Federal law requires states 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, according to the Ohio Department of Medicaid. The program has existed since 1995.
Although many health care costs are covered by Medicaid, recipients ages 55 or older — or those permanently institutionalized regardless of age — are subject to the estate recovery program, state documents show.
Ohio Medicaid officials said forms that include the following about its estate recovery program are provided to those applying for the benefits:
About estate recovery
Estate recovery seeks repayment of Medicaid benefits once a person enrolled in the program dies. An estate is all the property owned by a Medicaid recipient “at the time of their death, whether or not it passed through probate court.” A person’s house may be subject to estate recovery.
Medicaid payments received since January 1995 are subject to estate recovery. Medicare premium assistance payments made after Jan. 1, 2010 are subject to recovery only when the Medicaid recipient was permanently institutionalized.
The estate’s executor is responsible for notifying the Ohio Attorney General’s office of a Medicaid recipient’s death if that person was permanently institutionalized or was 55 or older.
Once the AG is notified, it will present a claim on an estate.
When can recovery occur?
Recovery of the estate will only be made:
• After the death of the Medicaid recipient’s surviving spouse.
• When the deceased Medicaid client has no surviving child younger than 21.
• When the deceased Medicaid client has no surviving child of any age who is considered blind or disabled under Medicaid regulations.
A will does not protect assets from estate recovery. Ohio Medicaid and other creditors are paid before any assets are distributed to heirs or other beneficiaries.
If there is an undue hardship to a survivor, the right to immediate recovery may be delayed or waived. Undue hardships are decided on a case-by-case basis.
Notice and responsibilities
After an Ohio Medicaid recipient dies, the attorney general’s office sends a notice to the estate’s executor requesting repayment for Medicaid benefits.
It’s the executor’s responsibility to notify any family or other heirs who may be affected by estate recovery. If the executor is not known to the attorney general’s office, they may need to contact the individual’s family members.
The Medicaid Estate Recovery Unit of the attorney general’s office can be contacted at: Medicaid Estate Recovery Unit, 30 E. Broad St., 14th Floor, Columbus, Ohio 43215.
It can also be contacted by phone at 614-752-8085. Online information is available at https://www.ohioattorneygeneral.gov/Business/Collections.
Inquiries can also made to the Ohio Medicaid Consumer Hotline at 1-800-324-8680.
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