Since the 1990s, federal law has required states to recover, under certain circumstances, the costs of Medicaid benefits after a Medicaid recipient passes away. Ohio’s Medicaid Estate Recovery program is managed by the Ohio Department of Medicaid (“ODM”) through the Ohio Attorney General.
NOTICE: The information contained on this website is provided solely for educational purposes. It does not constitute legal advice, and it should not be relied upon as such. Individuals are advised to consult with a qualified attorney for advice and guidance that may be specific to his or her circumstances regarding Medicaid-estate-recovery matters.
The recoverable benefits include (1) managed-care premiums, (2) fees for services that were received in a facility (like a nursing home), and/or (3) fees for services that were received in the community. ODM must have paid those benefits when the recipient was 55—or older—or, if the recipient is permanently institutionalized, at any age. See Ohio Administrative Code 5160:1-2-07(C).
There are times when ODM may delay or waive estate recovery. For example, ODM might delay recovery because the recipient’s spouse, child under 21, and/or blind or permanently disabled child are still alive. See Ohio Administrative Code 5160:1-2-07(D). ODM might also waive recovery when recovery would cause an undue hardship on the recipient’s survivors. See Ohio Adm.Code 5160:1-2-07(H). Because hardship requests are fact-specific, ODM considers them on a case-by-case basis.
Estate fiduciaries are required to notify the Ohio Attorney General when a Medicaid recipient passes away. See Ohio Administrative Code 5160:1-2-07(E). An “estate fiduciary” is the person responsible for managing a deceased person’s property. See R.C. 2109.01. The following
form, which is available through the Supreme Court of Ohio’s website, may be used to provide the requisite notice.
Please note that because this area of the law is complicated, it is recommended that relatives of a Medicaid recipients talk with an attorney when questions arise.
Some commonly needed forms are below. Both should be submitted to your local County Department of Job and Family Services Office:
Helpful links: