A team of legal aid attorneys from around the state have created a new resource to educate Ohioans about their rights if they are facing Medicaid Estate Recovery after the loss of a loved one.

Medicaid Estate Recovery is the process by which the State of Ohio seeks to get paid back for some or all of the cost of a deceased person's Medicaid benefits, usually by making a claim on any property - including their home - that the person owned at the time of their death.

The new resource helps Ohioans facing estate recovery assess if they are eligible for an exception, learn the process for filing for an exception, and find out how to get help.

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Here are the basics ...

If you get a notice from the State saying you have to pay back money for a loved one’s Medicaid benefits, or a letter from the Attorney General’s Office or a lawyer for the State (called “special counsel”) saying money is owed, or if there’s a Medicaid lien filed on a house, it means the State is making a claim. This is not a claim against you personally. It is a claim against your loved one’s estate (what they owned when they passed away) or property they had an interest in at the time of their death. You should talk to an attorney before answering any letter you receive.

If you can show the State or their lawyer that any of the following are true about the family of the  person who died, they should not try to collect the money right now: 

• Surviving Spouse Exemption: The person’s husband or wife is still alive. 
• Younger Child Exemption: The person has a child who is under 21 and still alive.
• Blind or Disabled Child Exemption: The person has a child of any age who is blind or permanently disabled (as decided by Social Security, like getting SSDI or SSI) and still alive.

If the only property that the person owned when they died was their home, there are 2 other options:

1. Caregiving Child Exception: A child of the person can show that they:

• Lived in the home for two years before their parent permanently moved to the institution such as a 
• nursing home or other facility, AND
• They kept living in the same home after their parent entered the facility, AND
• They provided care to their parent that delayed them needing to move to the facility, AND
• They have or can produce documents to prove all of these things.

2. Resident Sibling Exception: A brother or sister of the person shows that they:

• Lived in the home for at least one year immediately before their sibling moved to the institution AND
• They continued living in the home after their sibling moved to the institution.

Qualified State Long-Term Care Insurance Program Reduction: If your loved one had qualified long-term care insurance that paid for some of their long-term care, the state may collect less money.

Undue Hardship Exception: If none of the above exceptions apply, but paying this money would cause serious financial hardship for you and your family, you may qualify for a hardship waiver.

Examples of hardship include: 

• The estate (like a family farm) is your only source of income.
• Without money from the estate, you would be able to get public assistance.
• Paying the claim would leave you without basic needs like food, shelter, or clothing.
• You spent a significant amount of your own money to help care for your loved one who died. 
• You are 65 years old or older, or totally and permanently disabled, and you depend on the estate money to live.

Important Deadlines

• You only have 30 days from the date this notice was mailed to ask for an undue hardship waiver. 
• The Ohio Department of Medicaid has 60 days after receiving your request to tell you whether it has been approved (in full, in part, or for a limited time) or denied. 
• If you disagree with the decision, you have 30 days from when you receive it to appeal and ask the Medicaid director to review it.

Learn about the process of filing for a Medicaid Estate Recovery exception and access the forms you'll need, by downloading this new Know Your Rights: Medicaid Estate Recovery resource.