En esta noticia
The U.S. Medicaid program has a mechanism that can affect a deceased person’s inheritance because the agency can claim some of the assets they left behind to recover certain medical costs the government covered during their lifetime. The measure can reach property, savings and other assets that relatives expected to receive as an inheritance.
The provision is known as the Medicaid Estate Recovery Program (MERP) and is set out in federal law. In general, it applies to beneficiaries age 55 or older who received certain medical services, although each state may set additional conditions on the assets subject to recovery.
However, the rules also provide protections for certain family members, such as a surviving spouse and children under 21 or who are blind or disabled.
What Medicaid’s program is that allows a deceased person’s assets to be claimed
Through MERP, state Medicaid programs seek to recover certain medical costs they covered during a person’s lifetime. The provision is set out in Section 1917 of the Social Security Act, codified at 42 U.S.C. 1396p, and allows claims to be filed against the estates of deceased beneficiaries.
According to the Centers for Medicare and Medicaid Services (CMS), recovery is mandatory when the beneficiary was 55 or older when receiving certain services. The services covered include:
- Nursing home and skilled nursing care.
- Home- and community-based services.
- Hospital and prescription drug costs tied to those services.
States may also expand claims to other Medicaid-covered medical services, within the limits set by federal law.
What happens to the home and assets left by a deceased person
A Medicaid claim can reach assets that are part of a person’s probate estate, including real estate, cash and other assets. That means a family home may be subject to a claim to recover medical costs the program paid during the beneficiary’s lifetime. However, that does not mean the government automatically takes the house because the state must follow the proper procedures, and the claim is subject to the rules governing estate priority and administration.
Federal law requires states to recover assets included in the estate defined by local inheritance laws. But it also lets states broaden that definition to include certain assets that pass directly to family members or heirs, such as jointly owned property, interests in property or assets transferred through certain trusts. Medicaid’s official site warns that each state runs its recovery program under federal rules and its own regulations.
Which heirs are protected and when Medicaid cannot claim their assets
The federal government provides protections for certain family members of a deceased person who received Medicaid. Specifically, states cannot recover from the estate while the beneficiary has any of these surviving relatives:
- A surviving spouse.
- A child under 21.
- A blind or disabled child, regardless of age.
These protections are set out in Section 1917(b)(2) of the Social Security Act. So even if Medicaid paid for certain medical services during the beneficiary’s lifetime, the presence of any of these relatives prevents the state from moving forward with the claim while the protected status remains in place.
States must also have procedures to grant waivers when recovering the assets could cause undue financial hardship for heirs. In this regard, each jurisdiction sets the criteria for evaluating those requests, so not every family automatically qualifies for the exception.
As a result, other relatives, including adult children who do not have a disability covered by federal protections, could be affected by a claim against the estate they expected to inherit.