Maryland Medicaid Estate Recovery
After someone who received Medicaid long-term care dies, Maryland can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.
Based on Md. Code, Health-General 15-121 (claims against estates; hardship waiver to surviving dependents); COMAR 10.09.24.15 (Liens, Adjustments, and Recoveries: estate defined for State probate-law purposes, age 55, surviving spouse / child under 21 / blind-or-disabled-child bars, sibling-with-equity and caregiver-child home protections, Medicare cost-sharing and long-term care partnership exclusions, substantial-hardship waiver); federal baseline 42 U.S.C. 1396p(b).
What Maryland recovers
Maryland recovers the Medical Assistance (Medicaid) benefits the program correctly paid on behalf of a recipient who was age 55 or older when the benefits were received.
Covered services and programsThe full list of care and waiver programs the claim can include
Maryland recovers the Medical Assistance (Medicaid) benefits the program correctly paid on behalf of a recipient who was age 55 or older when the benefits were received. Recovery is pursued after death by filing a claim against the open probate estate (COMAR 10.09.24.15; Md. Code, Health-General 15-121). The federal baseline the regulation implements (42 U.S.C. 1396p(b)) covers nursing-facility care, home- and community-based services, and related hospital and prescription-drug costs. Because the recoverable estate is defined for State probate-law purposes, the claim reaches only property that passes through the deceased's probate estate. Separately, and while the recipient is still living, Maryland may place a lien on the home of a permanently institutionalized recipient who is not reasonably expected to return home (COMAR 10.09.24.15); that lien is satisfied when the home is later sold.
Maryland 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: Maryland is a probate-only estate recovery state: recovery is limited to the deceased's estate as defined for State probate-law purposes (COMAR 10.09.24.15), so assets that pass outside probate (property held in joint tenancy or, for spouses, tenancy by the entireties, a life estate, a living trust, or a transfer-on-death / payable-on-death or beneficiary designation) fall outside the recoverable estate. Two limits keep this from meaning the home is always safe. First, while the recipient is still living and permanently in a long-term care facility, Maryland can place a lien on the home under the same regulation, and that lien is satisfied when the home is later sold. Second, jointly held or beneficiary-designated property avoids recovery only if the title or designation is actually in place before death. Confirm your own situation with a Maryland elder-law attorney.
55 and older
Who is protected from recovery
Surviving spouse: Maryland does not seek recovery while a surviving spouse is living; recovery is deferred until after the surviving spouse's death (COMAR 10.09.24.15)
Surviving child under 21: no recovery while the deceased recipient is survived by an unmarried child under age 21 (COMAR 10.09.24.15)
Surviving blind or disabled child: no recovery while the recipient is survived by a son or daughter who is blind or disabled, regardless of the child's age (COMAR 10.09.24.15)
Sibling with an equity interest in the home: the home is protected when a sibling of the recipient has an equity interest in it and lawfully resided there for at least one year immediately before the recipient's admission to a long-term care facility and has resided there continuously since; this protection is tied to Maryland's home-lien restrictions (COMAR 10.09.24.15)
Caregiver son or daughter: the home is protected when a son or daughter lawfully resided in it for at least two years immediately before the recipient's admission to a long-term care facility, has resided there continuously since, and provided the care that allowed the recipient to stay at home rather than enter a facility (COMAR 10.09.24.15)
Substantial hardship: the Department may waive recovery when, in its judgment, enforcing the claim would cause substantial hardship, such as forcing the sale of property that would remove a dependent who lived there on the date of death, had resided there continuously for at least two years before the death, and has no alternative residence (Md. Code, Health-General 15-121(b); COMAR 10.09.24.15)
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Property that may be exempt
- Medicare cost-sharing paid as a Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiary (SLMB): Maryland does not recover Medical Assistance payments of Medicare premiums, copayments, or deductibles (COMAR 10.09.24.15)
- Long-term care partnership policy benefits: recovery may not reach the value of long-term care partnership insurance policy benefits furnished to the recipient up to the time of death (COMAR 10.09.24.15)
- Non-probate property: because recovery is limited to the estate as defined for State probate-law purposes, assets that pass outside probate (property held in joint tenancy or, for spouses, tenancy by the entireties, a life estate, a living trust, or a transfer-on-death / payable-on-death or beneficiary designation) are outside the recoverable estate
Undue-hardship waiver
Maryland can waive recovery when it would cause an undue hardship for the heirs. Contact Maryland Department of Health, Division of Recoveries and Financial Services (DRAFS) (formerly the Division of Medical Assistance Recoveries, Medical Care Compliance Administration) at 410-767-6614 to request the waiver and confirm deadlines.
Hardship waiver informationFrequently asked questions
Who is protected from Medicaid estate recovery in Maryland?
What does Maryland Medicaid recover after death?
Can I apply for an undue-hardship waiver in Maryland?
Who handles Medicaid estate recovery in Maryland?
Agency and statute sourcesOfficial references used for this page
- Md. Code, Health-General 15-121 (Claims against estates), Maryland General Assembly official statute text (mgaleg.maryland.gov). Read verbatim: (a) the Department may make claim against the estate of a deceased Program recipient for medical assistance payments in accordance with federal law under Title XIX; (b) the claim shall be waived if enforcement would cause substantial hardship to the surviving dependents of the deceased.
- COMAR 10.09.24.15 (Liens, Adjustments, and Recoveries), codified Code of Maryland Regulations via Cornell Legal Information Institute. Read verbatim: 'Estate' defined as all real and personal property and other assets included within an individual's estate, as defined for purposes of State probate law; recovery from the estate of an individual who was 55 years old or older when Medical Assistance was received; recovery only after the death of a surviving spouse, and none when there is a surviving child, a surviving blind or disabled son or daughter, a sibling with an equity interest residing in the home, or a caregiver son or daughter who resided in the home; no recovery for Medicare premiums/copayments/deductibles or to the extent of LTC partnership policy benefits; substantial-hardship waiver.
- State of Maryland Medical Assistance Manual, Section 1500 (Liens, Adjustment and Recoveries) implementing COMAR 10.09.24.15, Maryland Department of Health (official). Section 1500.1 lists recovery when 'The recipient is deceased and received MA benefits at 55 or over' and gives the Recoveries division address and phone 410-767-6614; Section 1500.5 (Estates) describes recovery by claim against the open estate and the surviving spouse / unmarried child under 21 / blind or disabled child bars plus the hardship waiver (note: Section 1500.5 carries a stale 'age 65' reference superseded by the current 55 threshold); Sections 1500.8-1500.16 cover the pre-death home lien and 'specified relatives.'
- Maryland Department of Health, Division of Recoveries and Financial Services (DRAFS) home page (the division that administers Medicaid estate recovery; formerly the Division of Medical Assistance Recoveries).
Information current as of July 21, 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 Maryland can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.