New York Medicaid Estate Recovery

No. New York recovers only from the probate estate, so assets that pass outside probate, such as joint tenancy with right of survivorship, life estates, living trusts, and transfer-on-death or pay-on-death accounts, are generally beyond recovery.

Recovery is generally blocked or delayed for: Surviving spouse: recovery may be made only after the death of the recipient's surviving spouse, if any (the claim is deferred while a spouse survives), and no lien may be placed on the home while the spouse resides there; Surviving child under age 21: recovery is barred while the recipient is survived by a child under 21, and no lien may be placed on the home while such a child resides there; Blind or permanently and totally disabled child of any age: recovery is barred while the recipient is survived by a blind or permanently and totally disabled child, and no lien may be placed on the home while such a child resides there; Sibling with an equity interest: no lien may be placed on (and recovery is restricted from) the home if a sibling of the recipient who has an equity interest in the home resided in the home for at least one year immediately before the recipient's admission to a medical institution and continues to lawfully reside there; Caretaker (caregiver) son or daughter: no lien may be placed on the home if a son or daughter resided in the recipient's home for at least two years immediately before the recipient's institutionalization and provided care that allowed the recipient to remain at home rather than in an institution, and continues to lawfully reside there; Undue hardship waiver: estate recovery shall be waived where it would cause undue hardship, as determined under department regulations and procedures (OHIP-0054 undue hardship process).

The local social services district may file a claim against the estate of a deceased Medicaid recipient to recover the correctly paid cost of medical assistance furnished from the date the recipient turned 55 (or the date of permanent institutionalization, whichever came first). For recipients whose eligibility rested on long-term care provisions, recovery is limited to nursing facility services, home and community based services, and related hospital and prescription drug services. The claim is asserted only against the recipient's probate estate, meaning real and personal property and other assets included within the individual's estate and passing under a valid will or by intestacy. Recovery cannot exceed the value of the estate and the recipient's interest in it; heirs are not personally liable beyond what they inherit.

Yes. New York offers an undue-hardship waiver. Contact New York State Department of Health, Office of Health Insurance Programs (OHIP), Medicaid program. Estate recovery claims are filed and pursued by the local social services district (the county Department of Social Services; in New York City, the Human Resources Administration) under NYS DOH supervision. at 800-541-2831 to request the waiver and ask about deadlines.

New York State Department of Health, Office of Health Insurance Programs (OHIP), Medicaid program. Estate recovery claims are filed and pursued by the local social services district (the county Department of Social Services; in New York City, the Human Resources Administration) under NYS DOH supervision., phone 800-541-2831, https://www.health.ny.gov/health_care/medicaid/.