Alabama Medicaid Estate Recovery
After someone who received Medicaid long-term care dies, Alabama can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.
Based on Ala. Admin. Code r. 560-X-33-.05 (Estate Recovery), authorized by Ala. Code 22-1-11 and 22-6-8 (1975); federal baseline 42 U.S.C. 1396p(b). Probate-notice requirement under Code of Alabama Title 43, Chapter 2, Article 18, Division 11 (Act 2019-489).
What Alabama recovers
Medicaid recovers the cost of medical assistance correctly paid from the deceased recipient's estate as defined by Alabama probate law. This includes all real and personal property and other assets in the estate, such as homes, land, vehicles, cash, and bank accounts. Recovery applies to benefits paid for recipients age 55 or older when services were received (except Medicare cost-sharing) and to permanently institutionalized recipients of any age in a nursing facility, ICF/IID, or other medical institution. A TEFRA lien may be placed on the home of a permanently institutionalized recipient.
Alabama recovers only from the probate estate. Assets that pass outside probate, such as joint property with survivorship, life estates, living trusts, and transfer-on-death or pay-on-death accounts, are generally beyond recovery.
55 (federal baseline). Alabama follows the federal rule: recovery applies to benefits received at age 55 or older, plus permanently institutionalized recipients of any age.
Who is protected from recovery
Surviving spouse: recovery is deferred until after the death of the surviving spouse, if any
Surviving child under age 21: recovery is barred while such a child survives
Blind or permanently and totally disabled child of any age, as defined in 42 U.S.C. 1382c: recovery is barred while such a child survives
Sibling with an equity interest in the home who lived in the home continuously for at least one year immediately before the recipient's institutionalization (bars or delays a TEFRA home lien and recovery)
Caregiver child (son or daughter) who resided in the home for at least two years immediately before institutionalization and provided care that allowed the recipient to stay home rather than enter an institution (delays home recovery)
Undue hardship waiver where the estate is a family farm or family business producing limited income (at or below the limit in Rule 560-X-25-.14) and is the sole income-producing asset of one or more heirs
Property that may be exempt
- Medicare cost-sharing benefits described in 42 U.S.C. 1396a(a)(10)(E), which are excluded from the recoverable amount
- Assets or resources disregarded under the Alabama Long-Term Care Insurance Partnership are not recoverable
- Non-probate assets that pass outside the probate estate, because Alabama limits recovery to the estate as defined by Alabama probate law
Undue-hardship waiver
Alabama can waive recovery when it would cause an undue hardship for the heirs. Contact Alabama Medicaid Agency, Estate Recovery Section (Third Party Liability) at (334) 242-5727 to request the waiver and confirm deadlines.
Hardship waiver informationFrequently asked questions
Does Alabama recover Medicaid costs from non-probate assets?
Who is protected from Medicaid estate recovery in Alabama?
What does Alabama Medicaid recover after death?
Can I apply for an undue-hardship waiver in Alabama?
Who handles Medicaid estate recovery in Alabama?
Settling an estate with a Medicaid claim?
Use the Alabama probate assessment to organize the estate and see how the claim fits the process.
Information current as of June 28, 2026
This content is for informational purposes only and does not constitute legal advice. Probate laws and procedures in Alabama can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.