06/05/2026
What is Estate Recovery for Medicaid after someone dies?
What is Estate Recovery for Medicaid after someone dies?
The NJ Medicaid Program and Estate Recovery
What You Should Know
What is Estate Recovery?
Under federal and New Jersey law, the Division of Medical Assistance and Health
Services (DMAHS) is required to recover funds from the estates of certain deceased
Medicaid beneficiaries, or former Medicaid beneficiaries, for all payments provided
through the Medicaid program for services received on or after age 55. This includes,
but is not limited to, capitation payments made to any managed care organization,
transportation broker, PACE provider, or any other capitated provider, regardless of
whether any services were received from an individual or entity that would have been
reimbursed by the managed care organization, transportation broker, PACE provider, or
other provider that is paid by capitation payments.
Why Estate Recovery?
DMAHS pursues recovery from estates to supplement funds available for medical
assistance programs and limit the burden upon taxpayers caused by rising medical
costs. Funds recovered help provide assistance to others in need.
Who is Affected?
The estates of beneficiaries or former beneficiaries who were 55 years of age or older at
the time they received services may be affected.
What is an Estate?
For Medicaid estate recovery purposes, an estate includes any property that belonged to
the deceased at the time of death or at the moment prior to their death. By law, estates
include property such as the decedent's home or share of a home, bank accounts
(whether solely or jointly held), trusts and annuities, stocks and bonds, and any other
real or personal property. It is important to understand that even though the deceased's
share of property may pass to survivor(s), it continues to be considered as part of the
estate for New Jersey Medicaid recovery purposes.
Will DMAHS seek recovery immediately upon death?
Yes, if the deceased has no surviving spouse, and has no surviving child under age 21,
and no surviving child who is blind or permanently and totally disabled according to
Social Security standards at 42 USC 1382c. The only time that recovery will not be
pursued is: I
1. If it would not be cost-effective to do so; or,
2. If property in the estate is the sole source of income for one or more of the
Page 1 of 3survivors and pursuit of recovery is likely to result in one or more of those
survivors becoming eligible for public assistance and/or Medicaid benefits; or,
3. If a family member of a deceased Medicaid beneficiary has, prior to the
beneficiary's death, continuously resided in a home owned by the beneficiary at
the time of the beneficiary's death, and that home was the client's primary
residence, and was, and remains, the family member's primary residence,
DMAHS may record a lien against the property, but will not enforce the lien until
the property is voluntarily sold, or the resident family member either dies or
vacates the property.
When will DMAHS not seek recovery immediately upon death?
DMAHS will not seek recovery if there is a surviving spouse or a surviving child who is
under the age of 21, or is blind or permanently and totally disabled according to Social
Security standards at 42 USC 1382c. In that case, repayment would be postponed until:
1. The child reached the age of 21, or,
2. The time of the spouse or child's death.
When any of these exceptions to DMAHS' right to recover from an estate no longer
apply (i.e., as a result of the death of a surviving spouse, attainment of age 21 by a
surviving child, and/or recovery from disability or death of a blind or permanently and
totally disabled child), DMAHS has a right to recover from any remaining estate assets
at that time.
Compliments of Kenneth Vercammen & Associates, PC Attorney at Law
2053 Woodbridge Ave · (732) 572-0500
What is Estate Recovery for Medicaid after someone dies?The NJ Med...
