Ones estate might include cash, checking and savings accounts, stocks and bonds, remaining funds in a qualified income trust and / or irrevocable funeral trust, a vehicle, and any other items of value. These exceptions include the following: 1. Medicaid Supplemental Payment & Directed Payment Programs, Form 8001, Medicaid Estate Recovery Program Receipt Acknowledgement. This process is called "estate recovery." The assets are used to reimburse (pay back) the state for the cost of care that MassHealth paid for the member. In addition to the pre-death lien discussed above, some states may put a lien on the home following a Medicaid recipients death. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 2117.061 AND 5162.21] THIS FORM SHALL BE FILED IN THE PROBATE COURT UPON COMPLETION OF . But, these rules are complicated, so if youre relying on this to protect your house from MERP, youll need to consult an estate planning professional or get legal advice. POLICY PRINCIPLES. The Medicaid program is a joint federal/state program. Another way to protect ones home from MERP is via the sibling exemption or the child caregiver exception. Therefore, the amount of the claim may continue to increase after death and a current claimamount shouldbe requested prior to making any payment. Categories. 1917. The deceased has a child of any age who is blind or disabled (as defined by the Social Security Administration). (A notable exception is a home; if the person's spouse or dependent is living in the home or the person intends to eventually return to the home, the value of the home is generally not counted as an asset in terms of Medicaid eligibilitybut it is subject to Medicaid estate recovery.). An expert Medicaid planner can be helpful regardless of whether one has yet to apply for long term care Medicaid or is a Medicaid recipient. Box 8486Harrisburg, PA 17105-9976(800) 528-3708 Phone(717) 772-6553 FaxRA-PWESTATERECOVERY@pa.gov. Heres how you know. A brother / sister who has equity interest (ownership) in the home lives there and first moved in a minimum of 1 year prior to a Medicaid recipients institutionalization. Funds remaining in a funeral trust after the funeral has been paid for in full. Estate recovery is a program, required by federal law, whereby Medicaid members with qualified assets reimburse the taxpayers for long term care and home and . For example, if the state paid $153,000, but ones estate is worth $300,000, Medicaid can only take $153,000. To see probate only states versus expanded recovery states, click here. Documents Effective Date: 8/2020 8001.pdf (227.69 KB) 8001-S.PDF (118.53 KB) The undersigned certifies that a Notice in compliance with Ohio Revised Code 2117.061 and 5162.21 These expenses include expenses of administration, funeral and cemetery expenses up $2,150, and may include certain expenses of the Medicaid recipients last illness. Specifically, the text of the legislation that implemented MERP clarifies that costs can be recovered for "nursing facility services, home and community-based services, services in an institution for mental diseases, home and community care, and community-supported living arrangements" (in other words, long-term care services, rather than basic medical care) for people who were 55 or older when the care was provided. This includes all real and personal property included within the Medicaid recipients probate estate. Explaining health care reform: questions about health insurance subsidies. Like expanded Medicaid, eligibility for the ACA's premium subsidies (premium tax credits) is also based only on income, without regard for assets. The lien may be lifted if the survivor wishes to sell the home. To ensure that the checks are successfully processed, DO NOT USE light colored ink when issuing the check. Funds are recovered from the member's estate, after death, for the cost of these services. When you are searching for a document, enter the number or a portion of the title in the search box below. Administrative rules are found in section 441 IAC 75.28(7). Members affected by the estate recovery policy are those who: Comm. Kaiser Family Foundation. By using our website, you agree to our terms of use and privacy policy. MERP cannot collect more than the value of the estate. Alabama Medicaid State Plan - Liens and Recoveries Omnibus Budget Reconciliation Act of 1993 (OBRA '93) Yes, Medicaid can put a lien on a Medicaid recipients home, but not all states do. Recall that there are state-specific estate recovery regulations. Payments to FSSA's Medicaid Estate Recovery Program can be in the form of a personal check, money order, or cashier's check and made payable to the "Treasurer, State of Indiana." Please include the Medicaid member's name and recipient identification number (RID) or last four digits of the Social Security number (SSN) on the payment. Massachusetts Medicaid Estate Recovery Program. Money remaining in the recipients bank account regardless if the account has a payable on death provision or has a joint owner. The Estate Recovery Unit is responsible for recovering the costs paid by the Agency from sources other than the probate estate. The Estate Recovery Program allows the Commonwealth to recover Medical Assistance payments made on behalf of an individual who received long-termcare Medical Assistance [including nursing facility, Home and Community Based Services (HCBS) and related services]from the time they turned 55 until their passing. 2001 Mail Service Center So depending on the circumstances, the amount the state is seeking to recoup may not match the amount of actual healthcare costs the person had while covered under the Medicaid program (ie, the amount recouped for a person who needed extensive care might be less than the cost of the care the person received, while it might be more than the cost of care provided to a person who needed very little care). There are additional protections that apply to American Indians and Alaska Natives. The Indiana Family & Social Services Administration Estate Recovery Program is the entity that administers the estate recovery process for the State of Indiana. Some states also attempt to recover money spent on other healthcare expenses. MERP Certification and Authorization Form -Revised September 2019. As stated in the Notice of Intent to File a Claim Against the Estate, the Medicaid Estate Recovery Program (MERP) will waive, in whole . Since federal and state taxpayers fund Medicaid, the goal of MERP is to lower Medicaid costs. Title XIX funded medical assistance includes Medicaid and various waiver programs, including the Medically Needy Program and the Elderly Waiver Program. The survivor would require medical and / or public assistance if estate recovery took place. Another reason a state may not attempt recovery is if the cost of selling the home will be more than the home is worth. States are allowed to recover Medicaid funds from assets that avoid probate, such as those that pass through a living trust or a joint tenancy (the holding of an estate or property by two or more parties). If you're enrolled in Medicaid, or if you have a loved one who is, it's worth understanding how your state handles Medicaid estate recovery. Assets that go through probate include those strictly in the deceaseds name, or if jointly owned, ones that are tenants in common. Most states do use Medicaid managed care. Medicaid's estate recovery program, abbreviated as MERP or MER, is a program through which a state's Medicaid agency seeks reimbursement of all long term care costs for which it paid for a Medicaid beneficiary. Eldercare Directory. Even in those that do, there is usually a statute of limitation, or put differently, a maximum amount of time in which Medicaid is able to initiate estate recovery. For this reason, it is highly suggested one consult with a professional Medicaid planner in regards to ones particular situation. [6] As an example, some states attempt reimbursement of costs for other Medicaid services outside of long term care. Click here for instructions on opening this form. Third Party Liability Notification. 4. MA-2285 - ESTATE RECOVERY. She's held board certifications in emergency nursing and infusion nursing. Medicaid Estate Recovery is the process by which the State of Indiana seeks to recover amounts paid by Medicaid on behalf of a qualified individual. Yes. Prior to OBRA, the decision to implement an estate recovery program was left to the discretion of each state. A lien cannot be put on a Medicaid recipients home if one of the following relatives lives in it: A spouse For example, in some states, a ladybird deed, a type of life estate deed, can be utilized to protect ones home. 2138 - Medicare and Medicaid budget reconciliation act of 1993, Fact Sheet: Nursing HomesA Guide for Medicaid, Medicaid expansion and what it means for you, Explaining health care reform: questions about health insurance subsidies, Medicaid's new adult group and estate recovery, State Medicaid Manual, Part 3Eligibility, Medicaid estate recovery statute of limitations, How Medicaid recovers the cost of long-term care from your estate after you die, Information for American Indians and Alaska natives applying for coverage. What is the Medicaid Estate Recovery Program? FactCheck.org. These exceptions allow ownership of the home to be transferred by a living Medicaid beneficiary without violating Medicaids look back rule and causing Medicaid ineligibility. 2001 Mail Service Center [42 U.S.C. 123: Important Information for You and Your Family Members About the Estate Recovery Program, Estate Recovery Frequently Asked Questions (FAQ), Local: (515) 246-9841FAX: (515) 246-0155Toll-free: (888) 513-5186Email: estates@dhs.state.ia.us, 2023 Iowa Department of Health and Human Services, Civil Commitment Unit for Sexual Offenders, Are 55 years of age or older, regardless of where they are living; or, Reside in a nursing facility, an intermediate care facility for persons with an intellectually disability, or a mental health institute, and. Both states may file a claim. Use of this content by websites or commercial organizations without written permission is prohibited. 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