Alaska Medicaid Estate Recovery
After someone who received Medicaid long-term care dies, Alaska can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.
Based on Alaska Medicaid State Plan section 4.17 and Attachment 4.17-A (liens and adjustments or recoveries); federal authority 42 U.S.C. 1396p(b)
What Alaska recovers
Alaska's Medicaid State Plan (section 4.17(b), as amended effective April 1, 2010) limits estate recovery to two groups.
Covered services and programsThe full list of care and waiver programs the claim can include
Alaska's Medicaid State Plan (section 4.17(b), as amended effective April 1, 2010) limits estate recovery to two groups. For a recipient who was 55 or older when the assistance was received, the state recovers from the estate only what it paid for nursing facility services, home and community-based services, and related hospital and prescription drug services; the plan box for recovering any other services is left unchecked and marked NONE. For a permanently institutionalized recipient of any age, the state recovers what it paid for services in a nursing facility, an intermediate care facility for individuals with intellectual disabilities, or another medical institution, either from the estate or when property carrying a lien is sold. Medicaid payments of Medicare premiums, deductibles, coinsurance and copayments for dual-eligible recipients 55 or older are protected for dates of service on or after January 1, 2010. The plan also says the state imposes liens on both real and personal property of a recipient after death. Under Attachment 4.17-A the department pursues a claim only when the likely recovery is at least twice its administrative and legal cost, with a minimum net recovery of $10,000.
Alaska 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.
Important: Three things narrow the probate-only rule in Alaska. The Alaska Court System says creditors have one year after death to make a claim against real property passed by a transfer on death deed, so a TOD deed does not by itself protect a home. It also says a personal representative can recover bank or credit union accounts that passed by survivorship or to a payable-on-death beneficiary when the estate cannot pay its creditor claims, if a creditor asks in writing and the case is filed within one year after death. And Alaska's Medicaid State Plan says the state imposes liens on a permanently institutionalized recipient's real property during life, and on real and personal property after death.
55 and older when the medical assistance was received (State Plan 4.17(b)(3)), the federal baseline in 42 U.S.C. 1396p(b)(1)(B). A permanently institutionalized recipient is subject to recovery at any age for nursing facility and other medical institution services (4.17(b)(1)); Alaska presumes a recipient who has been in a medical institution for 120 consecutive days cannot be expected to return home (Attachment 4.17-A, section I).
Who is protected from recovery
Surviving spouse: recovery is made only after the death of the recipient's surviving spouse (State Plan 4.17(c)(1)).
Child under 21: no recovery while the recipient has a surviving child under age 21 (State Plan 4.17(c)(1)).
Blind or disabled child: no recovery while the recipient has a surviving child of any age who is blind or disabled (State Plan 4.17(c)(1)).
Sibling in the home: no recovery from the home while a sibling who lived there for at least 12 months before the recipient was institutionalized, and has lived there continuously since, still lives there (State Plan 4.17(c)(2)(a) and Attachment 4.17-A, section III).
Caregiver child in the home: no recovery from the home while a son or daughter who lived there for at least 24 months before institutionalization, gave care that let the recipient stay at home, and has lived there continuously since, still lives there. Proof includes the address on a mailing address, driver's license or voter registration, plus a written statement from the parent or treating physician (State Plan 4.17(c)(2)(b) and Attachment 4.17-A, section II).
Recipient under 55 who was not permanently institutionalized: no estate recovery (State Plan 4.17(b)(1) and (b)(3)).
Low-income Medicare beneficiaries whose only Alaska Medicaid help was payment of Medicare copayments or deductibles are exempt (State Plan Attachment 4.17-A, section IV).
Services the recipient would not have had to pay for if not eligible for Medicaid are exempt from recovery (State Plan Attachment 4.17-A, section IV).
Small estates: the department pursues a claim only if the likely recovery is at least twice its cost, with a minimum net recovery of $10,000 (State Plan Attachment 4.17-A, section V).
Undue hardship: all or part of the claim can be waived to keep the recipient's family from impoverishment (State Plan Attachment 4.17-A, section IV).
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Property that may be exempt
- Certain American Indian and Alaska Native income, resources and property are exempt from recovery, including property on or near a current or former reservation, property derived from tribal lands, protected natural-resource income that can be clearly traced, trust-status property and judgment funds exempt under other laws, protected property that was inherited, and items of religious, spiritual, traditional or cultural significance or that support subsistence (State Plan Attachment 4.17-A, section IV).
- The home is not recovered from while a sibling who lived there for at least 12 months before the recipient was institutionalized, or a son or daughter who lived there for at least 24 months before and gave care that kept the recipient at home, still lives there (State Plan 4.17(c)(2) and Attachment 4.17-A).
- A home of modest value, meaning 50 percent or less of the average home price in the region or major community on the date of death, can qualify for an undue hardship waiver (State Plan Attachment 4.17-A, section IV).
- Medicaid payments of Medicare premiums, deductibles, coinsurance and copayments for dual-eligible recipients 55 or older are not recovered for dates of service on or after January 1, 2010 (State Plan 4.17(b)(3), page 53a-1).
- Property held in joint tenancy, a life estate, or a living trust is outside the estate definition in Attachment 4.17-A. No official Alaska source read for this file extends recovery to those assets, but the Alaska Statutes could not be read.
Undue-hardship waiver
Alaska can waive recovery when it would cause an undue hardship for the heirs. Contact Alaska Department of Health, Division of Health Care Services (Third Party Liability section) to request the waiver.
Under Alaska Medicaid State Plan, Attachment 4.17-A, sections IV and VI, any of these can qualify:
- The estate's only asset produces income, and recovery would cost the survivors their livelihood.
- The home a survivor lives in is the only asset of any real value in the estate, and recovering it would impoverish the survivor: it would make the survivor eligible for public assistance, keep the survivor on public assistance who could otherwise leave it, or deprive the survivor of food, clothing, shelter, other necessities or medical care.
- The estate is a home of modest value, meaning 50 percent or less of the average home price in the region or major community, based on Alaska Department of Labor figures, valued on the date of death.
- The applicant must have a beneficial interest in the estate.
A written, signed appeal contesting the amount claimed, or whether the recipient held legal title to the real property at death, goes to the Third Party Liability section of the Division of Health Care Services within 30 days of receiving the notice. The plan gives no mailing address or phone number for that section.
Deadline: Within 30 days after receiving notice of the department's claim. An application up to 30 days late may be treated as timely for good cause. A claim the department files in a probate case counts as notice to all heirs.
Decision: The department decides a waiver request within 30 days of receiving it; a denial can be appealed.
Frequently asked questions
Who is protected from Medicaid estate recovery in Alaska?
What does Alaska Medicaid recover after death?
Can I apply for an undue-hardship waiver in Alaska?
Who handles Medicaid estate recovery in Alaska?
Agency and statute sourcesOfficial references used for this page
- Alaska Medicaid State Plan section 4.17, Liens and Adjustments or Recoveries (Alaska Department of Health)
- Alaska Medicaid State Plan section 4.17(b), Adjustments or Recoveries, pages 53a and 53a-1 (Alaska Department of Health)
- Alaska Medicaid State Plan Attachment 4.17-A, Liens and Adjustments or Recoveries (Alaska Department of Health)
- Debts and Creditors, Alaska Court System self-help (probate)
- Transfer on Death Deed, Alaska Court System self-help (probate)
- Division of Health Care Services, Alaska Department of Health
- 42 U.S.C. 1396p, the federal Medicaid lien and estate recovery section (Office of the Law Revision Counsel)
Information current as of September 28, 2026
Settled Estate is not a law firm, and this content is for informational purposes only and does not constitute legal advice. Probate laws and procedures in Alaska can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.