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Medical Assistance (Medicaid) Estate Recovery Program

Medical Assistance (Medicaid) Estate Recovery Program

Questions about the Medical Assistance ("Medicaid") Estate Recovery Program? Watch our helpful video to get the answers you need!

This program requires the Department of Public Welfare (DPW) to recover the Medical Assistance costs from the estates of individuals 55 years of age or older who received certain Medical Assistance (“Medicaid”) benefits.   If you or someone you know, age 55 years or older, received Medical Assistance benefits for services received in a nursing home, for home and community based services (also referred to commonly as the “waiver program”), for any related hospital care and prescription drug services provided while receiving nursing home care or waiver services, then the Medical Assistance Estate Recovery Program will seek to reimburse itself for what it paid out for this individual.  When the person who received the Medicaid benefits dies, the Department will reimburse the Medical Assistance program by recovering these costs from the assets of the deceased person’s probated estate

It is important to note that there are exceptions to the right to recover.  One common question is whether the spouse will lose the home once the individual getting Medicaid benefits dies.  In that situation, if the deed to the property subject to recovery says “tenancy by the entireties” or “joint tenancy with right of survivorship”, then the spouse will get the home free and clear of Medical Assistance claims when the individual receiving Medicaid benefits dies.  There are also situations where the DPW has to postpone collection of its recovery claim.   One common misconception is that the state of PA will force the individual receiving Medicaid funded nursing home or waiver services to hand over their home to the state or force this individual to sign over the deed to their home to the State as a condition of receiving Medicaid benefits—this is not true.  You may own a home while you are living in the nursing home or receiving waiver services.   Individuals who are now receiving or plan to receive Medicaid benefits for nursing home services or waiver services should not transfer the deed to their property and should talk to an attorney before taking any such action.

What we can do: 

CLS will provide legal advice about the Estate Recovery program in order to assist individuals in making informed decisions about their health care and services. In order for CLS to provide legal advice, the individual receiving the Medicaid benefits must directly contact the CLS advocate. 

If the individual receiving services has passed away, CLS will advise and potentially represent family members dealing with the Estate Recovery process.  CLS will potentially represent clients who have a legal claim to postpone collection of recovery or those who qualify for a hardship waiver.

How to get help:

Walk-in Intake

Community Legal Services
North Philadelphia Law Center

1410 West Erie Avenue
Philadelphia, PA 19140
Monday, Wednesday, Friday
9:00 am -12:00 pm

Phone Intake

For Homebound Clients ONLY
(215) 227-2400