Estate Recovery OAC 5160:1-2-07
What is Estate Recovery?
Seeks repayment for Medicaid costs for:
» Individuals 55 and over who received Medicaid services
» Permanently institutionalized individuals regardless of age
Who is considered permanently institutionalized?
»An individual who is an inpatient in an institution
»An individual who cannot reasonably be expected to be discharged from the institution and return home as determined by the Department of Medicaid
When does Estate Recovery take place?
After the individual’s death, estate recovery starts when:
» The surviving spouse passes away
» There is no surviving child under 21
» There is no surviving blind or disabled child of any age
Who handles Estate Recovery?
Estate recovery is administered by the Ohio Attorney General’s office
Click HERE for additional information
See the chart below to determine who is subject to Estate Recovery based on the type of Medicaid received
|
Approved Base Medicaid Category + LTC Type
|
Estate Recovery
|
|
SSI + Facility
|
YES
|
|
SSI + Waiver
|
55 and over
|
|
MAGI + Facility
|
55 and over
|
|
MAGI (SIR Budgeting) + Facility
|
55 and over
|
|
MAGI + Waiver
|
55 and over
|
|
MAGI (SIR Budgeting) + Waiver
|
55 and over
|
|
MBIWD + Facility
|
YES
|
|
MBIWD + Waiver
|
55 and over
|
|
ABD + Facility
|
YES
|
|
ABD (SIR Budgeting) + Facility
|
YES
|
|
ABD + Waiver
|
55 and over
|
|
ABD (SIR Budgeting) + Waiver
|
55 and over
|
|
SIL/Facility
|
YES
|
|
SIL/Waiver
|
55 and over
|
|
Base Medicaid Only
|
Estate Recovery
|
|
SSI Medicaid
|
55 and over
|
|
ABD Medicaid
|
55 and over
|
|
MBIWD Medicaid
|
55 and over
|
|
SRS Medicaid
|
55 and over
|
|
MAGI Medicaid
|
55 and over
|
|
AEMA Medicaid
|
55 and over
|
|
RSS Medicaid
|
55 and over
|
MAGI=Modified Adjusted Gross Income
SIR=Spousal Impoverishment Rules
MBIWD=Medicaid Buy-In for Workers with Disabilities
ABD=Aged, Blind, Disabled
SIL=Special Income Level
SRS=Specialized Recovery Services
AEMA=Alien Emergency Medical Assistance
RSS=Residential State Supplement