Medicaid Estate Recovery

You've met with your elder law attorney, you've comeout of luck. It can't go after the kids' money. There
up with a plan of action, time has gone by, and yourmust be some assets that the nursing home resident
parent has entered the nursing home, with Medicaidhad a legal interest in, at the time of death, in order for
paying the full cost. Your family members havethe state to be repaid.
managed to preserve virtually all of their assetsIn many states, the only "legal interest" of a deceased
through careful planning, so you feel that the lawyer'sMedicaid recipient that is taken into consideration is the
fee was well worth it!individual's so-called "probate estate"; that's an asset
A number of years go by and your parent has nowthat was titled in the sole name of the individual, or as
passed on to a better place, but before you've finisheda "tenant in common" if jointly owned. It's the assets
grieving you get a letter from the state Medicaidthat will pass under a person's will. For example,
Recovery Unit requesting repayment of every dimesomething like a joint bank account, stock owned in
they paid out on your parent's behalf! You're"TOD" (transfer on death) form, a bank account with a
depressed, angry, confused. You stare at the paper"POD" (pay on death) beneficiary, an annuity interest,
and can't believe it. "I thought we were all set, thatand real estate that's titled as "JTWROS" or "joint
once Mom was on Medicaid we didn't have to worrytenants with right of survivorship," are all non-probate
about that any more....Can this be correct?" you askassets and therefore protected against the state's
your siblings.claim for reimbursement.
Unfortunately, the answer is "Yes." What you haveA number of other states, however, have passed
just been confronted with is something called Medicaidlaws that permit recovery against an "expanded
"estate recovery." Essentially, it requires repayment ofdefinition of estate." The federal Medicaid laws permit
the entire amount of Medicaid benefits that werethis. Under such an expanded definition "estate" could
made during your family member's stay in the nursingnow include joint property, life estates, living trusts, and
home.any other asset in which the deceased nursing home
Prior to 1993, such estate recovery was optional---aresident had any legal interest at the time of death.
state could implement it or not. However, in that year aBoy, that makes it tough! This even goes against
new federal law was passed (known as OBRA '93)hundreds of years of common law, but it is legal, and
that mandated that every state must seek estatethere have been a number of court cases that have
recovery from its Medicaid-receiving residents,backed this up.
following their deaths.Now if you live in one of the "probate estate only"
In essence, while you thought you had qualified yourstates, you should feel lucky, but remember that at any
family member for a government handout, all you'vetime your state can revise its laws and go with the
really received is an interest-free loan! And upon yourbroader definition. And your family member will not be
family's member's death, the state wants its loan paid"grandfathered in" if he or she received Medicaid
back.benefits before the change in law in your state; there
Now if you're sharp, you may be thinking "Wait ahave been court cases that have ruled on this, stating
minute...if someone qualifies for Medicaid, they have tothat it's the law in effect as of the date of death of
be essentially broke. So where exactly is this moneythe Medicaid recipient that counts.
coming from to repay the state?" That's a goodWell, what should you do to plan for this, assuming you
question, and the good news is that if your familycan do anything at all? And are there exceptions to
member died owning nothing, then indeed the state isthis harsh rule? See my other articles on this topic.