West Virginia Medicaid Estate Recovery

Recovery is generally blocked or delayed for: Surviving spouse: no recovery and no lien while the member's spouse is living; recovery is deferred until after the spouse's death; Child under age 21: no recovery while the member has a surviving child under age 21; Blind or permanently and totally disabled child: no recovery while a child of any age who meets the Social Security Act definition of blindness or permanent and total disability survives, and the home is protected from a lien while such a child lawfully resides there; Sibling with an equity interest: no lien on the home while a sibling who has an equity interest in the home and resided there for at least one year immediately before the member entered the medical institution continues to lawfully reside there; Caregiver adult child: no lien or recovery when an adult child resided continuously in the home for at least two years before the parent became a Medicaid member and continued to live there until the parent's death, and can establish that the care provided allowed the parent to remain at home without Medicaid for at least that two-year period (BMS Chapter 900, Section 900.6(a)); Family business: no recovery where an heir who maintained continuous employment in a family business for at least one year before the member's eligibility, or an adult child who did so for at least three years, and the property is an integral part of and required for the continued viability of that business (BMS Chapter 900, Section 900.6(b) and (c)); Dollar-for-dollar support reduction: documented monetary support that an adult child, an adult grandchild whose parents are both deceased, or a sibling provided for the member's medical care and other necessities reduces the recovery claim on a dollar-for-dollar basis (BMS Chapter 900, Section 900.6(d), (e), and (f)); Undue hardship waiver: an heir may apply by showing recovery would jeopardize the survival of the family unit or severely disrupt the family's income or business; a waiver is not granted where the hardship was created by the member's use of estate-planning methods to avoid recovery, and a will bequeathing specific property to heirs is not by itself evidence of hardship. Apply to BMS within 45 days of the lien placement or filing of the proof of claim; BMS decides within 90 days (BMS Chapter 900, Section 900.6).

The West Virginia Bureau for Medical Services (BMS), through the WV Recovery Unit, recovers Medicaid payments made for nursing facility services, home and community-based services (Section 1915(c) waivers), and related hospital and prescription drug services provided to a member who was age 55 or older when the services were received, or who was determined to be permanently institutionalized. Recovery is collected only after the member's death by filing a claim or lien against the member's estate as it passes to heirs under state probate law, whether by will or by intestacy. The order in which estate debts are paid under state law may reduce the amount recovered. No recovery is made from an estate valued at $5,000 or less at the time the estate is admitted to probate.

Yes. West Virginia offers an undue-hardship waiver. Contact West Virginia Department of Human Services (DoHS), Bureau for Medical Services (BMS), WV Recovery Unit to request the waiver and ask about deadlines.

West Virginia Department of Human Services (DoHS), Bureau for Medical Services (BMS), WV Recovery Unit, https://bms.wv.gov.