on a home if the beneficiary is survived by certain family members, including:
A living spouse.
A child under 21 years of age.
A blind or disabled child of any age, including adult children.
Hardship Waivers
If the estate recovery process creates an undue financial burden on heirs (e.g., the heir relies on the inherited property for their livelihood and will be impoverished), families can apply for an undue hardship waiver. State guidelines determine who qualifies for these exemptions.
Medicaid Estate Recovery can be avoided with proper estate planning and consultation with an elder law attorney prior to applying for Medicaid health care services. While in some states, Medicaid estate recovery claims are rare, in other states they are quite common and to be expected at the time of death of a Medicaid enrollee. For this reason, it is important to seek advice from a qualified professional in your state. QMC is proud to provide services in Missouri and beyond for those seeking Medicaid eligibility.