What’s the deal with Medicaid claims?

In Probate Creditors by Long

Of the many initial questions I ask a prospective client is whether or not they anticipate a Medicaid claim against the estate. Here’s a brief primer on “Florida Medicaid Estate Recovery“:

Florida Medicaid Estate Recovery Program

The Medicaid Estate Recovery Program is a federal-state program designed to recover some or all Medicaid-funded medical costs from the Estates of certain Medicaid beneficiaries, including nursing home residents whose costs of care were covered by Medicaid.

Are all recipients subject to Estate Recovery?

No. The state does not file a claim where the recipient is under the age of 55 at the time of death or where there is a surviving spouse, minor child or blind/disabled child.

Does the state try to recover all the monies paid on behalf of a recipient?

No. The claim only includes the amount paid on behalf of a Medicaid recipient for services rendered after the recipient reaches age 55.

How does the state know that an estate is opened?

Florida law requires the personal representative of an estate to notify all creditors that an estate is being administered. Medicaid is a creditor if an individual received benefits from the Medicaid Program. In addition, each month, the state obtains copies of reports prepared by the county Clerks of the Court which list the estates opened during the previous month. Estate information is matched against a list of Medicaid recipients and, as appropriate, a claim is filed.

The Medicaid Estate Recovery Program is also subject to Federally Mandated Information Exchange laws. As such, state agencies such as The Office of Vital Statistics (where the Florida death certificates are issued) and federal agencies such as the Social Security Administration office may share information regarding a deceased person. Again, estate information is matched against a list of Medicaid recipients and, as appropriate, a claim is filed.

What assets are subject to potential recovery?

All assets owned by the deceased recipient are considered. However, there are exceptions. For example, the Medicaid Estate Recovery Program will not force the sale of the homestead – where it has retained its Florida Constitutional Protection.