Estate Recovery

Estate Recovery OAC 5160:1-2-07

What is Estate Recovery?

Seeks repayment for Medicaid costs for:

» Individuals 55 and over who received Medicaid services

» Permanently institutionalized individuals regardless of age

Who is considered permanently institutionalized?

»An individual who is an inpatient in an institution

»An individual who cannot reasonably be expected to be discharged from the institution and return home as determined by the Department of Medicaid

When does Estate Recovery take place?

After the individual’s death, estate recovery starts when:

» The surviving spouse passes away

» There is no surviving child under 21

» There is no surviving blind or disabled child of any age

Who handles Estate Recovery?

Estate recovery is administered by the Ohio Attorney General’s office

Click HERE for additional information

See the chart below to determine who is subject to Estate Recovery based on the type of Medicaid received

 


Approved Base Medicaid Category + LTC Type

Estate Recovery

SSI + Facility

YES

SSI + Waiver

55 and over

MAGI + Facility

55 and over

MAGI (SIR Budgeting) + Facility

55 and over

MAGI + Waiver

55 and over

MAGI (SIR Budgeting) + Waiver

55 and over

MBIWD + Facility

YES

MBIWD + Waiver

55 and over

ABD + Facility

YES

ABD (SIR Budgeting) + Facility

YES

ABD + Waiver

55 and over

ABD (SIR Budgeting) + Waiver

55 and over

SIL/Facility

YES

SIL/Waiver

55 and over

Base Medicaid Only

Estate Recovery

SSI Medicaid

55 and over

ABD Medicaid

55 and over

MBIWD Medicaid

55 and over

SRS Medicaid

55 and over

MAGI Medicaid

55 and over

AEMA Medicaid

55 and over

RSS Medicaid

55 and over

 

 

MAGI=Modified Adjusted Gross Income
SIR=Spousal Impoverishment Rules
MBIWD=Medicaid Buy-In for Workers with Disabilities
ABD=Aged, Blind, Disabled
SIL=Special Income Level
SRS=Specialized Recovery Services
AEMA=Alien Emergency Medical Assistance
RSS=Residential State Supplement