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Question:

I have been on expanded Medicaid for three years. I am 61 years old. Is expanded Medicaid still subject to estate recovery? If I go off Medicaid now and don’t die till I’m, say 80, will my estate still be in jeopardy? Lastly, is there a way to find out how much Medicaid has paid out on your behalf to date?

Response:

Probably yes, your estate will be subject to claim, and probably no, you won’t be able to get a statement of the amount paid to date. Federal law requires the states to recover Medicaid expenses on behalf of beneficiaries after age 55 for “nursing facility services, home and community-based services, and related hospital and prescription drug services.” 42 U.S. Code § 1396p.

In all likelihood, the benefits you received fall within these categories.  However, some states only seek recovery against probate property. If you live in one of these states, you can avoid estate recovery by placing your assets into a revocable trust, joint ownership or, for some bank and investment accounts, naming a beneficiary. In addition, there’s no adjustment for inflation. So, if you received services in 2024, but do not pass away until 2050, the claim may be relatively small in 2050 dollars.

In terms of finding out how much is owed to date, that depends on your state Medicaid agency but most don’t calculate the total until the beneficiary has passed away.

Finally, there’s a chance that Congress will get rid of Medicaid estate recovery within the next couple of decades. There’s increasing recognition of how unequally it is applied and how it interferes with the intergenerational transfer of wealth by those with the least to pass on. Organizations that represent disabled individuals are working to get Congress to repeal the law.

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