People often wonder if Medi-Cal will try to recover costs of their medical bills from an estate after they die. It’s an uncomfortable thought, but an important one from an estate planning point of view. According to Medicaid law, all states have to try to recover whatever long-term care benefits it paid for the persons care from the estate. Plus, states can recover all Medicaid benefits from anyone over the age of 55, including any type of medical care it paid, not just long-term care. To be clear though, the law says that this recovery can’t happen until the person’s spouse also dies and it can’t happen as long as the deceased leaves behind children under 21-years-old, blind or disabled.
Medi-Cal Repayment Rules
Now, in California, the Medi-Cal program seeks repayment from the estates of only some Medi-Cal members after they die. The recovery only affects the estates of members for benefits that are paid out after their 55th birthday. If the person doesn’t own anything, they will also owe Medi-Cal nothing. So, the repayment to Medi-Cal is limited to estate assets subject to probate that were owned by the member at the time of death. Medi-Cal will only attempt to recover costs that include payments for managed care premiums, nursing facility services, home and community based services, and hospital services or medication costs from when the Medi-Cal member lived in a nursing facility or got home and community based services.
Exemptions To Medi-Cal Collections
The Department of Health Care Services (DHCS) is allowed to waive its claim against an estate if the repayment would cause a substantial hardship on the estate. So, if you’re going through probate and the Medi-Cal claim would cause a substantial hardship, you can submit a waiver. The waiver must be submitted to DHCS within 60 days of the date printed on the DHCS Estate Recovery claim letter that you are sent.
Also, if you’re Native American or an Alaskan Native, there are certain income and resources part of your estate that are actually exempt as well. If the Medi-Cal member’s property is on or near a federally recognized reservation, Pueblo, or Colony, let DHCS know. Talk it over with your attorney, but don’t just assume that because you were sent a DHCS Estate Recovery claim letter, that you don’t qualify for an exemption.
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