Utah Medicaid Estate Recovery
After someone who received Medicaid long-term care dies, Utah can file a claim against their estate. This guide explains what is recovered, who is protected, and how to ask for relief.
Based on Utah Code 26B-3-1013 (Estate and trust recovery); 'recovery estate' defined at Utah Code 26B-3-1001(12); TEFRA lien rules at Utah Code 26B-3-1015; federal authority 42 U.S.C. 1396p(b)
What Utah recovers
After a Medicaid recipient dies, the Office of Recovery Services (ORS), Bureau of Medical Collections, recovers the medical assistance Utah correctly paid for that person while the person was 55 years old or older.
Covered services and programsThe full list of care and waiver programs the claim can include
After a Medicaid recipient dies, the Office of Recovery Services (ORS), Bureau of Medical Collections, recovers the medical assistance Utah correctly paid for that person while the person was 55 years old or older. Utah Code 26B-3-1013(1)(a) lets the department recover from the recipient's recovery estate and from any trust in which the recipient was both the grantor and a beneficiary. The amount is a lien against that recovery estate or trust, and under 26B-3-1013(2)(b) the lien carries the same priority as the reasonable and necessary medical expenses of the last illness, so it is paid ahead of general creditors and ahead of anything reaching the heirs. The lien is of indefinite duration under 26B-3-1013(7). ORS lists the recoverable costs as doctor and hospital charges, prescription drugs, medical equipment, ambulance services, nursing home services, in-home or community-based services, and other services, and it includes payments made to a Medicaid managed care plan even for months in which the recipient used no service. ORS states that estate recovery does not apply to the Medicare cost-sharing programs QMB, SLMB, or QI-1. Two related powers sit outside estate recovery: medical assistance that was incorrectly provided is recoverable at any age under 26B-3-1014, and a TEFRA lien may be placed on the home during the recipient's lifetime under 26B-3-1015.
Utah 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: Utah's expanded reach is written into the statute rather than inferred. 'Recovery estate' at Utah Code 26B-3-1001(12) covers the probate estate as defined in 75-1-201, the augmented estate as defined in 75-2-203, and that part of other real or personal property in which the decedent had a legal interest at death, including assets conveyed to a survivor, heir, or assign through joint tenancy, tenancy in common, survivorship, a life estate, a living trust, or another arrangement. Utah Code 26B-3-1013(1)(a) separately reaches any trust in which the recipient was the grantor and a beneficiary, 26B-3-1013(5) makes any trust provision that denies recovery void at the time it is written, and 26B-3-1013(4) routes trust claims through the trust-claim sections of the probate code. So joint tenancy, a life estate, a payable-on-death or beneficiary designation, and a revocable living trust do not by themselves put the property beyond recovery in Utah. The home is not protected either: Utah excludes a home when it decides Medicaid eligibility, and both Utah Medicaid and ORS state that the same home can still be included in estate recovery after the recipient dies.
55 and older. Utah Code 26B-3-1013(1)(a) limits estate recovery to medical assistance correctly provided for the recipient when the recipient was 55 years old or older, which is the federal baseline at 42 U.S.C. 1396p(b). Utah's estate-recovery section carries no separate clause for a permanently institutionalized recipient under 55. Recovery of assistance that was incorrectly provided is a different power under 26B-3-1014 and carries no age limit.
Who is protected from recovery
No recovery while the deceased recipient's spouse is still living (Utah Code 26B-3-1013(1)(b)(i)).
No recovery if the deceased recipient leaves a surviving child under 21 years old (Utah Code 26B-3-1013(1)(b)(ii)(A)).
No recovery if the deceased recipient leaves a surviving child of any age who is blind or disabled as defined in the state Medicaid plan (Utah Code 26B-3-1013(1)(b)(ii)(B)). ORS accepts a determination of disability from the Social Security Administration or the Utah State Medical Review Board.
Heirs may ask ORS to waive or defer estate recovery. Utah Admin. Code R527-200-5(16) makes a request to approve or deny a waiver or deferral of estate recovery an informal adjudicative proceeding before the office, and 42 U.S.C. 1396p(b)(3)(A) requires the state to keep an undue-hardship waiver procedure.
During the recipient's lifetime, no TEFRA lien may be placed on the home while the spouse, a child under 21, a blind or permanently and totally disabled child, or a sibling who has an equity interest in the home and lived there for at least the year before the recipient entered the care facility is lawfully residing there (Utah Code 26B-3-1015(2)). The same list releases an existing TEFRA lien under 26B-3-1020(1)(b).
Utah's own TEFRA lien exemption list does not repeat the federal caregiver-child protection at 42 U.S.C. 1396p(b)(2)(B)(ii), which shields the home of an adult son or daughter who lived there for the two years before admission and whose care kept the recipient out of an institution. Utah Code 26B-3-1023 states that the federal Tax Equity and Fiscal Responsibility Act of 1982 takes precedence where the state sections conflict with it, so raise a caregiver child with ORS rather than assuming the state list is the whole rule.
ORS states that some adult children or siblings of the recipient may have other protections, and asks families to contact the office to confirm whether any apply to their case.
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Property that may be exempt
- Resources that Utah disregarded because the recipient held a qualifying long-term care insurance partnership policy are not subject to estate recovery, under Utah Admin. Code R414-305-3(28)(c). The protected amount is reduced by the value of anything the recipient transferred for less than fair market value, and it does not change how home equity above the state standard is treated.
- Only property in which the decedent held a legal interest at the time of death falls inside the recovery estate. Utah Code 26B-3-1001(12)(c) reaches that part of other real or personal property in which the decedent had a legal interest at the time of death, so property the decedent had genuinely parted with before death sits outside it. The department keeps a separate power under 26B-3-1021(2) to set aside a fraudulent or improper conveyance.
- Members of American Indian or Alaska Native groups may have additional protections. ORS publishes this without listing the protected property and asks families to contact the office to find out whether it applies. Federal law at 42 U.S.C. 1396p(b)(3)(B) requires state hardship procedures to exempt income, resources, and property that were exempt as of April 1, 2003 because of the federal responsibility for Indian Tribes and Alaska Native Villages.
Undue-hardship waiver
Utah can waive recovery when it would cause an undue hardship for the heirs. Contact Utah Department of Health and Human Services, Office of Recovery Services (ORS), Bureau of Medical Collections at (801) 536-8798 to request the waiver and confirm deadlines.
Hardship waiver informationFrequently asked questions
Who is protected from Medicaid estate recovery in Utah?
What does Utah Medicaid recover after death?
Can I apply for an undue-hardship waiver in Utah?
Who handles Medicaid estate recovery in Utah?
Agency and statute sourcesOfficial references used for this page
- Utah Code Section 26B-3-1013, Estate and trust recovery (Utah State Legislature, version effective 5/7/2025)
- Utah Code Section 26B-3-1001, Definitions for Medical Benefits Recovery (defines 'recovery estate')
- Utah Code Section 26B-3-1015, TEFRA liens authorized, grounds, and exemptions
- Utah Admin. Code R527-200-5, Informal Adjudicative Proceedings (Office of Recovery Services), official rule text from the Utah Office of Administrative Rules
- Utah Admin. Code R414-305-3, Aged, Blind and Disabled Medicaid resource provisions (long-term care partnership disregard), official rule text from the Utah Office of Administrative Rules
- Utah Office of Recovery Services, Estate Recovery
- Utah Office of Recovery Services, Contact Medicaid Recovery
- Utah Medicaid, Estate Recovery
- 42 U.S.C. 1396p, Liens, adjustments and recoveries, and transfers of assets (Office of the Law Revision Counsel)
Information current as of August 28, 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 Utah can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.