West Virginia Medicaid Estate Recovery

Recovery is delayed or barred in defined family situations

The statute says recovery after death occurs only after the death of a surviving spouse and after there is no surviving child under 21 or child meeting the referenced blindness or disability definition. The BMS manual also describes protections involving a sibling with an equity interest who meets the residence rule and an adult child who provided qualifying care in the home (West Virginia Code §9-5-11c; BMS Chapter 900 Estate Recovery).

For a person determined permanently institutionalized, the state manual describes a separate recovery-property-lien process. It says the lien dissolves within 30 days if the individual is discharged and returns home, which reinforces the difference between an institutionalization determination, a lifetime lien, and an estate claim after death (BMS Chapter 900 revised policy).

There is an undue-hardship process

Chapter 900 lists circumstances in which no lien or recovery is made, including qualifying adult-child caregiving, defined family-business situations, and certain documented support. It also allows beneficiaries to seek a hardship waiver by presenting evidence that recovery would jeopardize the family unit or severely disrupt family income or business, subject to the rule’s limits (BMS Chapter 900 hardship provisions).

The manual says a recipient, administrator, executor, beneficiary, or heir may request administrative review in writing within 30 days after receiving notice of an adverse administrative action. That deadline is procedural, not a substitute for promptly opening and reviewing every recovery notice with counsel (BMS Chapter 900 administrative-review procedure).