Detailed Answer
Under Iowa law, the Department of Human Services (DHS) can seek recovery of Medicaid benefits paid on behalf of a recipient from their estate, including real property passed to heirs. This process follows federal requirements (42 U.S.C. § 1396p(b)) and state rules (Iowa Code § 249A.25; Iowa Admin. Code r. 441—93).
Step 1: Confirm Medicaid Coverage and Qualifying Services
Only benefits for long-term care and related services provided after the recipient turned 55 qualify for estate recovery. Review the recipient’s Medicaid award letters and payment history to identify covered services.
Step 2: Identify Estate Assets
The “estate” includes all real and personal property in the decedent’s name at death. Inherited real estate—such as a family home—falls within this definition. Exemptions may apply (for example, a surviving spouse’s primary residence in certain circumstances).
Step 3: Notice of Claim
Within 60 days after qualifying for probate, DHS must mail a written claim to the personal representative or heirs. The notice typically outlines the amount owed and the deadline to object.
Step 4: File Creditor’s Claim in Probate
DHS must formally file its claim as a creditor under Iowa Code § 633.160 (Probate Claims). The claim attaches to probate assets, including real property held in the decedent’s estate.
Step 5: Objections and Court Hearing
Heirs or the personal representative may object. The probate court schedules a hearing to determine the validity and amount of DHS’s claim. The court may reduce the claim if it finds errors or exemptions apply.
Step 6: Lien or Sale of Property
If the claim is approved, DHS can record a lien against real estate or request sale of property to satisfy the debt. Iowa Admin. Code r. 441—93.8 outlines lien procedures and priorities.
Step 7: Hardship and Exemption Waivers
DHS may waive recovery if it causes undue hardship to a surviving spouse, minor child, or disabled child. Heirs must submit a written waiver request with supporting financial information early in probate.
Disclaimer: This information is for educational purposes and does not constitute legal advice. You should consult an attorney for guidance tailored to your situation.
Helpful Hints
- Gather all Medicaid benefit statements and payment summaries before probate begins.
- Track deadlines closely: probate claims often have strict filing windows.
- Consult a probate attorney experienced with Medicaid estate recovery.
- Explore exemption rules for surviving spouses and dependents.
- Maintain a detailed inventory of estate assets to assess potential liens.