Understanding Medicaid Estate Recovery and Your Options in Maryland

Short answer: Under Maryland law, Medicaid’s Estate Recovery Program can seek repayment from a deceased beneficiary’s estate — and that can include a home in many cases — but Medicaid cannot force you to sign over a deed while the beneficiary is alive. There are important exemptions, procedural protections, and options to explore before taking any action.

Detailed Answer

What the Medicaid Estate Recovery Program (MERP) does

Federal law requires states to try to recover Medicaid long‑term care costs from the estates of recipients who were age 55 or older when they received benefits, and from the estates of certain other beneficiaries. Maryland operates a Medicaid Estate Recovery Program to satisfy that federal requirement and to recover certain medical costs paid by the state. See the federal statute implementing estate recovery: 42 U.S.C. § 1396p. For Maryland’s program and procedures, see the Maryland Department of Health Medicaid Estate Recovery information: Medicaid Estate Recovery – Maryland Department of Health.

Can Medicaid put a claim on a living person’s home or force a deed transfer?

• Medicaid cannot compel a living beneficiary or a caregiver to sign a deed transferring ownership of the home to the state or anyone else. Signing a deed is a voluntary action; you should never sign away title to a property under pressure without independent legal advice.
• Generally, Maryland’s estate recovery efforts are directed at the estate after the Medicaid recipient dies. That often means a recovery claim or lien is filed against the probate estate (which may include the home) to recover benefits paid.

When will the home be subject to recovery?

The home can become the target of recovery if the property is part of the deceased Medicaid recipient’s estate or if a lien is properly recorded under Maryland procedures. Whether the home is reachable depends on how title is held (sole ownership, joint tenancy, trust, life estate), whether someone else has a legal interest (surviving spouse, dependent child), and whether exemptions or waivers apply.

Common exemptions and protections in Maryland

• Surviving spouse: Recovery is generally deferred while a surviving spouse is alive and residing in the home.
• Dependents: Recovery is often waived if a child who is under age 21 or who is permanently disabled lived in the home.
• Hardship waivers: Maryland may permit waivers or settlements for undue hardship. The state’s MERP rules describe the procedures to request review.

Transfers and the Medicaid “look‑back”

If someone transfers the home (or other assets) for less than fair market value before applying for or receiving Medicaid, that transfer may trigger a penalty period that delays Medicaid eligibility. This is a federal rule (the Medicaid transfer or “look‑back” rule) implemented by states. A transfer intended to avoid estate recovery can also be challenged. Because transfers have complex eligibility consequences, avoid transferring title without legal advice.

Practical examples (hypothetical)

– If a mother owns a home in her name and receives Medicaid long‑term care, Maryland may seek recovery from her estate after she dies. If she dies with the home still in her name, the state could make a claim against the estate to recover amounts paid for her care.

– If the mother conveys the house to an adult child while alive, Medicaid eligibility for long‑term care could be denied or delayed under the look‑back rules. If the transfer is recent and for less than market value, the state may impose a penalty period or later seek to recover benefits paid.

– If the spouse continues to live in the house after the beneficiary’s death, recovery may be deferred or limited.

How to respond if you’re contacted by Medicaid or receive notice of a claim

1. Carefully read any notice. Maryland’s MERP notices must explain the basis for recovery and the steps to contest it.
2. Gather documents: deed/title records, Medicaid application and eligibility notices, marriage and birth certificates for family members who live in the home, and any documents about transfers or trusts.
3. Request administrative review or file an appeal if you believe the recovery is wrong or if an exemption applies.
4. Ask about a hardship waiver if recovery would cause undue hardship to an eligible survivor or dependent.
5. Do not sign away title or otherwise transfer property under pressure. Transfers can create serious eligibility and legal problems.

Helpful Hints

• Get the official Maryland MERP materials. Start at the Maryland Department of Health MERP page for program details and contact information: Medicaid Estate Recovery – Maryland Department of Health.
• Review federal rules for background context: 42 U.S.C. § 1396p (Medicaid transfers and estate recovery).
• Do not agree to sign or transfer deed documents without independent legal advice. Once you transfer title, undoing it may be difficult or impossible and could affect Medicaid eligibility.
• If you receive a recovery notice, preserve deadlines. Administrative appeals and requests for hearings often have short filing windows.
• Keep thorough records: Medicaid applications, medical records, financial statements, and proof of residency for dependents or spouse can matter in exemptions and hardship claims.
• Consider professional counsel: An elder‑law attorney can advise on options such as trusts, life estates, or other planning tools — but these have look‑back and estate recovery consequences. Ask any attorney about their experience with Maryland Medicaid rules and estate recovery.
• If you cannot afford a private attorney, look for local legal aid or bar‑sponsored lawyer referral services. The Maryland courts also offer self‑help resources: Maryland Courts Self-Help, and the Maryland State Bar Association has a lawyer referral tool: MSBA Find a Lawyer.

Next Steps

If you face a notice of recovery or pressure to transfer property:

1. Do not sign any deed or transfer paperwork.
2. Request a written explanation from Maryland Medicaid or the MERP office showing the legal basis for recovery and any exemptions considered.
3. Contact an attorney experienced in Maryland Medicaid and elder law to review your situation and deadlines for appeal.