Estate Recovery of non-Long-Term-Care Related Medicaid and expanded Medicaid for People 55 and Over When They Received the Medicaid in the 50 States

Estate Recovery of non-Long-Term-Care Related-Medicaid and ACA expanded Medicaid

for People 55 and Over When They Received the Medicaid

By State

Legal Disclaimer: I am trying to put useful, helpful information on this page. However, I can not be responsible for any errors above. Therefore, please check with the appropriate state insurance departments, and/or seek legal advice, as appropriate, before relying on the information.

This table was filled in Aug, 2019. It is not yet complete. The intent is to fill it in for Medicaid Expansion states only, as those are the only states that we could expect to have health insurance coverage available for all.

The general point of the table is that, even in states that have expanded Medicaid, estate recovery of non-long-term-care-related expenses for people 55 and older, gives people who get Medicaid, including the ACA's expanded Medicaid, only a bomb of a loan (for uninsured medical expenses), rather than insurance. (More on this can be found on my ACA problems page, where the issue is "Issue 1".)

(While the table remains incomplete, some may find this post, from openminds.com, from July 2014, useful, as it attempts to report on statewise non-long-term-care-related estate recovery as it was in July, 2014.)

Directly to State: AL AR AK AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA MA ME MD MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Non-US

STATE

Expanded Medicaid Estate Recovery of Non-Long-Term-Care-Related Expenses for People 55 and Older?

(Refers to current year under current procedures. It may be possible that states with "NO" may change in the future to recover the current year retroactively, as far as I can tell.;
Filled in only for states that have expanded Medicaid.) Population

ALABAMA
NO

(Source: KFF here) Unknown

ARKANSAS
YES, (with work-requirement waiver)

(Source: KFF here) Unknown, seems to have been NO through 2016, from Source now on Wayback Machine Wayback Machine 2016 save, see p. 4

ALASKA
YES

(Source: KFF here) Unknown

ARIZONA
YES (with waiver)

(Source: KFF here) Probably NO (depends on exact reading of document)

Source document: AZ estate recovery program brochure. Exact text is (p. 2) "The Arizona Estate Recovery Program only applies to the estates of individuals who are ages 55 and older and who were enrolled in the Arizona Long Term Care System (ALTCS)." This seems to say you had to be in long-term-care, due to "and" rather than "or". (Unless the language is sloppy.)

CALIFORNIA
YES

(Source: KFF here) NO

Source: California State Estate Recovery document
or this pamphlet. See p. 5.

COLORADO
YES

(Source: KFF here) NO

Sources: here. (See the last column on p. 2.)

CONNECTICUT

YES (Source: KFF here) NO (But leaving a small Husky A--adults with dependent children--subgroup, as well as possibly non-negligible Husky C--disabled employees--group, out):

Source:

An internal CT Department of Social Services document corroborates this, indicated a state plan amendment CT-14-022 will be filed with the feds for Husky D, the new CT Medicaid designed for expanded Medicaid people.

And here we see it on the Federal website, approved on 6/5/14, retroactive to 1/1/14.

You may want to verify what the various CT Medicaid HUSKY programs are. You can do that here. You can see that that Husky A is limited to adults with minor children, so a person 55 or older, the people subject to non-long-term-care-associated estate clawback, would have to have had kids at age 37 or older to be in the group. People do have kids at that age, women and men. The group is not negligible. I don't why they didn't include Husky A. I consider that a mistake or laziness by the CT government. For Husky C, it sounds like some of this is care beyond ACA. But some of it is within the scope of ACA, and it seems like defeating the intent of ACA to estate recover for that within-ACA-scope care. (Also, it is not 100% clear from the website whether a person who does qualify for Husky C and reject it, and get the Husky D.)

Also CT Mirror story here as an interim step while the government formally changes its policy.

DELAWARE
YES

(Source: KFF here) Unknown

I found this: DE code section, which seems to reference only long-term-care, at least initially. However, it is unclear to me, as a non-lawyer, how to read S 5003, sentence (2), and further, it is unclear if recovery of all medical expenses for people 55 and older could be in some other section of the laws for DE.

DISTRICT OF COLUMBIA
YES

(Source: KFF here) YES,

Source: DC estate recovery fact sheet.

FLORIDA
NO

(Source: KFF here)

GEORGIA

NO (Source: KFF here)

HAWAII
YES

(Source: KFF here)

IDAHO
YES

(Source: KFF here) YES

Source: Idaho Care Line

ILLINOIS
YES

(Source: KFF here) YES, in early 2014 at least. (No evidence that this has changed in an internet search.)

Source: 2014 Chicago Tribune Story

INDIANA
YES (with work-requirement waiver)

(Source: KFF here) YES

Source: Indiana State Document

IOWA
YES (with waiver)

(Source: KFF here) YES

Sources: Iowa Legal Aid Doc (June 2019 revision) and IA State Estate Recovery Doc

KANSAS
NO

(Source: KFF here)

KENTUCKY
YES, (with work-requirement waiver)

(Source: KFF here)

LOUSIANA
YES

(Source: KFF here)

MASSACHUSETTS
YES

(Source: KFF here) YES

Sources: MassHealth General Policies (see 515.011-.012). The recovery is referenced as well on MA ACA application ("with help paying costs) on adobe p. 22 (items (9) and (10)), though the exact extent of the recovery is not specified there and you need to go to the regulations (the first link).

MAINE
YES, (with work-requirment waiver)

(Source: KFF here)

MARYLAND
YES

(Source: KFF here) YES, probably. (Needs confirmation.)

Google search and search on the Maryland Medicaid Agency page are both turning up Medical Assistance (Medicaid) property liens and estate recovery fact sheet, which is from 2006.

I am unable to get any information from the Maryland Exchange Site, including looking for a .pdf form application, or a list of "rights and responsibilities". Apparently, as it says here, you can only get a paper application by calling. They won't put a .pdf online.

This mutistate document indicates that as of 2014, Maryland was doing non-LTCR-related estate recovery, so the question is has there been a change since 2014. (No change is turning up in a search.)

MICHIGAN
YES, (with work-requirment waiver)

(Source: KFF here)

MINNESOTA
YES

(Source: KFF here) NO (with a question on permanence)

Source: here, and also here.

However, there is a valid concern for MN that it may retroactively decide to collect expanded Medicaid medical expenses for current years in the future. Because, on the MN MNSURE application (combined ACA expanded-Medicaid and on-exchange plan), there is one place an explicit statement (adobe p. 28) that that MN must collect nursing-home related expenses (this doesn't mess up ACA), but it also has (adobe p. 21) "If anyone on this application is eligible for Medical Assistance, I have read and understand that the state may claim repayment for the cost of medical care, or the cost of the premiums paid for care, from my estate or my spouse's estate". This seems to indicate MN may be allowing itself the freedom to retroactively decide to collect from estates for current ACA expanded Medicaid recipients, despite not doing it under current procedures. (Thank you Rick Rayburn for pointing this out to me.)

MISSISSIPPI
NO

(Source: KFF here)

MISSOURI
NO

(Source: KFF here)

MONTANA
YES (with waiver)

(Source: KFF here)

NEBRASKA
YES

(Source: KFF here)

NEVADA
YES

(Source: KFF here) YES

Sources: Nevada State Document

NEW HAMPSHIRE
YES (with work-requirement waiver)

(Source: KFF here) YES

Sources: NH State Estate Recovery Doc 1 and NH State Estate Recovery Doc 2

NEW JERSEY
YES

(Source: KFF here)
YES

Source: NJ estate recovery document.

NEW MEXICO
YES (with waiver)

(Source: KFF here)

NEW YORK
YES

(Source: KFF here) NO

Source: this NY state government post. See "Estate Recovery" at the bottom of the page.

This is confirmed by the text on the NY multipurpose application, which is one way to apply for all Medicaids. See p. 23, where there is a very comforting explicit condition "Recovery from assets in my estate upon my death is limited to the amount Medicaid paid for the cost of nursing home care, home and community-based services, and related hospital and prescription drug services received on or after my 55th birthday."

Also NY unified health insurance application paper (where there is not estate recovery listed for non-long-term-care related).

NORTH CAROLINA
NO

(Source: KFF here)

NORTH DAKOTA
YES

(Source: KFF here) YES

Source: North Dakota Estate Recovery Document

OHIO
YES (with waiver)

(Source: KFF here) YES

Source: Ohio Estate Recovery Document (Version: 1/2018)

OKLAHOMA
NO

(Source: KFF here)

OREGON
YES

(Source: KFF here) NO

Source documents: Oregon State Estate Recovery document.

Also, this article.

PENNSYLVANIA
YES

(Source: KFF here) NO

Sources: this document and this document

RHODE ISLAND
YES

(Source: KFF here) YES

Source:RI Regulations:210-10-00-4. (See the first section, 4.1., as well as 4.4)

SOUTH CAROLINA
NO

(RI)

SOUTH DAKOTA
NO

(Source: KFF here)

TENNESSEE
NO

(Source: KFF here)

TEXAS
NO

(Source: KFF here)

UTAH
YES

(Source: KFF here) Yes

Source: Utah Medicaid Recovery Document

VERMONT
YES

(Source: KFF here) NO

Source: Oral from VT Health Connect. I called the help number on the CT Health Connect Site and they indicated there is no recovery for non-long-term-care-related expenses for people under 65, including those 55-64. However they also indicated there is no on-the-web documentation to confirm this at all.

(Prior to discussion verbally, the .pdf application, VT ACA application "with help paying costs", left me unclear on the matter, because on p. 2, it says: "Medicaid: If you or anyone in your household enrolls in Medicaid, you give the Medicaid agency the right to pursue and get any money from other health insurance, legal settlements, or other third parties.". I had though "third parties" might refer to Medicaid Estate recovery for people 55 and over, though this would have been very unclear. On the phone, they told me no, it didn't refer to estate recovery, and there is no estate recovery of non-long-term-care-related expenses for people 55-64 when they received the Medicaid.)

VIRGINIA
YES

(Source: KFF here)

WASHINGTON
YES

(Source: KFF here) NO

Sources: current Washington State Estate Recovery document. (You may need to verify that Apple Health is Washington's term for Medicaid, which you can do here.

Here's also the current WA ACA application (see pp. 4 and 12, and the referenced document 182-527-2742.)

Also this article.

WEST VIRGINIA
YES

(Source: KFF here)

WISCONSIN
NO

(Source: KFF here)

WYOMING
NO

(Source: KFF here)

STATE	Expanded Medicaid	Estate Recovery of Non-Long-Term-Care-Related Expenses for People 55 and Older? (Refers to current year under current procedures. It may be possible that states with "NO" may change in the future to recover the current year retroactively, as far as I can tell.; Filled in only for states that have expanded Medicaid.)	Population
ALABAMA	NO (Source: KFF here)	Unknown
ARKANSAS	YES, (with work-requirement waiver) (Source: KFF here)	Unknown, seems to have been NO through 2016, from Source now on Wayback Machine Wayback Machine 2016 save, see p. 4
ALASKA	YES (Source: KFF here)	Unknown
ARIZONA	YES (with waiver) (Source: KFF here)	Probably NO (depends on exact reading of document) Source document: AZ estate recovery program brochure. Exact text is (p. 2) "The Arizona Estate Recovery Program only applies to the estates of individuals who are ages 55 and older and who were enrolled in the Arizona Long Term Care System (ALTCS)." This seems to say you had to be in long-term-care, due to "and" rather than "or". (Unless the language is sloppy.)
CALIFORNIA	YES (Source: KFF here)	NO Source: California State Estate Recovery document or this pamphlet. See p. 5.
COLORADO	YES (Source: KFF here)	NO Sources: here. (See the last column on p. 2.)
CONNECTICUT	YES (Source: KFF here)	NO (But leaving a small Husky A--adults with dependent children--subgroup, as well as possibly non-negligible Husky C--disabled employees--group, out): Source: An internal CT Department of Social Services document corroborates this, indicated a state plan amendment CT-14-022 will be filed with the feds for Husky D, the new CT Medicaid designed for expanded Medicaid people. And here we see it on the Federal website, approved on 6/5/14, retroactive to 1/1/14. You may want to verify what the various CT Medicaid HUSKY programs are. You can do that here. You can see that that Husky A is limited to adults with minor children, so a person 55 or older, the people subject to non-long-term-care-associated estate clawback, would have to have had kids at age 37 or older to be in the group. People do have kids at that age, women and men. The group is not negligible. I don't why they didn't include Husky A. I consider that a mistake or laziness by the CT government. For Husky C, it sounds like some of this is care beyond ACA. But some of it is within the scope of ACA, and it seems like defeating the intent of ACA to estate recover for that within-ACA-scope care. (Also, it is not 100% clear from the website whether a person who does qualify for Husky C and reject it, and get the Husky D.) Also CT Mirror story here as an interim step while the government formally changes its policy.
DELAWARE	YES (Source: KFF here)	Unknown I found this: DE code section, which seems to reference only long-term-care, at least initially. However, it is unclear to me, as a non-lawyer, how to read S 5003, sentence (2), and further, it is unclear if recovery of all medical expenses for people 55 and older could be in some other section of the laws for DE.
DISTRICT OF COLUMBIA	YES (Source: KFF here)	YES, Source: DC estate recovery fact sheet.
FLORIDA	NO (Source: KFF here)
GEORGIA	NO (Source: KFF here)
HAWAII	YES (Source: KFF here)
IDAHO	YES (Source: KFF here)	YES Source: Idaho Care Line
ILLINOIS	YES (Source: KFF here)	YES, in early 2014 at least. (No evidence that this has changed in an internet search.) Source: 2014 Chicago Tribune Story
INDIANA	YES (with work-requirement waiver) (Source: KFF here)	YES Source: Indiana State Document
IOWA	YES (with waiver) (Source: KFF here)	YES Sources: Iowa Legal Aid Doc (June 2019 revision) and IA State Estate Recovery Doc
KANSAS	NO (Source: KFF here)
KENTUCKY	YES, (with work-requirement waiver) (Source: KFF here)
LOUSIANA	YES (Source: KFF here)
MASSACHUSETTS	YES (Source: KFF here)	YES Sources: MassHealth General Policies (see 515.011-.012). The recovery is referenced as well on MA ACA application ("with help paying costs) on adobe p. 22 (items (9) and (10)), though the exact extent of the recovery is not specified there and you need to go to the regulations (the first link).
MAINE	YES, (with work-requirment waiver) (Source: KFF here)
MARYLAND	YES (Source: KFF here)	YES, probably. (Needs confirmation.) Google search and search on the Maryland Medicaid Agency page are both turning up Medical Assistance (Medicaid) property liens and estate recovery fact sheet, which is from 2006. I am unable to get any information from the Maryland Exchange Site, including looking for a .pdf form application, or a list of "rights and responsibilities". Apparently, as it says here, you can only get a paper application by calling. They won't put a .pdf online. This mutistate document indicates that as of 2014, Maryland was doing non-LTCR-related estate recovery, so the question is has there been a change since 2014. (No change is turning up in a search.)
MICHIGAN	YES, (with work-requirment waiver) (Source: KFF here)
MINNESOTA	YES (Source: KFF here)	NO (with a question on permanence) Source: here, and also here. However, there is a valid concern for MN that it may retroactively decide to collect expanded Medicaid medical expenses for current years in the future. Because, on the MN MNSURE application (combined ACA expanded-Medicaid and on-exchange plan), there is one place an explicit statement (adobe p. 28) that that MN must collect nursing-home related expenses (this doesn't mess up ACA), but it also has (adobe p. 21) "If anyone on this application is eligible for Medical Assistance, I have read and understand that the state may claim repayment for the cost of medical care, or the cost of the premiums paid for care, from my estate or my spouse's estate". This seems to indicate MN may be allowing itself the freedom to retroactively decide to collect from estates for current ACA expanded Medicaid recipients, despite not doing it under current procedures. (Thank you Rick Rayburn for pointing this out to me.)
MISSISSIPPI	NO (Source: KFF here)
MISSOURI	NO (Source: KFF here)
MONTANA	YES (with waiver) (Source: KFF here)
NEBRASKA	YES (Source: KFF here)
NEVADA	YES (Source: KFF here)	YES Sources: Nevada State Document
NEW HAMPSHIRE	YES (with work-requirement waiver) (Source: KFF here)	YES Sources: NH State Estate Recovery Doc 1 and NH State Estate Recovery Doc 2
NEW JERSEY	YES (Source: KFF here)	YES Source: NJ estate recovery document.
NEW MEXICO	YES (with waiver) (Source: KFF here)
NEW YORK	YES (Source: KFF here)	NO Source: this NY state government post. See "Estate Recovery" at the bottom of the page. This is confirmed by the text on the NY multipurpose application, which is one way to apply for all Medicaids. See p. 23, where there is a very comforting explicit condition "Recovery from assets in my estate upon my death is limited to the amount Medicaid paid for the cost of nursing home care, home and community-based services, and related hospital and prescription drug services received on or after my 55th birthday." Also NY unified health insurance application paper (where there is not estate recovery listed for non-long-term-care related).
NORTH CAROLINA	NO (Source: KFF here)
NORTH DAKOTA	YES (Source: KFF here)	YES Source: North Dakota Estate Recovery Document
OHIO	YES (with waiver) (Source: KFF here)	YES Source: Ohio Estate Recovery Document (Version: 1/2018)
OKLAHOMA	NO (Source: KFF here)
OREGON	YES (Source: KFF here)	NO Source documents: Oregon State Estate Recovery document. Also, this article.
PENNSYLVANIA	YES (Source: KFF here)	NO Sources: this document and this document
RHODE ISLAND	YES (Source: KFF here)	YES Source:RI Regulations:210-10-00-4. (See the first section, 4.1., as well as 4.4)
SOUTH CAROLINA	NO (RI)
SOUTH DAKOTA	NO (Source: KFF here)
TENNESSEE	NO (Source: KFF here)
TEXAS	NO (Source: KFF here)
UTAH	YES (Source: KFF here)	Yes Source: Utah Medicaid Recovery Document
VERMONT	YES (Source: KFF here)	NO Source: Oral from VT Health Connect. I called the help number on the CT Health Connect Site and they indicated there is no recovery for non-long-term-care-related expenses for people under 65, including those 55-64. However they also indicated there is no on-the-web documentation to confirm this at all. (Prior to discussion verbally, the .pdf application, VT ACA application "with help paying costs", left me unclear on the matter, because on p. 2, it says: "Medicaid: If you or anyone in your household enrolls in Medicaid, you give the Medicaid agency the right to pursue and get any money from other health insurance, legal settlements, or other third parties.". I had though "third parties" might refer to Medicaid Estate recovery for people 55 and over, though this would have been very unclear. On the phone, they told me no, it didn't refer to estate recovery, and there is no estate recovery of non-long-term-care-related expenses for people 55-64 when they received the Medicaid.)
VIRGINIA	YES (Source: KFF here)
WASHINGTON	YES (Source: KFF here)	NO Sources: current Washington State Estate Recovery document. (You may need to verify that Apple Health is Washington's term for Medicaid, which you can do here. Here's also the current WA ACA application (see pp. 4 and 12, and the referenced document 182-527-2742.) Also this article.
WEST VIRGINIA	YES (Source: KFF here)
WISCONSIN	NO (Source: KFF here)
WYOMING	NO (Source: KFF here)