If the state pays medical for people on Medicaid does it have to be paid back when they pass on?

If a person gets Medicaid, they don't have money. If there is a house being sold, they will recover once the house is sold. Medicare has nothing to do with Medicaid unless Medicaid is for health insurance.

In some places they examine the estate to see what value there is and if it's not that much, say under $5000., they will forego recovery efforts. They should notify family members or those in charge of estate of this information and their intentions, but, I think they are supposed to be notified of the recipients death as well.

It may depend on the state, but usually I think they will ask for any assets-- house, etc.

Some states do have Medicaid recovery programs if there money or other assets in the estate. Some states also have filial responsibility laws, although they are rarely used.