DHMH/E&L November 2006
Example 1
John Doe, age 85, was in a nursing home in May. He died June 3. Medicaid paid $2,000 for his
care. His estate is worth $50,000. Medicaid will recover $2,000, once all priority claims are
paid.
Example 2
Joe Smith dies while in the Older Adults Waiver. Medicaid paid $25,000 for his care. His estate
is worth $20,000. Medicaid will recover whatever remains once all priority claims are paid.
Are there exceptions in estate recovery?
Estate recovery may also be waived in certain circumstances due to hardship. A hardship means
Medicaid’s claim will result in the removal of a dependent who:
1. Lived in the property at the time of the Medicaid recipient’s death.
2. Lived there continuously for a period of two years before the Medicaid recipient’s
death, and
3. Cannot find another place to live.
Sometimes, when all the conditions above are not met, Medicaid will allow the dependent to
continue to live in the property, but may place a non-interest bearing mortgage on the property.
Medicaid, based on the dependent’s ability to pay, determines monthly payments. This
agreement protects the dependent who lives in the property and Medicaid’s interest in the
property.
What expenses can Medicaid recover?
All medical services are subject to repayment. This includes, but is not limited to, nursing home
care, hospital services, home and community based waivers (for example, Older Adults Waiver,
Living at Home Waiver), personal care, physician and pharmacy services. It is important to
note that recovery will be made even if Medicaid paid a relative, friend or agency to
provide services to the Medicaid recipient as allowed under certain Medicaid waivers (such
as the Older Adults Waiver). However, in those instances where Medicaid made Medicare
premium, co-pay and deductible payments only, the Medicaid Program will not seek
reimbursement.
Additional questions concerning estate and/or property lien recovery should be directed to your
caseworker at the local department of social services or:
Department of Health and Mental Hygiene
Office of Operations, Eligibility & Pharmacy
Recoveries and Financial Services Division
ATTN: Estates, Liens & Trust Section
P.O. Box 13045
Baltimore, MD 21203
Phone (410) 767-6613
Applicable references may be found at Article 15-120 of the Annotated Code of Maryland,
COMAR 10.09.24.15, and the Tax Equity and Fiscal Responsibility Act of 1982