Medicaid Estate Recovery Program

After a person dies, the Medicaid Program may collect payment from the person’s estate for the costs of care Medicaid covered. See Iowa Code section 249A.53.  A person’s estate includes any property, bank accounts, excess funds in a burial trust, or other assets in which the individual had any legal title or interest. This includes jointly held property, life estates, and any interest in trusts. This applies to the costs of care a Medicaid member has over the age of 55 and also applies to the costs of any other person, no matter their age, who lives in a long-term care setting and is not likely to return home. It does not apply if the person receiving Medicaid was under 55 and did not live in a long-term care setting. There is also not a recovery process if the person was enrolled in the Medicare Savings Program. There is no collection of costs if the estate does not have assets and no money is collected until certain other expenses have been paid out of the estate.

The State will not collect payment from the estate until the spouse or adult child dies if a spouse or adult disabled child is living after the death of the person who received Medicaid. If collection of the costs causes what is called an “undue hardship” on certain people who survive the person who received Medicaid, there will also not be collection. Any costs collected will be collected only from the person’s estate, not directly from family members, unless family members have taken money from the estate that would have been available to pay back the Medicaid program.

For more information, see the Iowa Department of Health and Human Services page on Iowa's Estate Recovery Law.