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Illinois Medicaid Estate Recovery

After someone who received Medicaid long-term care dies, Illinois can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.

Based on 305 ILCS 5/5-13 (claim against estate); 305 ILCS 5/5-13.1 (cost-effectiveness and hardship waivers); 89 Ill. Adm. Code 102.210 (estate claims); federal baseline 42 U.S.C. 1396p(b)

By Settled Estate Editorial
Probate estate only
Recovery reach
55+
Age when care was received
Protected
While a spouse is alive
Yes
Hardship waiver

What Illinois recovers

HFS collects by filing a claim against the deceased person's estate.

Covered services and programsThe full list of care and waiver programs the claim can include

HFS collects by filing a claim against the deceased person's estate. The claim covers medical assistance (Medicaid) paid on or after October 1, 1993 for services received at age 55 or older, and medical assistance paid at any age for a person who was an inpatient in a nursing facility, an intermediate care facility for persons with intellectual disabilities, or another medical institution. For people who received Aid to the Aged, Blind or Disabled (AABD) cash assistance, the claim also covers the cash assistance paid. For deaths on or after July 1, 2022, HFS must waive its claim against the first $25,000 of estate value, and the State never asks for more than it paid for services. Higher-priority estate debts, such as funeral costs, costs of administration, and a mortgage on the home, are paid before the HFS claim.

Illinois 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: Illinois collects through the probate estate, but non-probate assets are not always out of reach. The claim can also be filed against the estate of the recipient's spouse, so property that passed to the spouse can be reached after the spouse dies. When the probate estate cannot pay allowed claims, real estate that passed by a transfer on death instrument and assets in a revocable living trust remain liable for those claims (755 ILCS 27/85; 760 ILCS 3/505). And when eligibility involved a long-term care partnership insurance asset disregard, the estate definition expands to assets conveyed through joint tenancy, life estate, living trust, or similar arrangements. Confirm your situation with an Illinois elder law attorney.

55 and older for Medicaid paid on or after October 1, 1993 (the federal baseline). A claim can also cover a person of any age who was an inpatient in a nursing facility, an intermediate care facility for persons with intellectual disabilities, or another medical institution.

Who is protected from recovery

Surviving spouse: no recovery while the spouse is alive (the deferred claim can later be filed against the surviving spouse's estate)

Child under 21: no recovery while a child under age 21 survives

Blind or disabled child: no recovery while a child of any age who is blind or permanently and totally disabled under Social Security standards survives

Homestead occupancy: no enforcement against real estate occupied as a homestead by the surviving spouse or another dependent relative, subject to conditions when other creditors file claims

Small estate: HFS waives its claim against the first $25,000 of any estate for deaths on or after July 1, 2022

Cost-effectiveness: HFS waives recovery that would not be cost-effective, such as when the cost of selling property is more than the property is worth

Undue hardship: HFS waives its claim in whole or in part when recovery would cause undue hardship for an heir or beneficiary, such as a family business, farm, or ranch that is the heirs' primary income source, or when recovery would push heirs onto SSI, TANF, or SNAP (apply within 60 days of the notice date)

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Property that may be exempt

  • The first $25,000 of estate value for a person who died on or after July 1, 2022 (HFS waives its claim against that amount under 305 ILCS 5/5-13.1 and 89 Ill. Adm. Code 102.210(h))
  • Life insurance proceeds that go to a named beneficiary rather than to the estate
  • Bank accounts that pay on death to a named person
  • Medicare cost-sharing expenses (Part A and B premiums, deductibles, coinsurance, and copayments) where the payment request was made after January 1, 2010
  • Assets disregarded at Medicaid eligibility because the person was covered by a qualified long-term care partnership insurance policy, to the extent of the disregard (89 Ill. Adm. Code 102.210(f))

Undue-hardship waiver

Illinois can waive recovery when it would cause an undue hardship for the heirs. Contact Illinois Department of Healthcare and Family Services (HFS), Bureau of Collections, Technical Recovery Section at 217-785-2711 to request the waiver and confirm deadlines.

Hardship waiver information

Frequently asked questions

Who is protected from Medicaid estate recovery in Illinois?
Recovery is generally blocked or delayed for: Surviving spouse: no recovery while the spouse is alive (the deferred claim can later be filed against the surviving spouse's estate); Child under 21: no recovery while a child under age 21 survives; Blind or disabled child: no recovery while a child of any age who is blind or permanently and totally disabled under Social Security standards survives; Homestead occupancy: no enforcement against real estate occupied as a homestead by the surviving spouse or another dependent relative, subject to conditions when other creditors file claims; Small estate: HFS waives its claim against the first $25,000 of any estate for deaths on or after July 1, 2022; Cost-effectiveness: HFS waives recovery that would not be cost-effective, such as when the cost of selling property is more than the property is worth; Undue hardship: HFS waives its claim in whole or in part when recovery would cause undue hardship for an heir or beneficiary, such as a family business, farm, or ranch that is the heirs' primary income source, or when recovery would push heirs onto SSI, TANF, or SNAP (apply within 60 days of the notice date).
What does Illinois Medicaid recover after death?
HFS collects by filing a claim against the deceased person's estate. The claim covers medical assistance (Medicaid) paid on or after October 1, 1993 for services received at age 55 or older, and medical assistance paid at any age for a person who was an inpatient in a nursing facility, an intermediate care facility for persons with intellectual disabilities, or another medical institution. For people who received Aid to the Aged, Blind or Disabled (AABD) cash assistance, the claim also covers the cash assistance paid. For deaths on or after July 1, 2022, HFS must waive its claim against the first $25,000 of estate value, and the State never asks for more than it paid for services. Higher-priority estate debts, such as funeral costs, costs of administration, and a mortgage on the home, are paid before the HFS claim.
Can I apply for an undue-hardship waiver in Illinois?
Yes. Illinois offers an undue-hardship waiver. Contact Illinois Department of Healthcare and Family Services (HFS), Bureau of Collections, Technical Recovery Section at 217-785-2711 to request the waiver and ask about deadlines.
Who handles Medicaid estate recovery in Illinois?
Illinois Department of Healthcare and Family Services (HFS), Bureau of Collections, Technical Recovery Section, phone 217-785-2711, https://hfs.illinois.gov/medicalclients/medicaidestaterecovery.html.

Information current as of July 18, 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 Illinois can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.