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Detailed Answer

Under Massachusetts law, the Division of Medical Assistance (MassHealth) seeks to recover benefits paid on behalf of individuals aged 55 or older through the Estate Recovery Program. This program may claim inherited real property, such as a family home, to recoup costs. However, heirs can request a hardship waiver to protect inherited property from these claims when recovery would cause undue hardship. This waiver authority arises under federal rule 42 C.F.R. §433.36 and MassHealth regulation 130 CMR 519.012.

Eligibility for a Hardship Waiver

To qualify, an heir must show that estate recovery on the inherited property would:

• Threaten the heir’s basic shelter or living needs.
• Prevent the heir from paying necessary living expenses (e.g., utilities, medical care).
• Cause significant financial hardship without reasonable alternative sources of payment.

Statutory Authority

Massachusetts implements estate recovery under M.G.L. c.118E, §8. Federal law authorizes hardship waivers at 42 U.S.C. §1396p(b)(1) and 42 C.F.R. §433.36. MassHealth outlines waiver standards at 130 CMR 519.012, available here: 130 CMR 519.012. See M.G.L. c.118E, §8: MassGenLaws Ch.118E §8.

Step-by-Step Application Process

1. Gather Required Documents: Death certificate of the Medicaid recipient; heir’s proof of identity; property deed; MassHealth case number; income and expense statements demonstrating hardship.
2. Complete the Hardship Waiver Request Form: Download the form from MassHealth: Estate Recovery Hardship Waiver Request.
3. Prepare Supporting Statement: Write a personal statement describing how recovery would cause undue hardship. Include monthly budget, mortgage or rent payments, and other essential costs.
4. Submit Your Packet: Mail all documents to:
   MassHealth Estate Recovery Program
   P.O. Box 609
   Taunton, MA 02780-0609
5. Wait for a Decision: MassHealth reviews requests within 45 days of receipt. They may ask for additional information.
6. If Denied, File an Appeal: Under M.G.L. c.30A, §11, request an administrative hearing within 30 days of the denial mail date.

Disclaimer: This article is for educational purposes and is not legal advice. Consult a qualified attorney for advice on your specific situation.

Helpful Hints

• Submit complete documentation to avoid delays.
• Demonstrate projected monthly shortfall clearly.
• Keep copies of all forms and correspondence.
• Consider hiring probate counsel familiar with estate recovery.
• Check deadlines for appeals under M.G.L. c.30A, §11 (30 days).
• Explore homestead exemptions under M.G.L. c.188, §1 if applicable.