What is the Estate Recovery Program?
Certain Medicaid benefits provided to recipients who are 55 years of age or older, or recipients of any age, who receive institutional services may have to be repaid. Repayment will only be required from a recipient’s estate or from a lien on the recipient’s home. Collection of this repayment will not occur until the recipient is no longer survived by a spouse or child who is disabled or under 21 years of age. Virginia Medicaid can be repaid for services by filing:
• A claim on an estate of a deceased recipient.
• Liens (legal claims) on the homes of nursing home recipients who are determined unable to return home.
• A transfer by affidavit form with the person or institution that has the assets of a recipient’s estate worth no more than $20,000.
Through the Estate Recovery Program the state seeks repayment for certain long term care services paid for by Medicaid on behalf of recipients. Recovery is made from the estates of recipients and from liens placed on their homes. The money recovered is returned to the Medicaid Program. It is used to provide care for others in need.
The Estate Recovery Program applies mainly to recipients of long term care services. Long term care services include nursing home services and Medicaid community-based waiver services. Virginia spends approximately 50% of its total Medicaid budget to provide these long term care services to less than 10% of all the state’s Medicaid recipients.
To recover some of that money to provide services for other Medicaid recipients, Congress and the State Legislature passed the Estate Recovery Program laws. Those laws are designed to recover from the assets of those who received benefits from the Medicaid program. Recovery is made when a recipient and the recipient's dependents no longer need those assets.
*Data from state, fiscal year 1999
