Can You Avoid Medicaid Estate Recovery in Georgia?

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Through the Medicaid Estate Recovery Program (sometimes called MERP or MER), the State of Georgia may seek reimbursement from a deceased Medicaid beneficiary’s estate for long-term care costs paid to the beneficiary. In many cases, estate recovery means that surviving family members may have to sell the beneficiary’s home to pay the amount due. However, through advance planning with help from a Medicaid planning attorney, an elder may be able to avoid the forced sale of the family home through the MERP process.

How Does Georgia Medicaid Estate Recovery Work?

Federal Medicaid laws and regulations require the State of Georgia to have an Estate Recovery Program, as part of the State’s responsibility for administering the Medicaid program. The program requires the State to seek reimbursement from a deceased Medicaid beneficiary’s estate for all long-term costs paid to the beneficiary, including benefits paid for nursing home facilities, home and community-based health services, hospital and prescription drug costs, and personal care.

In Georgia, the State can pursue the deceased beneficiary’s entire estate, including their home. In many cases, Estate Recovery results in forcing sale of the family home, since it often is the only substantial asset remaining in the estate. The recovery program causes confusion, especially because a beneficiary’s home is not countable as an asset for purposes of determining Medicaid eligibility (up to an established limit). That means a beneficiary often may own a home and still qualify for Medicaid, but then have the home be vulnerable to Estate Recovery after the beneficiary’s death.

Advanced planning with assistance from a Medicaid planning professional may enable an elder to avoid Medicaid Estate Recovery. The laws and regulations are extremely complex. An individual should never attempt to circumvent the Medicaid Estate Recovery requirements on their own. Taking action without advice from a knowledgeable Medicaid planner can have disastrous consequences for the elder and their family.

Estate Recovery Limitations and Exemptions

The Georgia Estate Recovery Program applies to estates of deceased Medicaid beneficiaries who were in a nursing home at the time of death and beneficiaries aged 55 and older who were receiving Medicaid community-based benefits at the time of death. However, benefits received prior to May 3, 2006 cannot be recovered. An estate valued at $25,000 or less is exempt from estate recovery in Georgia. In addition, the State may waive reimbursement from the first $25,000 of an estate, regardless of the value of the estate.

If the deceased beneficiary is survived by a spouse, the State will not pursue Estate Recovery as long as the spouse is alive, any child of the beneficiary is under the age of 21 years, or the beneficiary has a child who is blind or permanently disabled as defined in the Social Security Act. The State also will delay estate recovery if any of the following persons are living in the home: 1) A sibling with an equity interest in the property who resided in the home for at least one year on a continuous basis immediately before the beneficiary was admitted to the nursing home, or 2) A child who resided in the home for at least two years on a continuous basis before the beneficiary was admitted and who establishes that they provided care that allowed the beneficiary to remain at home rather than going to a facility.

The State may also delay or waive recovery if a qualified heir can demonstrate that recovery would cause an undue hardship, as narrowly defined in the Medicaid regulations. The regulation specifically states that undue hardship does not exist when recovery would merely cause family members inconvenience or lifestyle restrictions. In addition, heirs cannot divest assets to qualify under the undue hardship provision.

Protecting a Family Home From Medicaid Estate Recovery

Advance planning is essential to protecting a family home from Medicaid Estate Recovery. One significant issue is the Medicaid five-year look back period, which can affect not only Medicaid eligibility but also the State’s ability to recover for benefits paid to a deceased beneficiary.

There are strategies that can be used to avoid Estate Recovery, but no action should ever be taken without receiving advice from a knowledgeable Medicaid planning lawyer. Your lawyer helps you with all aspects of planning for Medicaid, from becoming eligible to protecting your home from Estate Recovery. All Medicaid rules, including those that apply to eligibility and Estate Recovery, are extremely complex and complicated. Attempting to navigate them on your own can have significant adverse effects and consequences.

Talk With Our Georgia Medicaid Planning Attorneys

In our Cartersville practice at Asset Protection & Elder Law of Georgia, we help seniors and their families address all the unique needs of aging adults. Nursing home planning and Medicaid planning are important parts of our services, which include helping you understand and address Estate Recovery. We can answer all your questions and help you make the right decisions.

We provide elder law and planning services to clients throughout the communities northwest of Atlanta, including in Bartow County, Cobb County, Cherokee County, Gordon County, Floyd County and Paulding County. Call us at (770) 382-0984 or contact us through our online form.

Categories: Medicaid