Estate recovery is limited to recipients age 55 and over who receive certain Medicaid services or to recipients who are permanently institutionalized.

Recovery will not be claimed if the recipient is survived by a legal spouse, child(ren) under age 21 or blind or disabled child(ren) of any age who became blind or disabled before age 21 and still live on the property of the individual.

For permanently institutionalized individuals recovery shall be claimed for all Medicaid payments, including cost sharing charges for Medicare services and Medicare premiums, made on behalf of individuals for the period of time the individual received care in a medical institution, including the period of time prior to the date the recipient is determined permanently

For individuals age 55 and over recovery shall be claimed for Medicaid payments for the following services and benefits:

• Nursing facility level of care;

• Home and community based alternatives services;

• Related hospital care received while in long term care;

• Prescription drugs received while in long term care; and

• Medicare premiums paid while in long term care.

WAIVER OF RECOVERY