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Estate recovery applies to MA members who:
If either of these situations occur, a local agency must claim against an estate after the MA member dies to recover what MA paid for LTSS. In addition, if the MA member was permanently institutionalized, the claim must attempt to recover the costs of all MA services (not just LTSS) that the MA member received during the period of institutionalization.
No. MinnesotaCare is not the same program as MA and estate recovery does not apply to MinnesotaCare.
For the purpose of MA estate recovery, LTSS are the following:
If an MA member receives any of these LTSS at 55 years old or older, the cost of these LTSS can be recovered from the member’s estate after he or she dies.
If an MA member permanently resided in a medical institution at any age, the cost of all MA services received during the period of institutionalization, not just the cost of LTSS, can be recovered from the member’s estate after he or she dies.
Generally, estate recovery happens after an MA member dies. But, local agencies delay recovery if the deceased MA member is survived by a spouse or has a child who is under 21 years old, blind or permanently disabled.
Once a deceased MA member’s surviving spouse dies, local agencies are required to recover MA costs from the spouse’s estate. But recovery can be further delayed if a child who is under 21 years old, blind or permanently disabled is still living in the home when the surviving spouse dies.
Generally, local agencies make an MA estate claim when the property of a deceased person is being distributed after death. Sometimes this happens in a court setting, but sometimes it does not.
Federal and state law require local agencies to try to recover from the estate of a surviving spouse.
This requirement comes out of a protection for the surviving spouse of a deceased MA member. When an MA member dies, local agencies cannot collect on an estate claim if a spouse survives the deceased MA member. If the surviving spouse receives assets from the deceased MA member’s estate, the surviving spouse can use the assets without having to repay MA for the deceased member’s health insurance costs while the surviving spouse is still alive.
Once the surviving spouse dies, though, a local agency can claim against the surviving spouse’s estate for repayment to the MA program.
No. An MA member’s children do not have to use their own assets to reimburse the state for any MA services the member received.
Local agencies that recover on an MA estate claim do so with priority over distributions to heirs. This means that MA should be repaid before heirs receive assets from the estate. Repayment of MA costs ensures that future MA members have funding to receive health care services.
Liens for MA repayment apply to two main populations of MA members.
First, liens may apply to members who permanently reside in a medical institution. For this situation, DHS may file a lien called an “MA lien.”
Second, liens apply to MA members who receive LTSS at 55 years old or older. For this situation, DHS files a lien called a “notice of potential claim” (NPC).
DHS files two types of liens to secure repayment of MA: MA liens and notices of potential claim (NPCs). MA liens and NPCs have different impacts on MA members and their estates.
An MA lien is enforceable for 10 years from the date of its filing. DHS may renew the lien for another 10 years.
No. MinnesotaCare is not the same program as MA and liens do not apply to MinnesotaCare.
Population | Affected by the law change? | Can the costs of MA services be recovered? | Services for which costs can be recovered by estate
claim or lien after January 1, 2014 |
Medical Assistance (MA) member under 55 years old, not permanently residing in a medial institution | No | No | None |
MA member permanently residing in a medical institution at any age | No | Yes, if DHS has filed an MA lien | All MA services |
MA member 55 years old or older | Yes | Sometimes |
|
MA member 55 or older receiving waiver HCBS | Yes | Yes |
|
People enrolled in both Medicare and MA (including waiver HCBS) | Yes | Yes |
|
People enrolled MA only for help with Medicare costs | No | No | None |
MinnesotaCare | No | No | None |
People enrolled in MinnesotaCare as a basic health program (BHP) | No | No | None |
People who received subsidies for private insurance purchased on MNsure (advanced premium tax credits) | No | No | None |