Missouri Medicaid Estate Recovery
After someone who received Medicaid long-term care dies, Missouri can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.
Based on Mo. Rev. Stat. 473.398 (MO HealthNet debt due the state, recovered as a probate-estate claim) and 208.215; nonprobate-transfer liability under Mo. Rev. Stat. 461.300; federal baseline 42 U.S.C. 1396p(b)
What Missouri recovers
MO HealthNet (Missouri Medicaid) recovers the total amount it paid for long-term care services, including nursing facility care, intermediate care facility services, and home and community-based services (HCBS), provided to a participant who was age 55 or older when the services were received.
Covered services and programsThe full list of care and waiver programs the claim can include
MO HealthNet (Missouri Medicaid) recovers the total amount it paid for long-term care services, including nursing facility care, intermediate care facility services, and home and community-based services (HCBS), provided to a participant who was age 55 or older when the services were received. Recovery happens only after the participant's death, by filing a claim against the participant's probate estate, allowed as a sixth-class or eighth-class claim under RSMo 473.397. A probate estate for a person who was enrolled in MO HealthNet at death cannot be closed until the MO HealthNet Division files a release of its estate recovery claim. Recovery does not apply to participants who received only QMB or SLMB Medicare Savings Program cost-sharing.
Missouri 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: Missouri is a probate-only estate recovery state: MO HealthNet collects by filing a claim against the participant's probate estate under RSMo 473.398, so assets that pass outside probate, such as a beneficiary deed, a POD or TOD account, or survivorship property, are generally not reached in routine estate recovery. That is not an absolute shield. Under Missouri's Nonprobate Transfers Law, RSMo 461.300, a nonprobate transfer is a recoverable transfer that the recipient is liable to account for, on a pro rata basis, to pay statutory allowances and claims that remain unpaid after the probate estate is applied, when a qualified claimant such as a creditor, or the personal representative, makes a written demand within sixteen months after death and brings an action for accounting within eighteen months after death. Confirm your own situation with a Missouri elder-law attorney before relying on a nonprobate transfer to avoid recovery.
55 and older
Who is protected from recovery
Surviving spouse: no recovery is made from the estate during the lifetime of the surviving spouse
Surviving child under age 21: recovery is deferred while the participant is survived by a child under age 21
Blind or disabled child: recovery is deferred during the lifetime of a child who is blind or permanently and totally disabled, regardless of the child's age
Sibling with an equity interest: the home is protected where a sibling has an equity interest in it and had resided in the participant's home for at least one year immediately before the participant's institutionalization
Adult caregiver child: protection for a son or daughter who resided in the participant's home for at least two years immediately before the participant entered a medical institution and who provided care that delayed the participant's institutionalization
Undue hardship: the MO HealthNet Division may waive or compromise all or part of its claim when recovery would create an undue hardship for the heirs; the director or the director's designee may compromise, settle, or waive a claim in whole or in part
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Property that may be exempt
- Property that passes outside the probate estate, such as a Missouri beneficiary deed under RSMo 461.025, a payable-on-death or transfer-on-death account, jointly owned property with right of survivorship, or life insurance and retirement accounts with a named beneficiary, is generally outside routine MO HealthNet estate recovery because recovery is filed as a claim against the probate estate (see the scope caveat: RSMo 461.300 can reach these nonprobate transfers when the probate estate is insufficient to pay allowed claims)
- Benefits limited to QMB or SLMB Medicare Savings Program cost-sharing are not subject to estate recovery
Undue-hardship waiver
Missouri can waive recovery when it would cause an undue hardship for the heirs. Contact MO HealthNet Division, Cost Recovery Unit (Missouri Department of Social Services) at 573-751-2005 to request the waiver and confirm deadlines.
Hardship waiver informationFrequently asked questions
Who is protected from Medicaid estate recovery in Missouri?
What does Missouri Medicaid recover after death?
Can I apply for an undue-hardship waiver in Missouri?
Who handles Medicaid estate recovery in Missouri?
Agency and statute sourcesOfficial references used for this page
- MO HealthNet Division, Estate Recovery (official Missouri DSS page; Cost Recovery Unit contact)
- Mo. Rev. Stat. 473.398 (debt due the state on death; MO HealthNet probate-estate claim and release-before-closing requirement)
- Mo. Rev. Stat. 208.215 (MO HealthNet payer of last resort, TEFRA liens, and home protections for spouse / child under 21 / blind or disabled child / sibling with equity, subsection 13)
- Mo. Rev. Stat. 461.300 (Nonprobate Transfers Law; recoverable transfers liable to account for unpaid claims and statutory allowances; 16-month written demand, 18-month action)
- Missouri DSS Estate Recovery memo attachment (probate-estate scope, age 55+, long-term care services, exemptions, undue hardship)
- MO HealthNet for the Aged, Blind and Disabled Manual 0880.005.00 Estate Recovery (age 55+; QMB/SLMB-only excluded)
Information current as of July 17, 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 Missouri can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.