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When a Medicaid recipient in Missouri passes away, the Department of Social Services may seek to recover medical benefits paid on their behalf from the recipient’s estate. Under Missouri law, RSMo § 208.070 authorizes this recovery. However, you can apply for a hardship waiver if recovery would impose an undue hardship on surviving heirs or dependents or if the estate’s only asset is inherited property that you need to keep your home.

1. Understand Hardship Waiver Eligibility

Missouri follows federal guidance (42 C.F.R. § 433.36) allowing a waiver when recovery would deprive the family of necessary shelter or income. You may qualify if:

• You are the deceased’s spouse, minor or disabled child, or dependent.
• The inherited property serves as your primary residence.
• Estate recovery would leave you without basic living needs.

2. Gather Supporting Documentation

Prepare the following:

• Death certificate of the Medicaid recipient.
• Letters testamentary or letters of administration.
• Property deed showing your interest.
• Appraisal or tax assessment of the property’s fair market value.
• Proof of your relationship to the decedent (e.g., birth or marriage certificate).
• Monthly budget detailing income, expenses, and needs.

3. Complete the Hardship Waiver Request

Contact the Missouri Department of Social Services, Division of Legal Services, Estate Recovery Unit. Request a “Hardship Waiver Application” or download it from the Estate Recovery page: Missouri Medicaid Estate Recovery. Fill out the form completely, describing how recovery would cause undue hardship.

4. Submit Your Application

Send your application and all supporting documents by certified mail or courier to:

5. DSS Review and Decision

DSS has 90 days to review. They may:

• Approve the waiver fully or partially.
• Request additional information.
• Deny the waiver, providing reasons in writing.

6. Appeal a Denial

If DSS denies your request, you have 30 days to file a request for an administrative hearing under RSMo § 208.070. A hearing officer will review evidence and issue a binding decision.

Disclaimer: This article is for informational purposes only. It does not constitute legal advice. Consult an attorney for advice tailored to your situation.

Helpful Hints

• Act quickly: Missouri estate recovery can start as soon as 60 days after death.
• Keep copies: Always submit copies of documents and retain originals.
• Document hardship: Attach medical bills, rent statements, or care costs.
• Seek free help: Contact legal aid in Missouri if you have low income.
• Use deadlines: Note the 90-day review period and 30-day appeal window.