Medicaid Estate Recovery
Links & Resources
- California Advocates for Nursing Home Reform html
- Daily Kos
- CA Health Care Foundation
- Simple Explanation CA HealthLine 12.23.2016
- Insure Me Kevin.com –
- Check out Long Term Care Coverage
- DHCS.CA.Gov Explanation
- Insurance and Annuity Disclosure form – might trigger change in Medi Cal eligibility?
Resources, Child Pages & Sibling Pages
Medi Cal and Medi Cal Technical Info.
LIS Low Income Subsidy Part D Rx Medicare
- Advance Strategic Planning – Medi-Cal
- ALW – California Assisted Living Waiver
- Medi Cal – Estate Recovery
California Health Benefit Advisors cahba.com – Forum – Comments
California’s new budget includes $30 million to limit Medi-Cal estate recovery only to that required by federal law. See actual code below. KQED News 6.16.2016 * 3.24.2015 * SB 33 * SB 833 * Simple Explanation CA HealthLine 12.23.2016 * DHCS.CA.Gov
Read below and modules on the borders, Medi Cal can still take your home for nursing care! There are ways to plan, check out our child & sibling pages along with our pages on Long Term Care Insurance.
to see if you qualify for Medi-Cal or Covered CA subsidies.
Here’s the Actual NEW CA Law
SB 833 §14009.5. Effective 1.1.2017
(a) It is the intent of the Legislature, with the amendments made to this section by the act that added subdivision (g), to do all of the following:
§14009.5. (a) Notwithstanding any other provision of this chapter, the department shall claim against the estate of the decedent, or against any recipient of the property of that decedent by distribution or survival an amount equal to the payments for the health care services received or the value of the property received by any recipient from the decedent by distribution or survival, whichever is less.
(b) The department may not claim in any of the following circumstances:
(1) The decedent was under 55 when services were received, except in the case of an individual who had been an inpatient in a nursing facility.
(2) Where there is any of the following:
(A) A surviving spouse during his or her lifetime. However, upon the death of a surviving spouse, the department shall make a claim against the estate of the surviving spouse, or against any recipient of property from the surviving spouse obtained by distribution or survival, for either the amount paid for the medical assistance given to the decedent or the value of any of the decedent’s property received by the surviving spouse through distribution or survival, whichever is less. Any statute of limitations that purports to limit the ability to recover for medical assistance granted under this chapter shall not apply to any claim made for reimbursement.
(B) A surviving child who is under age 21.
(C) A surviving child who is blind or permanently and totally disabled, within the meaning of Section 1614 of the federal Social Security Act (42 U.S.C.A. Sec. 1382c).
(3) Any exemption described in paragraph (2) that restricts the department from filing a claim against a decedent’s property shall apply only to the proportionate share of the decedent’s estate or property that passes to those recipients, by survival or distribution, who qualify for an exemption under paragraph (2).
(c) (1) The department shall waive its claim, in whole or in part, if it determines that enforcement of the claim would result in substantial hardship to other dependents, heirs, or survivors of the individual against whose estate the claim exists.
(2) The department shall notify individuals of the waiver provision and the opportunity for a hearing to establish that a waiver should be granted.
(d) The following definitions shall govern the construction of this section:
(1) “Decedent” means a beneficiary who has received health care under this chapter or Chapter 8 (commencing with Section 14200) and who has died leaving property to others either through distribution or survival.
(2) “Dependents” includes, but is not limited to, immediate family or blood relatives of the decedent. CA Legal Info
CA Department of Health Care Services Estate Recovery, liens, brochure and so forth.
Federal and State laws require DHCS to seek recovery
from the estates of deceased Medi-Cal beneficiaries, or from any recipient of the decedent’s property by distribution or survival, for services and premiums paid on behalf of the decedent on or after age 55.
- California Code of Regulations (CCR) sections 50960-50966
- Welfare and Institutions Code (W&IC) section 14009.5
- Probate Code section 215
- Probate Code section 9202
- Probate Code section 19202
- United Stated Code (USC) section 1396
What is Medi-Cal?
What is Medi-Cal Recovery?
What Was the Law Prior to January 1, 2017?
Medi-Cal Recovery Reforms
Which Medi-Cal Beneficiaries Will be Subject to Recovery?
Medi-Cal Services Subject to Recovery After January 1, 2017
Estate Recovery Exemptions
Estate Recovery Limited to Probate Estate
What Property is Exempt From an Estate Recovery Claim?
How Can I Protect My Home?
How Do I Find Out the Amount of the Estate Recovery Claim?
What Happens After a Medi-Cal Recipient Dies?
Reviewing the Estate Recovery Claim
If I Do Not Meet Any of the Exemptions, How Will I Pay?
This is dated 9.2014 so it doesn't reflect SB 833 on Medi Cal health premiums either
No estate recovery for Medi-Cal - Health Coverage
Official Medi Cal Brochure on Estate Recovery
2015 – so it doesn’t reflect SB 833!
What is Estate Recovery
Medi-Cal pays for medical services for people who are unable to pay for their own care. This can include payments to Medicare, for dental services, and for premiums to managed care health plans, among others.
When a Medi-Cal member passes away, the person’s estate may have to repay these costs through the Medi-Cal Estate Recovery Program, which then helps pay for care of other members. Medi-Cal will never collect more than the value of the assets owned by the Medi-Cal member at the time of death, or the amount that Medi-Cal paid on behalf of the member, whichever is less.
What is an Estate?
All real and personal property and other assets in which the member had any legal title or interest in at the time of death.
This includes houses, mobile homes, cash assets, cars, jewelry, etc.
Does Estate Recovery Affect Everyone?
Estate Recovery only affects
Medi-Cal members who are 55 and older, or those of any age who are cared for at an institution, such as a nursing home. The majority of Medi-Cal members and their heirs will owe nothing