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My Mother has died now Medicaid wants her entire estate. Of the 20 years on Medicaid she was only in convelescent care for 3 months when she broke her foot.

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Sorry for your loss Tom

In Ohio, a lien is placed on the home from day 1 of Medicaid acceptance,as mentioned, On death, the Attorney General must be notified.

Ironically, to see how important in Ohio,it is to recover Medicaid costs, the state will probably be paying out a lot of money of 3 men who are accused of a crime are found innocent. They were in prison 20 years. If this happens, they could get wrongful imprisonment compensation that could be a lot. Ohio could be paying out a lot of money to these men, and would depend on Medicaid recourse to refill their coffers.
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Tom, first my heartfelt sympathy to you and your family.

One usually forgets that Medicaid is paid by the taxpayers and Federal funds to help those who cannot afford medical care such as doctor appointments, medical tests, rehab care, nursing home care, etc. Thus, the State needs to take from the Estate what they can for reimbursement. Otherwise the States would go bankrupt and/or our taxes would go sky high to help fund Medicaid. I am glad that we have Medicaid as it makes my own aging not so frightful as time passes and if I should need to apply for this service.
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Tom - I'm assuming that you have gotten a NOI (notice of intent) from either state or the states outside contractor that since mom was on Medicaid the state wants to be repaid for all services Medicaid paid for her. The letter will not be warm & fuzzy but more "we're sorry for your loss and heres what is owed". The correspondence will be addressed to you or whomever was on file as mom's contact person for Medicaid. There should be a $ amount and perhaps a multipage questionnaire & a specific date (30 - 90 out) as to when it must be returned. It is a form letter that was generated once mom's death was recorded by state and then her Medicaid tally dovetails to produce the letter, questionnaire, etc. It will be followed up with other letters and a multitude of phone calls very much from the playbook of what a debt collection agency will do. If your state uses an outside contractor (HMS & PCG are the 2 big ones), they will very much press the recovery; keep in mind that they get a % of the recovery $ plus fees and that whatever they tell you is from that vantage point….comprende? So is this the situation??

If so, what you are & will be dealing with is MERP - Medicaid Estate Recovery (or Recoup) Program (or Policy). Just how it will run & your ability / likelihood to have the house go as per the terms of your mom's will is very much interdependent on your states property & probate laws & administrative code AND your ability to be very detail document driven. AND imho - to open probate & be a determined & organized executor. About the interdependence on states laws, for example some states place the $ amount as a lien on the property from day 1 of Medicaid while other states it is an after death claim against the estate. Some states probate are Level of Claim by Class for priority while others are all claims are equal.

Some states Administrative Code allows for a deduction for:
- all normal expenses of the vacant property (taxes, insurance, repairs, yard upkeep). If MERP does not allow for this or has issues with the expenses, you can submit all as a debt or claim against the estate in probate.
- all caregiving paid for by family which kept their elder at home and off Medicaid. The "at home" can be at the actual home but also for paying for IL or AL. Again you need documentation (in detail) provided to MERP.
- all sorts of other exclusions and exemptions exist….like caregiver, disabled heir, low income heir, family biz at the property, etc.
You have to go through code & MERP/Medicaid website for info, It's not simple.

What is your probability of success??….well to me its going to depend on all sorts of factors: tax assessor value & actual value of house, documented & valid expenses you or family paid on the vacant property & mom's care, valid will & who the heirs are, exemptions, & your tenacity & wallet. It can be done, but not simple.

But before this gets too deep, I'd first suggest you look carefully into when mom went onto medicaid & IF all the services she got on Medicaid flowed from her eligibility determined from her original application 20 years ago. VERY IMPORTANT!

Here's why: Medicaid has had some sort of recovery ability since the 1990's Omnibus Bills passed BUT how states did this varied. Most applications did NOT have an "acknowledgement of participation" statement that informs the applicant that by applying for Medicaid you allow for MERP to be done. Recovery rates were low across the US with many states at zero as legally no way to enforce as no binding statement in the applications. Then in 2005 Bush signed in DRA (deficit reduction act) which required uniformity for Medicaid including recovery. Each state then signed DRA into their administrative code. It is only for applications for eligibility for programs done after DRA that now can be totally clearly subject to recovery as now there is an "acknowledgement of participation (for recovery)" within the application. You need to find out just what the dates were for any & all Medicaid applications done on your late mom. It could well be that all Medicaid services done before she enter a convalescent home were done on her old 1990's eligibility and only the last 3 months of Medicaid were on a new application for LTC Medicaid. If so, recovery can be only for those 3 months. If this sounds like a good possibility, post the details as some on this site will have specific ideas of how to deal with it.
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The state probably has a lien on the home already.
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As to why this should be true, well, I don't think it should be. I don't think that medical help for the elderly should be considered "welfare." But that is a social and political decision. As it stands, that is the way it is. Your mother received "welfare" for 20 years even though she owned a house. Now it is pay back time.

Fair? Suitable? The way it should be? Lots could be argued either way. But that is the way things are now.
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Why should you have to? Because that was the legal agreement Mother was involved in. I'm not sure how much you were aware of the conditions of receiving Medicaid, but state recovery from the estate is part of the deal. For most people, the house is the only asset that is left in the estate, and that must be sold and the state is entitled to be reimbursed for their costs.

This is instead of insisting that people sell the house before they can be considered eligible. They can keep the house and one car, but only until they die. It is not available for them to pass on to others.
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What amount are they saying and what service was if for?
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