New Hampshire Medicaid Estate Recovery
After someone who received Medicaid long-term care dies, New Hampshire can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.
Based on RSA 167:14-a (recovery of assistance, including the revocable trust reach at paragraph V and the joint tenancy and life estate reach at paragraph VI); RSA 167:13 (claim against the estate, and the cost-effectiveness and undue-hardship waivers); RSA 167:14 (claims and liens); RSA 167:16 (enforcement of assistance liens and the 6-month claim window); RSA 167:16-a (the age 55 limit, the survivor bars, and the limits on lifetime liens); RSA 167:4, IV(d) (long-term care partnership exemption); RSA 554:19 (priority of charges); New Hampshire Code of Administrative Rules He-W 895 (undue hardship); federal baseline 42 U.S.C. 1396p.
What New Hampshire recovers
New Hampshire recovers what the state actually paid, out of a statutory estate that is wider than the probate estate.
Covered services and programsThe full list of care and waiver programs the claim can include
New Hampshire recovers what the state actually paid, out of a statutory estate that is wider than the probate estate. RSA 167:13, I allows the total amount of assistance paid under RSA 167 or RSA 161 as a claim against the estate of a person who received old age assistance, aid to the needy blind, Medicaid for employed adults with disabilities, or aid to the permanently and totally disabled, after the charges ranked ahead of it in RSA 554:19 are paid. RSA 167:14, II makes the estate of every recipient liable for all medical assistance granted and directs the commissioner to file a claim for recovery against it. RSA 167:14-a, V adds that all property, real or personal, in a revocable trust is subject to recovery, and RSA 167:14-a, VI(a) adds property held at death in joint tenancy with rights of survivorship or in a life estate, for any such title or interest established on or after July 1, 2005. Administrative rule He-W 895.02(d) states the same estate definition and adds tenancy in common. Recovery against those non-probate interests is limited to the value of the recipient's own ownership interest and can never exceed the total medical assistance paid for that person. The Estate Recovery Unit says the programs it recovers for are Old Age Assistance, Aid to the Needy Blind, Aid to the Permanently and Totally Disabled, Medicaid for Employed Adults with Disabilities, Granite Advantage, and the Breast and Cervical Cancer Program. Where a lien was filed under RSA 167:14, RSA 167:16 lets the state enforce it by filing a verified notice of lien with the probate court and a verified claim against the estate, and RSA 167:16, IV blocks approval of a sale of real estate or a distribution of probate assets until the court finds the claim satisfied or the lien otherwise protected.
New Hampshire uses an expanded estate definition and can reach certain assets that pass outside probate. Check the details and sources below, because the reach depends on the asset type.
Important: New Hampshire reaches beyond probate, and two boundaries on that reach matter. First, the statute names a closed list. RSA 167:14-a, V and VI(a) name revocable trusts, joint tenancy with rights of survivorship, and life estates, and rule He-W 895.02(d) adds tenancy in common. The joint tenancy and life estate reach applies only where the title or interest was established on or after July 1, 2005, and never to an interest a non-recipient owner bought at fair market value. Neither the statute nor the rule names a payable-on-death or transfer-on-death beneficiary designation on a bank or investment account, while the department's own Estate Recoveries page describes the estate more broadly as taking in assets that pass outside probate. Treat a POD or TOD account as unsettled and ask the Estate Recovery Unit before relying on either reading. Second, real property that passes by a New Hampshire transfer-on-death deed under RSA 563-D is not named in RSA 167:14-a at all, but it is not out of range either: RSA 563-D:16, I lets the estate enforce an allowed claim against property transferred by a transfer-on-death deed to the extent the probate estate cannot satisfy that claim, and RSA 563-D:16, III shuts that door once 2 years pass from the death with no administration granted. Confirm your own situation with a New Hampshire elder-law attorney.
55 and older for medical assistance, with no age limit on cash assistance. RSA 167:16-a, IV allows recovery of correctly paid medical assistance only from the estate of an individual who was 55 years of age or older when the assistance was received, which matches the federal floor at 42 U.S.C. 1396p(b)(1)(B). That age rule does not reach cash assistance: RSA 167:13, I and RSA 167:14, I make the estate liable for old age assistance, aid to the needy blind, and aid to the permanently and totally disabled cash benefits with no age condition, and the Estate Recovery Unit states that all cash assistance must be repaid.
Who is protected from recovery
Surviving spouse: RSA 167:16-a, IV allows recovery of medical assistance only after the death of the surviving spouse, if any. The Estate Recovery Unit puts it the same way, saying it files a medical assistance claim if you were unmarried or widowed when you died.
Surviving child under age 21: RSA 167:16-a, IV(a) blocks recovery of medical assistance while the person has a surviving child under 21.
Surviving child who is blind or permanently and totally disabled as section 1614 of the Social Security Act defines those terms, at any age (RSA 167:16-a, IV(a)).
Sibling with an equity interest who lives in the home: RSA 167:16-a, II(c) bars a lifetime lien on the home while such a sibling resides there, and RSA 167:16-a, IV(b)(1) bars recovery on a home lien where a sibling lived in the home for at least one year immediately before the admission to the medical institution and has lawfully lived there continuously since. He-W 895.04(e) makes the same facts a hardship waiver ground.
Caregiver child: RSA 167:16-a, IV(b)(2) bars recovery on a home lien where a son or daughter lived in the home for at least 2 years immediately before the admission, satisfies the state that the care they gave let the person stay at home instead of an institution, and has lawfully lived there continuously since. He-W 895.04(d) sets out the proof, including affidavits from at least 2 medical professionals who treated the recipient before the admission.
Grandchild the recipient raised: He-W 895.04(d)(2) extends that caregiver ground to a grandchild of a recipient who died on or after January 1, 2008 where the recipient had guardianship over the grandchild as a minor or stood in loco parentis, and the other caregiver conditions are met.
Someone who paid for their own remainder or joint interest: He-W 895.04(f) waives recovery against the home where the applicant is the remainderman under a life estate or the surviving joint tenant and can show they paid value for that interest either when it was created or to cure a transfer of asset penalty.
Undue hardship: RSA 167:13, III(b) lets the department waive adjustment or recovery where it would cause undue hardship under rules adopted under RSA 541-A, and He-W 895.04 lists six qualifying situations, including a farm or business on the land that produces more than half an heir's livelihood, income-producing property the heir has maintained for the past 12 months that produces more than half their livelihood, and an estate of personal property only where recovery would push the heir onto public assistance.
Recovery that is not worth pursuing: RSA 167:13, III(a) lets the department waive recovery that is not cost-effective, and He-W 895.02(b) defines cost effective as recovering at least $500.00 more than the cost to the department of pursuing it.
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Property that may be exempt
- Any joint tenancy or life estate interest created before July 1, 2005. RSA 167:14-a, VI(a) reaches property held in joint tenancy with rights of survivorship or in a life estate only for title or interest established on or after that date, so an older interest sits outside the statutory estate.
- The share of a jointly held asset that belongs to someone else. RSA 167:14-a, VI(a) limits recovery to the value of the recipient's own ownership interest, and the total can never exceed the medical assistance paid for that person.
- Property in which a non-recipient owner paid fair market value for the interest when it was acquired. RSA 167:14-a, VI(a) says recovery shall not extend to such an interest.
- Costs and expenses of administering the estate, which RSA 554:19, I(a) ranks ahead of the department's claim.
- Reasonable and necessary funeral, burial, and cremation expenses, ranked ahead of the department's claim by RSA 554:19, I(b). He-W 895.07 also gives a surviving joint tenant or the remainderman of a life estate a dollar-for-dollar reduction in the claim for personal funds they advanced to cover a shortfall in those burial expenses, proved by cancelled checks and billing statements from the funeral home, crematory, or monument company. He-W 895.07(c) refuses that reduction for flowers, music, meals after the service, travel, telephone, and postage.
- Debts and taxes that carry a preference under federal law, ranked ahead of the department's claim by RSA 554:19, I(c).
- An amount equal to the benefits paid by a qualifying policy under the New Hampshire long-term care partnership. RSA 167:4, IV(d) exempts the estate of an institutional-level-of-care recipient whose resource ceiling was adjusted from recovery under RSA 167:13 and RSA 167:14, in an amount equal to the insurance benefit payments received.
- The home while a surviving spouse lives in it, as against a cash-assistance lien. RSA 167:13, I bars extending a lien filed under RSA 167:14 to enforce recovery and bars any forced sale of the real estate of an old age assistance, aid to the needy blind, Medicaid for employed adults with disabilities, or aid to the permanently and totally disabled recipient while a surviving spouse occupies it as a home.
- Medical assistance paid before the person turned 55. RSA 167:16-a, IV allows recovery of correctly paid medical assistance only from the estate of someone who was 55 or older when the assistance was received.
Undue-hardship waiver
New Hampshire can waive recovery when it would cause an undue hardship for the heirs. Contact New Hampshire Department of Health and Human Services, Estate Recovery Unit at 603-271-9236 to request the waiver and confirm deadlines.
Hardship waiver informationFrequently asked questions
Who is protected from Medicaid estate recovery in New Hampshire?
What does New Hampshire Medicaid recover after death?
Can I apply for an undue-hardship waiver in New Hampshire?
Who handles Medicaid estate recovery in New Hampshire?
Agency and statute sourcesOfficial references used for this page
- RSA 167:14-a, the New Hampshire estate recovery section (the revocable trust reach at paragraph V, the joint tenancy with rights of survivorship and life estate reach and the July 1, 2005 date band at paragraph VI(a), the cap at the recipient's own interest and the fair-market-value carve-out at VI(a), and the 45-day notice to joint owners and their 30-day response at VI(b)). Source line: 1973, 412:1 ... 2010, 15:1, eff. May 7, 2010
- RSA 167:16-a, the limits on recovery and on lifetime liens (the bar on pre-death liens at paragraph I, the spouse, minor or disabled child and sibling-with-equity residents bar at II, the dissolution on discharge at III, the age 55 limit and the surviving spouse, child under 21, blind or disabled child, sibling and caregiver-child bars at IV, and the RSA 556:6 filing route at V). Source line: 1961, 271:6 ... 2008, 52:8, 9, eff. July 11, 2008
- RSA 167:13, the claim against the estate on the death of an old age assistance, aid to the needy blind, Medicaid for employed adults with disabilities, or aid to the permanently and totally disabled recipient, subject to the RSA 554:19 priority; the bar on enforcing a lien or forcing a sale while a surviving spouse occupies the home (paragraph I); the cost-effectiveness and undue-hardship waivers (paragraph III); and the estate administration fund and the department's authority to administer an estate under RSA 553:2, III (paragraph IV). Source line: 1937, 202:19 ... 2007, 263:55, eff. July 1, 2007
- RSA 167:14, claims and liens (paragraph I makes the estate of the recipient and the estate of the recipient's spouse liable for cash assistance and sets the notice-and-hearing requirement before a notice of lien is filed with the register of deeds, which records it without a fee; paragraph II makes every recipient's estate liable for medical assistance, requires the commissioner to file a claim, and forbids a lien against real property for medical assistance except in conformance with RSA 167:16-a). Source line: 1937, 202:34 ... 2005, 175:7, eff. Aug. 29, 2005
- RSA 167:16, enforcement of assistance liens (paragraph II makes a claim timely if filed within 6 months from the initial grant of administration; paragraph III conclusively presumes the administrator accepted the claim unless an equitable action in superior court is commenced within 12 months from that grant; paragraph IV blocks approval of a sale of real estate or a distribution of probate assets until the claim is satisfied or the lien protected). Source line: 1951, 139:9 ... 2000, 156:5, eff. Jan. 1, 2001
- RSA 167:4, eligibility for assistance. Paragraph IV(d) directs the commissioner to establish a long-term care partnership under section 1917(b)(1) of the Social Security Act as amended by DEFRA and exempts the estates of institutional-level-of-care recipients whose resource ceiling was adjusted from recovery under RSA 167:13 and RSA 167:14, in an amount equal to the long-term care insurance benefit payments received. Source line: 1937, 202:10 ... 2023, 79:576, eff. July 1, 2023
- RSA 554:19, the order in which an administrator pays claims: administration costs; reasonable and necessary funeral, burial, and cremation expenses; debts and taxes with a federal preference; claims for financial or medical assistance provided by the department of health and human services together with RSA 126-A:34 and RSA 166:19 charges; just debts of the deceased; then legacies or distribution to heirs. Source line: RS 159:14 ... 2013, 144:38, eff. July 1, 2013
- RSA 563-D:16, part of the New Hampshire Uniform Real Property Transfer on Death Act. Paragraph I lets the estate enforce an allowed claim against property transferred by a transfer on death deed to the extent the probate estate is insufficient; paragraph II apportions that liability among multiple properties; paragraph III bars any proceeding to enforce it if no administration is granted within 2 years of the transferor's death. Source line: 2024, 1:1, eff. July 1, 2024
- RSA 553:2, the order of the right to administer a New Hampshire estate: the executor named in the will; the widow, husband, or next of kin or their nominee; one of the devisees or creditors (paragraph III, the provision RSA 167:13, IV relies on when the department administers an estate); then any other person the judge thinks proper.
- RSA 556:6, the route RSA 167:16-a, V names for filing demands for adjustment or recovery: demands not due and demands depending on a contingency may be filed in the court of probate, and the judge may require the administrator to retain enough on settlement of the account to pay them.
- New Hampshire Code of Administrative Rules, Part He-W 895 (Undue Hardship), published within CHAPTER He-W 800 ELIGIBILITY FOR MEDICAL ASSISTANCE on the General Court rules site. He-W 895.02(b) defines cost effective as a recovery exceeding the department's collection cost by $500.00 or more, He-W 895.02(d) defines estate to include revocable trust property under RSA 167:14-a, V and joint tenancy, tenancy in common, and life estate property under RSA 167:14-a, VI, He-W 895.03 requires notice of the waiver right, He-W 895.04 lists the six hardship grounds, He-W 895.05 lists the required contents and documentation, He-W 895.06 sets the 30-day filing window and the 90-day decision window, He-W 895.07 gives the burial-expense reduction, and He-W 895.08 sets the 30-day He-C 200 appeal window. Source lines: ss by #11170, eff 8-26-16. The same page carries He-W 890.01 (Source. #13769, eff 9-28-23) on the RSA 167:16-a acknowledgment at application.
- New Hampshire Department of Health and Human Services, Estate Recoveries (the Estate Recovery Unit page: the six recoverable programs, the county Registry of Deeds lien and the notice-and-hearing right before one is filed, the age 55 rule for medical assistance, the statement that the estate takes in assets passing both through and outside probate including joint tenancy, life estates, and living trusts, the spouse and minor-or-disabled-child bars, the sibling-with-equity bar, the hardship waiver, and the rule that leftover cash-assistance debt can be collected from the surviving spouse's estate while leftover medical-assistance debt cannot)
- New Hampshire Department of Health and Human Services, Estate Recovery Unit contact record (Brown Building, 129 Pleasant Street, Concord, NH 03301; phone 603-271-9236; fax 603-271-8135; email [email protected]), the profile the Estate Recoveries page links from its Contact Information block
- 42 U.S.C. 1396p, the federal Medicaid estate recovery baseline: the age 55 rule and the service options at subsection (b)(1)(B), the surviving spouse and child bars and the sibling and caregiver-child lien protections at subsection (b)(2), the undue hardship waiver at subsection (b)(3), the mandatory probate-estate definition at subsection (b)(4)(A), and the optional wider definition at subsection (b)(4)(B) covering joint tenancy, tenancy in common, survivorship, life estate, and living trust, which New Hampshire adopted in part at RSA 167:14-a, V and VI
Information current as of August 3, 2026
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