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Washington Medicaid Estate Recovery

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

Based on RCW 43.20B.080 (Washington's estate recovery authority: liens, adjustment and recovery consistent with 42 U.S.C. 1396p, recovery from the estate and from nonprobate assets as defined by RCW 11.02.005 for a person 55 or older, enforcement against a decedent's life estate or joint tenancy interest, the law-as-of-service-date rule, and the undue hardship waiver); RCW 74.39A.170 (state-funded long-term care payments recoverable without regard to the recipient's age); RCW 43.20B.090 (legislative intent behind RCW 43.20B.080 and RCW 74.39A.170); RCW 43.20B.750 (the recorded request for notice of transfer or encumbrance, which is not a lien); RCW 11.02.005 (the nonprobate asset definition that sets the reach); chapter 182-527 WAC, Estate Recovery and Pre Death Liens, sections 182-527-2730 through 182-527-2753 (the operating rules: the estate definition, lifetime liens, the general right to recover, the age, service and asset limitations, the undue hardship delay, and hearings); RCW 11.40.020 and RCW 11.62.010 (the notices a personal representative or a small estate affiant must mail to the Office of Financial Recovery); RCW 11.40.051 (claim time limits, effective against both probate and nonprobate assets); RCW 43.17.240 (one percent per month interest on a past-due debt); federal baseline 42 U.S.C. 1396p, whose subsection (b)(4)(B) is the optional expanded estate definition Washington adopted.

By Settled Estate Editorial
Expanded recovery
Recovery reach
55+
Age when care was received
Protected
While a spouse is alive
Yes
Hardship waiver

What Washington recovers

Washington recovers the cost of long-term care and related medical services, and it does not stop at the probate estate.

Covered services and programsThe full list of care and waiver programs the claim can include

Washington recovers the cost of long-term care and related medical services, and it does not stop at the probate estate. RCW 43.20B.080(3) directs the department to seek adjustment or recovery from the estate of a person who was 55 or older when they received medical assistance, and from nonprobate assets of that person as defined by RCW 11.02.005, but only for medical assistance consisting of nursing facility services, home and community-based services, other services the department determines to be appropriate, and related hospital and prescription drug services. WAC 182-527-2730 writes the same reach into the operating rule: an estate is all property and any other assets that pass on the client's death under the will or by intestate succession under chapter 11.04 or 11.62 RCW, reduced by any valid liability against the client's property at death, and for a client who died on or after September 14, 2006 it also includes nonprobate assets as defined by RCW 11.02.005 and any life estate interest held by the client immediately before death. RCW 43.20B.080(7) lets the department enforce its lien against a decedent's life estate or joint tenancy interest in real property. Which services are billed depends on when they were delivered, because RCW 43.20B.080(4) makes the department apply the estate recovery law as it existed on the date the benefits were received. WAC 182-527-2742 sets that schedule out band by band. For dates of service on or after January 1, 2014 the recoverable list is nursing facility services, basic plus waiver services, community first choice services, community option program entry system services, community protection waiver services, core waiver services, hospice services, intermediate care facility services for individuals with intellectual disabilities in a private community setting or a rural health clinic, individual and family services, medicaid personal care services, New Freedom consumer directed services, personal care services funded under Title XIX or XXI, private duty nursing, residential habilitation center services, residential support waiver services, roads to community living demonstration project services, the portion of a managed care premium used to pay for authorized long-term care under the program of all-inclusive care for the elderly, and the hospital and prescription drug services provided while the client was receiving any of those. For dates of service from June 1, 2004 through December 31, 2013 the reach was far wider and took in all medicaid services and managed care premiums. State-only funded long-term care is recovered too, under the carve-outs in WAC 182-527-2742(1). Collection runs through liens and probate claims. After the client dies the agency may file a lien to recover correctly paid services (WAC 182-527-2738(1)), and it must first mail notice stating the amount it seeks, the client's identifying details, the county where the property sits, and how to request an administrative hearing. It may file the lien 28 calendar days after mailing that notice unless an administrative or court order says otherwise (WAC 182-527-2753(6)). Interest on a past-due debt runs at one percent per month under RCW 43.17.240, and the agency may waive it where reasonable efforts to sell the property have failed. Washington also puts the notice duty on the estate: under RCW 11.40.020(1)(d) a personal representative who gives notice to creditors must also mail a copy, including the decedent's social security number, to the Department of Social and Health Services Office of Financial Recovery, and under RCW 11.62.010(5) the same office must be mailed a copy of a small estate affidavit. RCW 11.40.051 sets the claim time limits, and subsection (3) makes that bar effective against both probate and nonprobate assets.

Washington 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: Washington reaches well past probate, and four Washington-specific points decide most real cases. First, a community property agreement is not a shield. It is one of the most common Washington estate plans, and RCW 11.02.005(14) names it as a nonprobate asset; WAC 182-527-2730 carved community property agreements out of the estate only for clients who died after June 30, 1995 and before July 27, 1997, and that carve-out has not applied to anyone dying since. Second, a revocable living trust is not a shield either, because the same definition names a trust of which the person is grantor and that becomes effective or irrevocable only upon the person's death. Third, a transfer-on-death deed does not escape: RCW 11.02.005(14) names a transfer on death deed, along with joint tenancy with right of survivorship, a joint bank account with right of survivorship, a payable-on-death or trust bank account, a transfer-on-death security or security account, a deed whose possession is postponed until death, an individual retirement account, and a note or other contract whose payment or performance is affected by the person's death. Fourth, the reach into a life estate or a joint tenancy is bounded rather than total: RCW 43.20B.080(7) and WAC 182-527-2746(3) and (4) cap the lien at the value of the decedent's own interest, measured by the Social Security Administration life estate factor for a life estate or by an equal fractional share for a joint tenancy, and neither can be enforced against a property right that vested before July 1, 2005 or against a bona fide purchaser who took after the death and before the department recorded. The clearest thing outside the reach is a payable-on-death provision of a life insurance policy, an annuity or another similar contract, or of an employee benefit plan, which RCW 11.02.005(14) excludes from the definition by name. Medicaid transfer-penalty rules during the look-back period are a separate eligibility question and still apply. Confirm your own situation with a Washington elder-law attorney.

55 and older for medicaid services, and any age for state-funded long-term care. WAC 182-527-2740(1) sets the medicaid track: from July 26, 1987 an estate was liable for recoverable services provided on or after the client's 65th birthday, and from July 1, 1994 it is liable for recoverable services provided on or after the client's 55th birthday, which matches the federal floor at 42 U.S.C. 1396p(b)(1)(B). WAC 182-527-2740(2) is the part that has no age condition at all: an estate is liable for all state-only-funded long-term care services the home and community services division of the Department of Social and Health Services provided on or after July 1, 1995, and for all state-only-funded long-term care the developmental disabilities community services division provided on or after June 1, 2004. RCW 74.39A.170(1) is the authority behind that, saying all payments made in state-funded long-term care are recoverable as if they were medical assistance payments subject to recovery under 42 U.S.C. 1396p and chapter 43.20B RCW, but without regard to the recipient's age. The Office of Financial Recovery describes its own practice the same way, recovering from estates of recipients of state-funded long-term care services without regard to age and of medicaid services aged 55 and older at the time of death. So a Washington estate can face a claim for state-funded long-term care delivered before the person turned 55.

Who is protected from recovery

Surviving spouse: WAC 182-527-2738(3)(a) bars the agency from recovering from the client's estate so long as there remains a surviving spouse, which matches the federal floor at 42 U.S.C. 1396p(b)(2). This defers recovery rather than cancelling it. The Health Care Authority's own estate recovery page says recovery is deferred until the death of a surviving spouse, and that when the surviving spouse dies recovery action will be taken against property in which the deceased individual had an interest at the time of death.

Surviving child age 20 or younger: WAC 182-527-2738(3)(b)(i) blocks recovery from the estate while such a child survives.

Surviving child who is blind or disabled as WAC 182-512-0050 defines those terms, at any age: WAC 182-527-2738(3)(b)(ii).

Spouse or state-registered domestic partner living in the home, as against a lien filed while the client is alive: WAC 182-527-2734(1)(a)(iii)(A) bars a lifetime lien on the home while either lawfully resides there.

Sibling with an equity interest who lives in the home, as against a lien filed while the client is alive: WAC 182-527-2734(1)(a)(iii)(C) bars a lifetime lien where a sibling who holds an equity interest in the home has resided there for at least one year immediately before the client's admission to the medical institution. Washington states this as a bar on the lifetime lien, and its own estate recovery rules do not repeat it as an exemption from recovery after death.

Caregiver child, as against a lien on the home: Washington's own estate recovery rules state no caregiver-child exemption. Chapter 182-527 WAC was read in full on 2026-08-07 and no section in it mentions a son or daughter who provided care. The protection reaches Washington through RCW 43.20B.080(1), which requires the department to act consistent with 42 U.S.C. 1396p, and 42 U.S.C. 1396p(b)(2)(B)(ii) bars enforcement of a lien on the home while a son or daughter who resided there for at least two years immediately before the admission, and who satisfies the state that the care they gave let the person live at home rather than in an institution, continues lawfully residing there.

Surviving state-registered domestic partner: RCW 43.20B.080(5)(a) directs the department to recognize an undue hardship for a surviving domestic partner whenever recovery would not have been permitted had that person been a surviving spouse, and says the department is not authorized to pursue recovery under such circumstances. WAC 182-527-2750(1)(a)(iii) lists the same fact as an undue hardship ground.

Undue hardship where the property is an heir's sole income-producing asset: WAC 182-527-2750(1)(a)(i) lets that heir ask the agency to delay recovery.

Undue hardship where recovery would deprive an heir of shelter and the heir cannot afford alternative shelter: WAC 182-527-2750(1)(a)(ii). Undue hardship does not exist if the client or the heir created the circumstances to avoid estate recovery (WAC 182-527-2750(1)(b)).

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Property that may be exempt

  • Death benefits payable to a named beneficiary under a life insurance policy, an annuity or another similar contract, or under an employee benefit plan. RCW 11.02.005(14) expressly excludes a payable-on-death provision of those instruments from the nonprobate asset definition Washington's estate recovery rule adopts. A policy payable to the estate itself is a different matter, because it lands in the probate estate the rule already reaches.
  • An interest the client had irrevocably transferred before death, or one where the client had waived the power to transfer it, or, in a contractual arrangement, had waived the unilateral right to rescind or modify it (RCW 11.02.005(14)). Medicaid transfer-penalty rules during the look-back period are a separate eligibility question and still apply.
  • An interest the client held solely in a fiduciary capacity (RCW 11.02.005(14)).
  • Any property right that vested before July 1, 2005, as against a lien on a life estate or a joint tenancy interest. WAC 182-527-2746(3)(c) and (4)(c) both say the agency may not enforce such a lien against a right that vested before that date, and RCW 43.20B.080(7)(d) says the same at the statute.
  • The part of a life estate or of jointly held property that exceeds the decedent's own valued interest. WAC 182-527-2746(3)(b) caps a life estate lien at fair market value multiplied by the life estate factor for the client's age at their last birthday, using the life estate and remainder interest tables maintained by the Social Security Administration. WAC 182-527-2746(4)(b) caps a joint tenancy lien at fair market value divided by the number of joint tenants on the day the client died. RCW 43.20B.080(7)(a) and (b) set the same two measures, and (b) describes the joint interest as the fractional interest the recipient would have owned had the tenants held title as tenants in common on the date of death.
  • Property in the hands of a bona fide purchaser or encumbrancer who obtained an interest after the recipient's death and before the department recorded either its lien or its request for notice of transfer or encumbrance under RCW 43.20B.750 (RCW 43.20B.080(7)(c)).
  • Assets designated as protected by a qualified long-term care partnership policy issued after November 30, 2011. WAC 182-527-2746(5) allows them to be disregarded for estate recovery, but the person claiming the protection must give the Office of Financial Recovery clear and convincing evidence before the final recovery settlement, including proof of a valid policy, verification from the insurer of the dollar amount paid out, and a current asset designation form where the policy paid out more than was previously designated.
  • Certain American Indian and Alaska Native property. WAC 182-527-2746(6) exempts it where the deceased client was enrolled in a federally recognized tribe and the estate or heir documents an ownership interest in trust or nontrust real property and improvements on a reservation, near a reservation as designated and approved by the Bureau of Indian Affairs, within the most recent boundaries of a prior federal reservation, or within the contract health service delivery area boundary for social services the client's tribe provides to its enrolled members. The same section covers certain tribal income and resources, and ownership interests in or usage rights to items of unique religious, spiritual, traditional or cultural significance or that support subsistence or a traditional life style.
  • Government reparation payments that federal law specifically excludes in determining eligibility, so long as the funds have been kept segregated, not commingled with other countable resources, and remain identifiable (WAC 182-527-2746(6)(e)).
  • Property made exempt from claims by federal law or treaty, including tribal artifacts held by individual Native Americans. RCW 43.20B.080(5)(b) puts that limit in the statute itself.
  • Valid liabilities against the client's property at the time of death. WAC 182-527-2730 reduces the value of the estate by them before recovery is measured.
  • Long-term services and supports authorized under the medicaid transformation project for dates of service beginning July 1, 2017. WAC 182-527-2742(10) exempts them and names medicaid alternative care under WAC 182-513-1600, tailored supports for older adults under WAC 182-513-1610, supportive housing under WAC 388-106-1700 through 388-106-1765, and supported employment under WAC 388-106-1800 through 388-106-1865.
  • Five state-only funded services that WAC 182-527-2742(1) carves out of recovery: adult protective services, offender reentry community safety program services, supplemental security payments authorized by developmental disabilities community services, volunteer chore services, and guardianship and conservatorship assistance program services.
  • Medicare Savings Program spending in two situations. For dates of service through December 31, 2009, where the client was eligible for the Medicare Savings Program but not otherwise medicaid eligible, WAC 182-527-2742(8) limits the estate's liability to the sums paid for medicare premiums and cost-sharing benefits. For dates of service beginning January 1, 2010, where the client was eligible for both medicaid and the program, WAC 182-527-2742(9) says the estate is not liable for any sum paid to cover medical assistance cost-sharing benefits.
  • A home the client transferred before death to a spouse, or to a child who was under 21 or who meets the disability criteria in WAC 182-512-0050(1)(b) or (c). The Health Care Authority's estate recovery page states that such a home is not considered part of the individual's estate, and WAC 182-513-1363(1)(d)(i) through (iii) treats the transfer as not triggering a transfer penalty for long-term care eligibility.
  • Two old value exemptions that are still on the books and still reachable through the law-as-of-service-date rule in RCW 43.20B.080(4). For services received before July 25, 1993, WAC 182-527-2746(1) lets the agency exempt the first fifty thousand dollars of the estate's value at the client's death plus sixty-five percent of the remaining value. For services received from July 25, 1993 through June 30, 1994, WAC 182-527-2746(2) exempts two thousand dollars' worth of personal property.

Undue-hardship waiver

Washington can waive recovery when it would cause an undue hardship for the heirs. Contact Washington State Health Care Authority and the Department of Social and Health Services Office of Financial Recovery at 1-800-562-6114 to request the waiver and confirm deadlines.

Hardship waiver information

Frequently asked questions

Who is protected from Medicaid estate recovery in Washington?
Recovery is generally blocked or delayed for: Surviving spouse: WAC 182-527-2738(3)(a) bars the agency from recovering from the client's estate so long as there remains a surviving spouse, which matches the federal floor at 42 U.S.C. 1396p(b)(2). This defers recovery rather than cancelling it. The Health Care Authority's own estate recovery page says recovery is deferred until the death of a surviving spouse, and that when the surviving spouse dies recovery action will be taken against property in which the deceased individual had an interest at the time of death; Surviving child age 20 or younger: WAC 182-527-2738(3)(b)(i) blocks recovery from the estate while such a child survives; Surviving child who is blind or disabled as WAC 182-512-0050 defines those terms, at any age: WAC 182-527-2738(3)(b)(ii); Spouse or state-registered domestic partner living in the home, as against a lien filed while the client is alive: WAC 182-527-2734(1)(a)(iii)(A) bars a lifetime lien on the home while either lawfully resides there; Sibling with an equity interest who lives in the home, as against a lien filed while the client is alive: WAC 182-527-2734(1)(a)(iii)(C) bars a lifetime lien where a sibling who holds an equity interest in the home has resided there for at least one year immediately before the client's admission to the medical institution. Washington states this as a bar on the lifetime lien, and its own estate recovery rules do not repeat it as an exemption from recovery after death; Caregiver child, as against a lien on the home: Washington's own estate recovery rules state no caregiver-child exemption. Chapter 182-527 WAC was read in full on 2026-08-07 and no section in it mentions a son or daughter who provided care. The protection reaches Washington through RCW 43.20B.080(1), which requires the department to act consistent with 42 U.S.C. 1396p, and 42 U.S.C. 1396p(b)(2)(B)(ii) bars enforcement of a lien on the home while a son or daughter who resided there for at least two years immediately before the admission, and who satisfies the state that the care they gave let the person live at home rather than in an institution, continues lawfully residing there; Surviving state-registered domestic partner: RCW 43.20B.080(5)(a) directs the department to recognize an undue hardship for a surviving domestic partner whenever recovery would not have been permitted had that person been a surviving spouse, and says the department is not authorized to pursue recovery under such circumstances. WAC 182-527-2750(1)(a)(iii) lists the same fact as an undue hardship ground; Undue hardship where the property is an heir's sole income-producing asset: WAC 182-527-2750(1)(a)(i) lets that heir ask the agency to delay recovery; Undue hardship where recovery would deprive an heir of shelter and the heir cannot afford alternative shelter: WAC 182-527-2750(1)(a)(ii). Undue hardship does not exist if the client or the heir created the circumstances to avoid estate recovery (WAC 182-527-2750(1)(b)).
What does Washington Medicaid recover after death?
Washington recovers the cost of long-term care and related medical services, and it does not stop at the probate estate. RCW 43.20B.080(3) directs the department to seek adjustment or recovery from the estate of a person who was 55 or older when they received medical assistance, and from nonprobate assets of that person as defined by RCW 11.02.005, but only for medical assistance consisting of nursing facility services, home and community-based services, other services the department determines to be appropriate, and related hospital and prescription drug services. WAC 182-527-2730 writes the same reach into the operating rule: an estate is all property and any other assets that pass on the client's death under the will or by intestate succession under chapter 11.04 or 11.62 RCW, reduced by any valid liability against the client's property at death, and for a client who died on or after September 14, 2006 it also includes nonprobate assets as defined by RCW 11.02.005 and any life estate interest held by the client immediately before death. RCW 43.20B.080(7) lets the department enforce its lien against a decedent's life estate or joint tenancy interest in real property. Which services are billed depends on when they were delivered, because RCW 43.20B.080(4) makes the department apply the estate recovery law as it existed on the date the benefits were received. WAC 182-527-2742 sets that schedule out band by band. For dates of service on or after January 1, 2014 the recoverable list is nursing facility services, basic plus waiver services, community first choice services, community option program entry system services, community protection waiver services, core waiver services, hospice services, intermediate care facility services for individuals with intellectual disabilities in a private community setting or a rural health clinic, individual and family services, medicaid personal care services, New Freedom consumer directed services, personal care services funded under Title XIX or XXI, private duty nursing, residential habilitation center services, residential support waiver services, roads to community living demonstration project services, the portion of a managed care premium used to pay for authorized long-term care under the program of all-inclusive care for the elderly, and the hospital and prescription drug services provided while the client was receiving any of those. For dates of service from June 1, 2004 through December 31, 2013 the reach was far wider and took in all medicaid services and managed care premiums. State-only funded long-term care is recovered too, under the carve-outs in WAC 182-527-2742(1). Collection runs through liens and probate claims. After the client dies the agency may file a lien to recover correctly paid services (WAC 182-527-2738(1)), and it must first mail notice stating the amount it seeks, the client's identifying details, the county where the property sits, and how to request an administrative hearing. It may file the lien 28 calendar days after mailing that notice unless an administrative or court order says otherwise (WAC 182-527-2753(6)). Interest on a past-due debt runs at one percent per month under RCW 43.17.240, and the agency may waive it where reasonable efforts to sell the property have failed. Washington also puts the notice duty on the estate: under RCW 11.40.020(1)(d) a personal representative who gives notice to creditors must also mail a copy, including the decedent's social security number, to the Department of Social and Health Services Office of Financial Recovery, and under RCW 11.62.010(5) the same office must be mailed a copy of a small estate affidavit. RCW 11.40.051 sets the claim time limits, and subsection (3) makes that bar effective against both probate and nonprobate assets.
Can I apply for an undue-hardship waiver in Washington?
Yes. Washington offers an undue-hardship waiver. Contact Washington State Health Care Authority and the Department of Social and Health Services Office of Financial Recovery at 1-800-562-6114 to request the waiver and ask about deadlines.
Who handles Medicaid estate recovery in Washington?
Washington State Health Care Authority and the Department of Social and Health Services Office of Financial Recovery, phone 1-800-562-6114, https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/estate-recovery.
Agency and statute sourcesOfficial references used for this page

Information current as of August 7, 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 Washington can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.