North Carolina Medicaid Estate Recovery
After someone who received Medicaid long-term care dies, North Carolina can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.
Based on N.C. Gen. Stat. 108A-70.5 (Medicaid Estate Recovery Plan); federal baseline 42 U.S.C. 1396p(b)
What North Carolina recovers
The Department recovers an amount not exceeding the medical assistance correctly paid on behalf of the recipient. Recoverable services under N.C. Gen. Stat. 108A-70.5(b) are: (1) for recipients of any age who were inpatients of a nursing facility, intermediate care facility, or other medical institution with no reasonable expectation of returning home, all medical assistance paid; and (2) for recipients age 55 or older, nursing facility services, home and community-based services, and related hospital and prescription drug services (and, where applicable, personal care services). The Department is a sixth-class creditor against the estate under G.S. 28A-19-6.
North Carolina 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.
55 and older
Who is protected from recovery
Surviving spouse: no recovery may be made while there is a surviving spouse (federal bar under 42 U.S.C. 1396p(b)(2), implemented in NC Medicaid policy MA-2285); recovery is deferred until after the spouse's death.
Surviving child under age 21: no recovery while the deceased recipient has a surviving child under age 21.
Blind or permanently and totally disabled child: no recovery while the deceased recipient has a surviving child of any age who is blind or permanently and totally disabled.
Sibling with an equity interest in the home: not separately codified in N.C. Gen. Stat. 108A-70.5; the federal sibling-equity protection (42 U.S.C. 1396p) and undue-hardship considerations may apply (not independently verified for NC).
Caregiver child: not separately codified in N.C. Gen. Stat. 108A-70.5; may be addressed through the undue-hardship waiver (not independently verified for NC).
Property that may be exempt
- Assets that do not pass through the probate estate are generally not reachable, because recovery is limited to property that is an asset of the estate available for the discharge of debt under G.S. 28A-15-1 (probate estate). Exception: for recipients who received benefits under a qualified long-term care partnership policy, the estate definition is expanded to include non-probate interests (joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement).
Undue-hardship waiver
North Carolina can waive recovery when it would cause an undue hardship for the heirs. Contact North Carolina Medicaid Estate Recovery Program (NC DHHS, Division of Health Benefits; recovery handled by the HMS Estate Recovery Unit) at 1-866-455-0109 to request the waiver and confirm deadlines.
Hardship waiver informationFrequently asked questions
Does North Carolina recover Medicaid costs from non-probate assets?
Who is protected from Medicaid estate recovery in North Carolina?
What does North Carolina Medicaid recover after death?
Can I apply for an undue-hardship waiver in North Carolina?
Who handles Medicaid estate recovery in North Carolina?
Settling an estate with a Medicaid claim?
Use the North Carolina probate assessment to organize the estate and see how the claim fits the process.
Information current as of June 28, 2026
This content is for informational purposes only and does not constitute legal advice. Probate laws and procedures in North Carolina can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.