Who can be subject to a claim
The Office of the Medicaid Inspector General states that recovery can apply to people who received Medicaid at age 55 or older or who were permanently institutionalized (OMIG Estate Recovery).
Recovery is deferred while a surviving spouse, a child under 21, or a blind or disabled child of any age remains alive (OMIG estate recovery memo; New York Social Services Law §369).
Probate-only recovery does not eliminate the possibility of a TEFRA lien during life, which is governed by a separate federal-state process (OMIG TEFRA liens).
Key timing rule: A hardship waiver must be requested within 30 days after the notice of intent to recover. The state does not treat inability to maintain a prior lifestyle alone as hardship (
NYS DOH ADM-8 attachment;
OMIG hardship materials).
TEFRA liens are a separate home issue
OMIG may place a TEFRA lien on a home when a Medicaid recipient has been in a medical institution for six or more consecutive months and is not reasonably expected to return home (OMIG TEFRA liens).
A TEFRA lien cannot be placed when a spouse or a child under 21 or disabled child lives in the home, and it dissolves if the recipient is discharged and returns home (OMIG TEFRA liens).
Probate avoidance is not a complete Medicaid answer
Probate-only recovery is important, but it does not resolve eligibility, transfer penalties, liens, tax basis, or family-control questions. Review The Home pillar and compare Florida's probate-focused discussion on the Florida Medicaid estate recovery page.
Estate recovery planning should be coordinated with an attorney who can evaluate the title, beneficiary designations, timing, and potential Medicaid claim.
Not mutually exclusive. Most families combine two or three funding pillars — this one rarely stands alone.
The
Journey Assessment ranks all ten pillars against your specific situation and
recommends the top three.
