Medicaid Estate Recovery: What Families Need to Know

What is Medicaid Estate Recovery?

Under federal and New Jersey law, the Division of Medical Assistance and Health Services (DMAHS) is required to recover funds from the estates of some deceased Medicaid beneficiaries. 

For individuals aged 55 or older, states are required to seek recovery of payments from the individual’s estate for nursing facility services, home and community-based services, and related hospital and prescription drug services.

DMHAS usually seeks Medicaid Estate recovery immediately upon death if the deceased has no surviving spouse, no surviving child under the age of 21, and no surviving child who is blind or permanently and totally disabled. 

After your loved one has passed away, those involved in the handling of the estate must contact DMAHS in writing as soon as possible after the death It is the responsibility of a loved one to notify DMAHS to find out if DMAHS has a claim against the estate before any funds from the estate are spent. 

What is a claim against an estate?

A claim against an estate is a demand for payment from a state Medicaid agency or a creditor. The amount owed is all or some of the Medicaid payments spent on the deceased Medicaid beneficiary. 

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