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.
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 informationFrequently asked questions
Who is protected from Medicaid estate recovery in Washington?
What does Washington Medicaid recover after death?
Can I apply for an undue-hardship waiver in Washington?
Who handles Medicaid estate recovery in Washington?
Agency and statute sourcesOfficial references used for this page
- RCW 43.20B.080, Washington's estate recovery authority. Subsection (1) requires the department to file liens, seek adjustment or otherwise effect recovery for medical assistance correctly paid on behalf of an individual consistent with 42 U.S.C. Sec. 1396p. Subsection (3) is the reach used here: in the case of an individual who was 55 or older when they received medical assistance, the department shall seek adjustment or recovery from the individual's estate, and from nonprobate assets of the individual 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. Subsection (4) applies the estate recovery law as it existed on the date the benefits were received. Subsection (5)(a) is the undue hardship waiver and the surviving domestic partner rule; (5)(b) excludes property made exempt from claims by federal law or treaty, including tribal artifacts. Subsection (7) authorizes enforcement against a decedent's life estate or joint tenancy interest, with the valuation measures at (a) and (b), the bona fide purchaser protection at (c), and the July 1, 2005 vesting cutoff at (d). Subsection (8) sets the pre-death lien conditions. Enactment line read at the section: [ 2010 c 94 s 12 ; 2008 c 6 s 302 ; 2005 c 292 s 6 ; 1999 c 354 s 2 ; 1997 c 392 s 302 ; 1995 1st sp.s. c 18 s 67 ; 1994 c 21 s 3 .]
- RCW 74.39A.170, the authority for recovering state-funded long-term care. Subsection (1) is the provision used here: all payments made in state-funded long-term care shall be recoverable as if they were medical assistance payments subject to recovery under 42 U.S.C. Sec. 1396p and chapter 43.20B RCW, but without regard to the recipient's age. Subsection (2) imposes the same transfer-of-asset rules for eligibility. Subsections (3) and (4) put the advance disclosure duty on the department. Enactment line read at the section: [ 1999 c 354 s 1 ; 1995 1st sp.s. c 18 s 56 .]
- RCW 43.20B.090, the legislature's stated intent behind Washington estate recovery. Subsection (1) says the estate recovery provisions of RCW 43.20B.080 and 74.39A.170 balance the interests of individuals, surviving spouses and dependent children, adult nondependent children, more distant heirs, and the state. Subsection (2) confirms that chapter 21, Laws of 1994 repealed and substantially reenacted the state's medicaid estate recovery laws without eliminating authority to recover assistance paid before October 1, 1993. Cited here for the pairing of the two recovery statutes, not for any operative rule. Enactment line read at the section: [ 1997 c 392 s 301 .]
- RCW 43.20B.750, the recorded request for notice of transfer or encumbrance. Subsection (1) lets the Department of Social and Health Services present a request for notice of transfer or encumbrance to the county auditor for recording in the deed and mortgage records where a medical assistance recipient holds record title or is a purchaser under a land sale contract. Subsection (5) is the point relied on here: the request does not affect title to real property and is not a lien on, encumbrance of, or other interest in the real property. Enactment line read at the section: [ 2005 c 292 s 1 .]
- RCW 11.02.005, the Title 11 definitions. Subsection (14) is the definition that sets the reach of Washington estate recovery, because both RCW 43.20B.080(3) and WAC 182-527-2730 adopt it by reference. Nonprobate asset means those rights and interests of a person having beneficial ownership of an asset that pass on the person's death under a written instrument or arrangement other than the person's will, and includes but is not limited to a right or interest passing under a joint tenancy with right of survivorship, joint bank account with right of survivorship, transfer on death deed, payable on death or trust bank account, transfer on death security or security account, deed or conveyance if possession has been postponed until the death of the person, trust of which the person is grantor and that becomes effective or irrevocable only upon the person's death, community property agreement, individual retirement account or bond, or note or other contract the payment or performance of which is affected by the death of the person. It does not include a payable-on-death provision of a life insurance policy, annuity, or other similar contract, or of an employee benefit plan; a right or interest passing by descent and distribution under chapter 11.04 RCW; a right or interest irrevocably transferred before death or as to which the power to transfer or the unilateral right to rescind or modify was waived; or a right or interest held solely in a fiduciary capacity. Enactment line read at the section: [ 2026 c 204 s 15 ; 2021 c 140 s 1012 ; 2020 c 312 s 708 ; 2018 c 22 s 6 ; 2014 c 58 s 18 . Prior: ... ]
- RCW 11.40.020, the Washington notice to creditors. Subsection (1) lets a personal representative give notice requiring claims to be presented within the time in RCW 11.40.051 or be forever barred as to claims against the decedent's probate and nonprobate assets, and then sets what the personal representative must do: file the notice with the court, publish it once each week for three successive weeks in a legal newspaper in the county where the estate is administered, and, at (1)(d), also mail a copy of the notice including the decedent's social security number to the state of Washington department of social and health services office of financial recovery. That mandatory mailing to the Office of Financial Recovery is the fact used here. Enactment line read at the section: [ 2005 c 97 s 4 ; 1999 c 42 s 601 ; 1997 c 252 s 8 ; 1974 ex.s. c 117 s 34 ; 1965 c 145 s 11.40.020 . Prior: ... ]
- RCW 11.40.051, the Washington claim bar. Subsection (1) applies whether or not notice is provided under RCW 11.40.020 and sets three limits: a creditor given actual notice must present its claim within the later of 30 days after service or mailing and four months after first publication; a creditor not given actual notice has four months after first publication if it was not reasonably ascertainable, and 24 months after the date of death if it was reasonably ascertainable; and where no notice was provided under chapter 11.40 or 11.42 RCW the limit is 24 months after the date of death. Subsection (3) is the point that matters for an expanded-recovery state: this bar is effective as to claims against both the decedent's probate and nonprobate assets. Enactment line read at the section: [ 2005 c 97 s 6 ; 1997 c 252 s 11 .]
- RCW 11.62.010, the Washington small estate affidavit. Cited here only for subsection (5), which requires that a copy of the affidavit, including the decedent's social security number, be mailed to the state of Washington, department of social and health services, office of financial recovery. That is the reason the small estate route does not keep an estate out of the state's view. Enactment line read at the section: [ 2008 c 6 s 923 ; 2006 c 360 s 16 ; 1995 1st sp.s. c 18 s 60 ; 1993 c 291 s 1 . Prior: ... ]
- WAC 182-527-2730, the definitions for chapter 182-527 WAC. The Estate definition is the single most important fact in this file: an estate means all property and any other assets that pass upon the client's death under the client's will or by intestate succession under chapter 11.04 or 11.62 RCW, reduced by any valid liability against the client's property when the client died, and an estate also includes, for a client who died after June 30, 1995 and before July 27, 1997, nonprobate assets as defined by RCW 11.02.005 except property passing through a community property agreement; for a client who died after July 26, 1997 and before September 14, 2006, nonprobate assets as defined by RCW 11.02.005; and for a client who died on or after September 14, 2006, nonprobate assets as defined by RCW 11.02.005 and any life estate interest held by the client immediately before death. The section also defines heir, life estate, lis pendens, long-term care services, property, qualified long-term care insurance partnership, and recover. Rule history read at the section: Statutory Authority RCW 41.05.021 and 41.05.160, WSR 25-22-083 filed 11/4/25 effective 12/5/25; WSR 16-05-054 filed 2/12/16 effective 3/14/16; and earlier orders back to WSR 95-19-001.
- WAC 182-527-2734, the pre-death lien rule. Subsection (1)(a) allows a lien on a living client's property only where the client resides in a skilled nursing facility, an intermediate care facility for individuals with an intellectual disability or another medical institution under WAC 182-500-0050; the agency has determined the client cannot reasonably be expected to return home, on a physician's verification or because the client has resided in an institution six months or longer; and none of the following lawfully reside in the home: the client's spouse or state-registered domestic partner, the client's child who is age twenty or younger or is blind or permanently disabled as defined in WAC 182-512-0050, or a client's sibling who has an equity interest in the home and who has been residing in the home for at least one year immediately before the client's admission to the medical institution. Subsection (1)(b) releases the lien if the client returns home. Subsections (2) through (5) cover the amount of the lien, the notice, interest at one percent per month under RCW 43.17.240, and the hearing route. Rule history read at the section: WSR 17-12-019 filed 5/30/17 effective 7/1/17; WSR 16-05-054 filed 2/12/16 effective 3/14/16.
- WAC 182-527-2738, the general right to recover after death. Subsection (1) lets the medicaid agency file liens after a Washington apple health client has died to recover the cost of services subject to recovery that were correctly paid on the client's behalf. Subsection (2) sets the notice requirement and its contents, including the amount sought and how to request an administrative hearing. Subsection (3) is the exemption used here: the agency may not recover from the client's estate so long as there remains a surviving spouse, or a surviving child who is age twenty or younger or is blind or disabled as defined in WAC 182-512-0050. Subsection (4) sets interest at one percent per month under RCW 43.17.240 and defines when a lien becomes a past-due debt. Rule history read at the section: Statutory Authority RCW 41.05.021 and 41.05.160, WSR 16-05-054 filed 2/12/16 effective 3/14/16.
- WAC 182-527-2740, the age limits. Subsection (1)(a): beginning July 26, 1987, a client's estate is liable for medicaid services subject to recovery that were provided on or after the client's 65th birthday. Subsection (1)(b): beginning July 1, 1994, a client's estate is liable for medicaid services subject to recovery that were provided on or after the client's 55th birthday. Subsection (2)(a): a client's estate is liable for all state-only-funded long-term care services provided by the home and community services division of the Department of Social and Health Services on or after July 1, 1995. Subsection (2)(b): the same for the developmental disabilities community services division on or after June 1, 2004. Subsection (2) states no age condition, which is the source of the any-age reach for state-funded long-term care. Rule history read at the section: WSR 25-22-083 filed 11/4/25 effective 12/5/25; WSR 16-05-054 filed 2/12/16 effective 3/14/16.
- WAC 182-527-2742, the service list. Subsection (1) makes state-only funded services recoverable except 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. Subsection (2) lists the eighteen categories recoverable for dates of service on and after January 1, 2014. Subsections (3) through (7) set the earlier date bands, including all medicaid services and managed care premiums from June 1, 2004 through December 31, 2013. Subsections (8) and (9) limit Medicare Savings Program liability. Subsection (10) exempts long-term services and supports authorized under the medicaid transformation project for dates of service beginning July 1, 2017, naming 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. Rule history read at the section: WSR 25-22-083 filed 11/4/25 effective 12/5/25; WSR 24-12-011 filed 5/23/24 effective 6/23/24; earlier orders back to WSR 95-19-001.
- WAC 182-527-2746, the asset limits. Subsection (1) allows the pre-July 25, 1993 exemption of the first fifty thousand dollars of the estate's value at death plus sixty-five percent of the remaining value. Subsection (2) exempts two thousand dollars' worth of personal property for services received from July 25, 1993 through June 30, 1994. Subsection (3) governs a lien against a life estate interest, capping it at fair market value multiplied by the life estate factor for the client's age at their last birthday from the Social Security Administration life estate and remainder interest tables, and barring enforcement against a property right that vested before July 1, 2005. Subsection (4) does the same for a joint tenancy, capping the lien at fair market value divided by the number of joint tenants on the day the client died. Subsection (5) covers the qualified long-term care partnership disregard and its clear and convincing evidence requirements. Subsection (6) sets out the American Indian and Alaska Native protections and the government reparation payments exemption; note that (6)(b) refers to subsection (4) of this section, a cross-reference that does not match its own subject. Rule history read at the section: Statutory Authority RCW 41.05.021 and 41.05.160, WSR 16-05-054 filed 2/12/16 effective 3/14/16.
- WAC 182-527-2750, the undue hardship rule. Subsection (1)(a) lets an heir ask the agency to delay recovery, and says undue hardship exists only when the property subject to recovery is the sole income-producing asset of an heir, recovery would deprive an heir of shelter and the heir cannot afford alternative shelter, or the client is survived by a state-registered domestic partner. Subsection (1)(b) says undue hardship does not exist if the client or the heir created circumstances to avoid estate recovery. Subsection (2) allows a delay until the hardship no longer exists. Subsection (4) sets the eight conditions an heir granted a delay must keep, including not selling, transferring or encumbering the property, residing on it, paying taxes and utilities, insuring it for fair market value and naming the state of Washington as primary payee on the policy. Subsections (5) and (6) cover restart of recovery and the hearing route. Note the section grants a DELAY, while RCW 43.20B.080(5)(a) speaks of a waiver. Rule history read at the section: Statutory Authority RCW 41.05.021 and 41.05.160, WSR 16-05-054 filed 2/12/16 effective 3/14/16.
- WAC 182-527-2753, the hearing rule for chapter 182-527 WAC. Subsection (1) limits what an administrative hearing may decide, including, for a lien filed after death, the cost the agency correctly paid for services subject to recovery, whether the client or the estate holds legal title to the identified property, and whether the agency's denial of a request for a delay of recovery for undue hardship under WAC 182-527-2750 was correct. Subsection (2) requires the request to be in writing, signed, stating the basis and giving the client's name and the requestor's address and telephone number, and filed within twenty-eight days of the date on the agency's notice with the Office of Financial Recovery either in person at 712 Pear St. S.E., Olympia, WA 98504-0001 or by certified mail return receipt requested to P.O. Box 9501, Olympia, WA 98507-9501. Subsection (5) forbids distributing disputed assets while in litigation. Subsection (6) lets the agency file a lien twenty-eight calendar days after mailing notice of intent absent an order to the contrary. Rule history read at the section: Statutory Authority RCW 41.05.021 and 41.05.160, WSR 16-05-054 filed 2/12/16 effective 3/14/16.
- WAC 182-513-1363, the transfer-of-asset rule for long-term care eligibility. Cited here only for subsection (1)(d), the home transfer exceptions: a home transferred to the person's spouse, to a child who meets the disability criteria under WAC 182-512-0050(1)(b) or (c), to a child who was under age twenty-one, to a child who lived in the home and provided care where the six conditions at (d)(iv)(A) through (F) are met including at least two years of residence and verifiable care immediately before the current period of institutional status and physician documentation that the in-home care was necessary to prevent it, or to a sibling who has lived in and has had an equity interest in the home for at least one year immediately before the date the person attained institutional status. This is an ELIGIBILITY rule about transfer penalties, not an estate recovery exemption, and it is recorded here to keep the two apart.
- Washington State Health Care Authority, Estate recovery. The agency's public estate recovery page. It reprints all eight sections of chapter 182-527 WAC and then adds a Clarifying information block that is the source of several agency-level facts used here: that the Office of Financial Recovery administers estate recovery collections for the agency and for the Department of Social and Health Services; that recovery applies at age 55 for medicaid long-term care and at any age for state funded long-term care as of July 1, 1995; that a home transferred to a spouse or to a minor, blind or disabled child before death is not considered part of the individual's estate; that recovery is deferred while a surviving child under 21 or a blind or disabled child lives and until the death of a surviving spouse, after which recovery action will be taken against property in which the deceased individual had an interest at the time of death; that a hardship waiver request must be made in writing to the Office of Financial Recovery; that liens placed through the estate recovery process are valid for 20 years; and the Office of Financial Recovery toll free number 1-800-562-6114. The page is a reprint and diverges from the adopted rule in three places recorded in the notes of this file, so the codified rule governs. Page carries a revised date of April 23, 2026.
- Washington State Department of Social and Health Services, Office of Financial Recovery. The collecting office's own page. Used here for its contact details, 360-664-5700, toll free 1-800-562-6114, TTY WA 1-800-833-6388, mailing address PO Box 9501, Olympia, WA 98507-9501, and for its own description of the estate recovery function: the office recovers correctly paid long-term care services, medicaid assistance and related medical charges from the estates of decedents, and recovery may be made 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. The page also describes the mechanics, that on notice of a death the office investigates whether the estate has resources and whether a claim can be made within the parameters of the estate recovery statute, and that a lien is filed against the decedent's property and a notice to the creditor claim is filed against the estate in probate court.
- 42 U.S.C. 1396p, the federal Medicaid estate recovery baseline that RCW 43.20B.080(1) and RCW 74.39A.170(1) both incorporate by reference. Subsection (b)(1)(B) sets the age 55 rule and the covered service list. Subsection (b)(2)(A) is the surviving spouse and surviving child bar. Subsection (b)(2)(B)(i) and (ii) are the sibling and caregiver-child protections against enforcement of a lien on the home, the caregiver child requiring residence for at least two years immediately before admission and proof to the state's satisfaction that the care permitted the individual to reside at home rather than in an institution. Subsection (b)(3) is the undue hardship waiver. Subsection (b)(4)(A) is the mandatory probate-estate definition, and (b)(4)(B) is the OPTIONAL wider definition covering assets conveyed through joint tenancy, tenancy in common, survivorship, life estate, living trust or other arrangement, which Washington DID adopt.
Information current as of August 7, 2026
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