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Texas Medicaid Estate Recovery

After someone who received Medicaid long-term care dies, Texas can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.

Based on 1 Texas Administrative Code (TAC) Chapter 373 (Medicaid Estate Recovery Program); Texas Estates Code; Texas Government Code; federal authority 42 U.S.C. 1396p(b) (Social Security Act section 1917)

By Settled Estate Editorial
Probate estate only
Recovery reach
55+
Age when care was received
Yes
Hardship waiver

What Texas recovers

Texas recovers the cost of certain long-term care services and supports received on or after age 55, but only if the recipient first applied for those services after March 1, 2005 (people who applied before that date are not affected). Covered services include nursing facility care, Intermediate Care Facility services for individuals with an intellectual disability or related condition (ICF/IID), and the listed Medicaid waiver programs (Community Attendant Services, Community Based Alternatives, Community Living Assistance and Support Services, Consolidated Waiver Program, Deaf-Blind with Multiple Disabilities, Home and Community-based Services, Integrated Care Management, STAR+PLUS long-term care services, and Texas Home Living). Certain related hospital and prescription drug services may also be recoverable. Primary Home Care (PHC) is not affected. The state never recovers more than it actually paid for the recipient's services, and MERP collects by filing a claim against the deceased recipient's probate estate.

Texas 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. Texas recovers only for long-term care services and supports received after age 55, and only if the recipient first applied for those services after March 1, 2005. This follows the federal baseline at 42 U.S.C. 1396p(b)(1)(B), under which a state must seek recovery from the estate of an individual who was 55 years of age or older when the individual received the medical assistance.

Who is protected from recovery

Surviving spouse: the state will not recover while a spouse is still alive

Child under 21: the state will not recover while there is a surviving child under 21 years of age

Blind or disabled child of any age: the state will not recover while there is a surviving child of any age who is blind or permanently and totally disabled under Social Security requirements

Unmarried adult child residing in the home: no recovery if there is an unmarried adult child who lived full time in the Medicaid recipient's home for at least one year before the recipient died

Small estate: no recovery if the value of the estate is $10,000 or less

Low claim amount: no recovery if the amount of Medicaid costs (the claim) is $3,000 or less

Cost-ineffective recovery: no recovery if the cost of selling the property would be more than the property is worth

Undue hardship: the state will not recover when doing so would cause an undue hardship for the heirs (heirs must request a waiver and provide proof). Recognized hardship circumstances include the estate property having been a family business, farm, or ranch for at least 12 months before death and being the heirs' main source of income; heirs needing government financial assistance if the claim were filed; heirs being able to come off government assistance if the claim were not filed; the deceased having received services as a crime victim; or a homestead-specific hardship where the homestead is valued under $100,000 and one or more heirs have family income under the annual limit (in 2025, $46,950 for one person and $63,450 for a family of two, adjusted each year)

Property that may be exempt

  • Life insurance policies that name a person (beneficiary) to receive the payment
  • Bank accounts that are payable on death (POD) to another person
  • Other non-probate property that passes outside the probate estate; Texas MERP reaches only assets in the probate estate, not assets that transfer by survivorship, beneficiary designation, or similar non-probate means
  • Estate debts with priority over the MERP claim are paid first, including funeral costs, legal costs, and a home mortgage

Undue-hardship waiver

Texas can waive recovery when it would cause an undue hardship for the heirs. Contact Texas Health and Human Services Commission (HHSC), Medicaid Estate Recovery Program (MERP), administered under contract by Health Management Systems, Inc. (HMS) at 800-641-9356 to request the waiver and confirm deadlines.

Hardship waiver information

Frequently asked questions

Does Texas recover Medicaid costs from non-probate assets?
No. Texas 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.
Who is protected from Medicaid estate recovery in Texas?
Recovery is generally blocked or delayed for: Surviving spouse: the state will not recover while a spouse is still alive; Child under 21: the state will not recover while there is a surviving child under 21 years of age; Blind or disabled child of any age: the state will not recover while there is a surviving child of any age who is blind or permanently and totally disabled under Social Security requirements; Unmarried adult child residing in the home: no recovery if there is an unmarried adult child who lived full time in the Medicaid recipient's home for at least one year before the recipient died; Small estate: no recovery if the value of the estate is $10,000 or less; Low claim amount: no recovery if the amount of Medicaid costs (the claim) is $3,000 or less; Cost-ineffective recovery: no recovery if the cost of selling the property would be more than the property is worth; Undue hardship: the state will not recover when doing so would cause an undue hardship for the heirs (heirs must request a waiver and provide proof). Recognized hardship circumstances include the estate property having been a family business, farm, or ranch for at least 12 months before death and being the heirs' main source of income; heirs needing government financial assistance if the claim were filed; heirs being able to come off government assistance if the claim were not filed; the deceased having received services as a crime victim; or a homestead-specific hardship where the homestead is valued under $100,000 and one or more heirs have family income under the annual limit (in 2025, $46,950 for one person and $63,450 for a family of two, adjusted each year).
What does Texas Medicaid recover after death?
Texas recovers the cost of certain long-term care services and supports received on or after age 55, but only if the recipient first applied for those services after March 1, 2005 (people who applied before that date are not affected). Covered services include nursing facility care, Intermediate Care Facility services for individuals with an intellectual disability or related condition (ICF/IID), and the listed Medicaid waiver programs (Community Attendant Services, Community Based Alternatives, Community Living Assistance and Support Services, Consolidated Waiver Program, Deaf-Blind with Multiple Disabilities, Home and Community-based Services, Integrated Care Management, STAR+PLUS long-term care services, and Texas Home Living). Certain related hospital and prescription drug services may also be recoverable. Primary Home Care (PHC) is not affected. The state never recovers more than it actually paid for the recipient's services, and MERP collects by filing a claim against the deceased recipient's probate estate.
Can I apply for an undue-hardship waiver in Texas?
Yes. Texas offers an undue-hardship waiver. Contact Texas Health and Human Services Commission (HHSC), Medicaid Estate Recovery Program (MERP), administered under contract by Health Management Systems, Inc. (HMS) at 800-641-9356 to request the waiver and ask about deadlines.
Who handles Medicaid estate recovery in Texas?
Texas Health and Human Services Commission (HHSC), Medicaid Estate Recovery Program (MERP), administered under contract by Health Management Systems, Inc. (HMS), phone 800-641-9356, https://www.hhs.texas.gov/regulations/legal-information/your-guide-medicaid-estate-recovery-program.

Agency and statute sources

Settling an estate with a Medicaid claim?

Use the Texas 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 Texas can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.