On May 3, 2006, the State of Georgia implemented “estate recovery” for certain individuals who were receiving Medicaid benefits for nursing home or community based services at the time of their death. This program enables the State of Georgia Medicaid program, through the Department of Community Health, to attempt to recover the costs incurred on behalf of a Medicaid member by making a claim against his or her estate. The claim amount will be equal to the amount that the Department of Community Health expended on behalf of the Medicaid recipient while living. By now, I think most people who work with or around Medicaid programs have an understanding of the basic concept of Estate Recovery. If you would like a more technical, detailed explanation of Medicaid Estate Recovery please see my blog post on May 14, 2012 titled “What is Medicaid Estate Recovery”.
The following are five things that you should know (and most people don’t) about Medicaid Estate Recovery in Georgia:
1. Estate Recovery only applies to Medicaid members who are in a nursing home and persons aged fifty-five or older who were receiving Medicaid benefits for community based services at the time of their death.
2. The Department of Community Health may only pursue costs associated with medical assistance and/or services that the Medicaid member received on or after May 3, 2006. Any cost or expenses incurred prior to May 3, 2006 cannot be recovered through Estate Recovery.
3. The Department of Community Health will not pursue Estate Recovery if the Estate of the deceased Medicaid member is valued at less than $25,000.
4. If the deceased Medicaid member is survived by a spouse the Department of Community Health will not pursue Estate Recovery against the Estate so long as the surviving spouse is alive.
5. The Department of Community Health may delay or waive recovery from an estate if doing so would cause an “undue hardship”. Any heir of the estate can request that DCH waive or delay recovery based on undue hardship.
Legal Disclaimer: This information has been provided for informational purposes only. It does not constitute legal advice. Proper legal advice can only be given based upon the specific facts and relevant law for each individual. Therefore, you should always seek appropriate counsel before acting upon the information contained herein.
