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Detailed Answer

This article is for informational purposes only and does not constitute legal advice.

Under federal law (42 U.S.C. §1396p(b)) and Oklahoma’s Estate Recovery Program (56 O.S. §240.1), Medicaid may seek reimbursement from a deceased recipient’s estate, including inherited real property. However, Oklahoma allows heirs to apply for a hardship waiver to protect inherited property from recovery claims when enforcing recovery would cause undue hardship.

Here’s how the process generally works in Oklahoma:

1. Confirm Estate Recovery Notification. After the Medicaid recipient’s death, the Oklahoma Health Care Authority (OHCA) or Department of Human Services (DHS) sends a notice of estate recovery. This notice outlines the estate recovery claim and advises heirs of their rights, including the right to request a hardship waiver.
2. Review Hardship Waiver Criteria. Oklahoma follows federal regulation 42 C.F.R. §433.274, which permits waiver where recovery “would work an undue hardship on the individual’s heirs, surviving spouse, or dependents.” Undue hardship often arises if the heir is disabled, on a fixed income, or needs the property equity for basic living expenses.
3. Gather Supporting Documentation. You must prove undue hardship. Common documents include:
   • Proof of residency (heir’s driver’s license or utility bills)
   • Medical records or disability verification
   • Income statements (Social Security, pension, wages)
   • Property appraisal showing current fair market value
4. Prepare and Submit the Waiver Request. Complete the OHCA Estate Recovery Hardship Waiver form, available at the OHCA website: https://oklahoma.gov/ohca/individuals/eligibility/medicaid-recovery–liens–estates.html. Attach all supporting documents and a written statement explaining the hardship. Mail or deliver it to the address on the form within 60 days of the notice.
5. OHCA Review. The OHCA reviews your submission under 56 O.S. §240.1 and federal guidelines (42 C.F.R. §433.274). They may request additional information or an in-person interview.
6. Decision and Appeal Rights. OHCA will issue a written decision. If the waiver is granted, the property is protected from recovery. If denied, you have the right to appeal the decision by requesting a fair hearing within 30 days, as set out in 56 O.S. §240.2.

Following these steps promptly and thoroughly will improve your chances of obtaining a hardship waiver and preserving inherited property.

Helpful Hints

• Start early: Gather appraisals and financial records before the 60-day deadline.
• Be specific: Clearly explain how foreclosure or sale would disrupt your housing, medical care, or ability to pay basic expenses.
• Get professional help: Consider a legal aid clinic or non-profit if you cannot afford an attorney.
• Keep copies: Always keep copies of forms, notices, and supporting documents you submit.
• Track deadlines: Note appeal deadlines in case of denial to protect your right to a hearing.

For more details on estate recovery regulations, see 56 O.S. §240.1 (Estate Recovery Program) and federal regulations at 42 C.F.R. §433.274.