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Understanding estate recovery under Medicaid

Georgians who receive Medicaid are often extremely thankful for the financial assistance. However, they are often surprised and saddened when they learn that their home and assets may be subject to Medicaid Estate Recovery after they die. This program was enacted by the Georgia legislature in 2006 pursuant the requirement in the federal Omnibus Budget Reconciliation Act of 2003. The federal statute requires the states to enact laws allowing for the recovery of money paid out of Medicaid for long term care and home and community-based care paid for by Medicaid.

The program can affect persons of any age who reside in a nursing facility, intermediate care facility or other medical institution. Persons older than 55 who receive nursing home care or community-based services may also find that they are subject to estate recovery. The state government is required to provide notice of potential liability for estate recovery when an individual first applies for Medicaid assistance.

The government can claim reimbursement for any service provided in a long-term care facility or in the person's home if the care was provided as an alternative to institutionalization. The services include nursing services, personal care services, home and community-based services, hospital services and prescription drug services. The government cannot seek estate recovery as long as the member, the member's spouse or any family members reside in the home. Also, estates less than $25,000 in value are exempt from estate recovery.

Many people who have received Medicaid benefits have found the advice of an attorney knowledgeable about estate recovery very helpful in either avoiding estate recovery altogether or reducing the amount that the state can recover.

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