Which Kentucky services can lead to recovery
The rule defines an aged institutionalized individual as a recipient age 55 or older who received Medicaid-paid nursing-facility, ICF/IID, HCB-waiver, Supports for Community Living, ABI, ABI long-term-care, or Michelle P. services. It also covers a permanently institutionalized person, defined as residing in a nursing facility or ICF/IID for six months or more (907 KAR 1:585 estate-recovery rule).
Recoverable expenditures include the listed long-term-care services as well as related prescriptions, hospital and physician services, Medicare cost sharing and premiums, and managed-care capitation payments. CHFS's Third-Party Liability Branch summarizes the same core rule: after a person who received nursing-home or waiver services dies, Medicaid asks the estate to repay amounts it paid, up to the amount paid (907 KAR 1:585 estate-recovery rule; CHFS Third-Party Liability Branch).
Recovery is deferred in specified survivor situations
Kentucky's regulation bars recovery while there is a surviving spouse. It also bars recovery while there is a surviving child who is under 21 or blind or disabled under the referenced federal definition; the estate rule uses those survivor definitions in setting the recovery limits (907 KAR 1:585 estate-recovery rule).
For purposes of administration, the rule says recovery is not cost effective if the date-of-death estate subject to recovery is no more than $10,000 or less than the administrative cost of recovery. This is not an asset-protection rule for lifetime eligibility and should not be treated as a guaranteed exemption from a particular claim (907 KAR 1:585 estate-recovery rule).
There is an undue-hardship procedure
The department must waive recovery to the extent it would work an undue hardship. The regulation gives the example of an asset subject to recovery that is the sole income-producing family farm or business conveyed to a surviving recipient family member, while excluding residential rental property from that example (907 KAR 1:585 estate-recovery rule).
An estate representative must make a written hardship request within 30 days of the recovery notice and provide verification. The department must issue a decision within 30 days after receiving the request and supporting documentation; the cited regulation should be checked for the current notice and appeal procedures (907 KAR 1:585 estate-recovery rule).
Expanded estate scope: Kentucky recovery can reach probate property and qualifying interests passing by joint tenancy, life estate, living trust, or another arrangement. Do not assume nonprobate title alone defeats recovery (
907 KAR 1:585 estate-recovery rule).
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