Toward fewer surprises in Medicaid estate recovery

Since 1993, every state except Michigan has been legally entitled to recover the costs of long-term care and related Medicaid expenses from the estates of people who received those services. Merely by enrolling, the 55 million low-income Americans presently receiving Medicaid “agreed” that their estates would pay the money back to the extent funds are available.

But they and their families may not realize it, especially as few other federal programs require repayment. According to a recently released AARP report, “Requiring low-income Medicaid beneficiaries to reimburse the government for services received often stuns surviving spouses and family members of deceased Medicaid recipients.”


Protections in Medicaid Estate Recovery: Findings, Promising Practices, and Model Notices, was developed in response to another report in 2005 by the American Bar Association’s Commission on Law and Aging study. The earlier study called for “more rigorous and uniform notice and other procedural protections. . .(to) check misperceptions about estate recovery and ensure the effectiveness of hardship waiver requirements.”

The new 75 page report concentrates on current state practices for clarifying protections, showing “promising practices and model notifications that can be replicated throughout the country for the benefit of both estate recovery programs and the people affected by them.”