Whose estates Ohio recovers from
Under ORC 5162.21 and OAC 5160:1-2-07, the Ohio Attorney General seeks recovery for the Ohio Department of Medicaid from the estate of:
- a permanently institutionalized person of any age (for example, a nursing home resident not expected to return home), for all Medicaid benefits correctly paid, or
- a person who was 55 or older, for Medicaid benefits paid after age 55.
The amount includes managed care payments the state made to plans on your behalf, such as MyCare Ohio. It does not include Medicare Premium Assistance Program benefits paid since January 1, 2010.
When Ohio can't recover
- While your spouse is alive.
- While you have a surviving child under 21, or a child who is blind or permanently and totally disabled.
- From the home of a permanently institutionalized person while a sibling who lived there at least a year before admission, or a son or daughter who lived there at least two years and provided care that delayed the move, still lives there continuously.
Survivors can also request an undue hardship waiver. Losing an expected inheritance is not by itself a hardship.
How a house is handled
Ohio's definition of estate is broad: it includes probate property and property that passes outside probate, such as through joint ownership, survivorship deeds, life estates or living trusts. The person responsible for the estate must notify the Attorney General. If the family wants to keep a house instead of selling it, the Attorney General may set up a payment schedule, promissory note or lien.
Long-term care partnership policies can protect some assets from estate recovery. For your situation, talk with an elder law attorney. For Medicare questions, you can request a call from a licensed insurance agent.
Related questions
Does Ohio Medicaid pay for nursing home care?
Eligibility and the 60-month look-back.
What is a qualified income trust in Ohio?
Trust rules and what's left at death.
Can I have Ohio Medicaid and Medicare?
How dual eligibility works.
Sources
- Ohio Administrative Code — Rule 5160:1-2-07, Medicaid: estate recovery
- Ohio Revised Code — Section 5162.21, Medicaid estate recovery program
- Ohio Administrative Code — Rule 5160:1-3-05.13, treatment of the home
- Social Security Act — Section 1917, liens, adjustments and recoveries
More questions in this guide
- Can I have Ohio Medicaid and Medicare at the same time?
- Does Ohio Medicaid pay for nursing home care?
- Is MyCare Ohio available in my county?
- What is the difference between Medicare and Medicaid in Ohio?
- What is a dual eligible special needs plan in Ohio?
- What is a qualified income trust (Miller trust) in Ohio?
- What is MyCare Ohio?
- What is Next Generation MyCare Ohio?
- What is the PASSPORT waiver in Ohio?
Part of the guide: Ohio Medicaid and Medicare together · All questions
Frequently asked questions
Will Ohio Medicaid take my house while I'm alive?
Not for eligibility while it is your home. Ohio doesn't count your home while you live in it or intend to return, or while your spouse or a dependent relative lives there (OAC 5160:1-3-05.13). Estate recovery happens after death.
Does estate recovery apply to Medicare Savings Program benefits?
No. Ohio's rule excludes Medicare Premium Assistance Program benefits (QMB, SLMB, QI) paid on or after January 1, 2010.
Can my family ask Ohio to waive estate recovery?
Yes. The Ohio Department of Medicaid may grant an undue hardship waiver case by case, for example when the estate is a survivor's only income-producing asset, like a family farm, or recovery would leave a survivor without food, shelter or clothing.
Does it include assets outside probate?
Yes. Ohio defines the estate to include property passed by joint tenancy, survivorship, life estate or a living trust, not just probate assets.
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