Working Caregiver- Medicaid Recovery Estate Program

Medicaid Recovery Estate Program

3564  Claim Filing Process

Medicaid Estate Recovery Program claims are filed in Probate Courts within 70 days after the state receives notice of the death of a Medicaid recipient, age 55 and older, and who after March 1, 2005, applied for and received certain Medicaid long-term care services as previously described. A Medicaid Estate Recovery Program Notice of Intent to File a Claim Form will be sent to the estate representative of a Medicaid recipient within 30 days of notification of the death of a Medicaid recipient. The notice will include a program overview, a questionnaire regarding allowable exemptions and deductions, an undue hardship waiver request form and the date and source from which the state received notice of the Medicaid recipient's death.

Following receipt of a Medicaid Estate Recovery Program Notice of Intent to File a Claim Form, an estate representative has up to 40 days to submit an undue hardship waiver request. Determination of an undue hardship waiver will be evaluated on a case-by-case basis and will be completed within 40 days of receipt of the request and supporting documentation. Should an undue hardship waiver be denied, the estate representative may submit an appeal by writing to the Medicaid Estate Recovery Program. An appeal of denial must be submitted within 40 days following receipt of the denial.

If no exemptions apply, a claim will be filed against the estate of a deceased Medicaid recipient in Probate Court for the cost of covered Medicaid services received after the effective date of the program. Medicaid Estate Recovery Program claims may be filed in accordance with the requirements contained in sections 298 and 301 of the Texas Probate Code. Section 322 of the Texas Probate Code contains the classification and priority of claims from a decedent's estate. The acceptance of certain Medicaid long-term care services provides a basis for a Class 7 claim after:

Read more