Disclaimer: This article provides educational information about California Medi-Cal estate recovery. It is not legal advice. Please consult an attorney for advice regarding your situation.
Detailed Answer
When a beneficiary receives California Medi-Cal benefits for long-term care, the state may seek reimbursement from the beneficiary’s estate after death. This process is known as Medi-Cal estate recovery. Under Welfare & Institutions Code § 14009.5 and related statutes, the California Department of Health Care Services (DHCS) follows specific steps to enforce its claim.
Step 1: Determine Applicability of Estate Recovery
DHCS reviews all Medi-Cal benefits paid for nursing facility care, home and community-based services, and related long-term care services. Recovery applies to costs paid after the beneficiary turns 55 or for nursing facility care at any age.
Step 2: Identify and Value Estate Assets
The estate includes probate assets such as real property and certain non-probate assets reachable by a lien. Exemptions under WIC § 14009.5(c) include:
- The surviving spouse’s share.
- Property passing to a child who is under 21 or who is blind or disabled.
- Community spouse’s sole and separate property.
Step 3: Filing a Lien on Real Property
DHCS records a Notice of Medi-Cal Estate Recovery Lien with the county recorder where the real property is located. The lien attaches to the decedent’s interest in the property.
Step 4: Presenting a Claim in Probate or Enforcing the Lien
If the estate goes through probate, DHCS presents a claim as a creditor, typically within four months after issuance of letters (Probate Code § 9002). For non-probate assets, DHCS may enforce the lien directly by filing an action in superior court.
Step 5: Notice and Opportunity to Contest
The personal representative or successor in interest receives notice of DHCS’s claim. Interested parties may object or file a petition to determine the claim’s validity or amount under Probate Code § 215. The court resolves any disputes before asset distribution.
Step 6: Satisfying the Claim and Distributing Assets
Once approved, the lien is paid from estate assets or proceeds of a property sale. Any remaining assets pass to heirs or beneficiaries. DHCS cannot recover more than the net estate value after other valid claims and exemptions.
Helpful Hints
- Gather all Medi-Cal benefit records to verify service dates and amounts.
- Identify all heirs, including minor or disabled children, who may qualify for exemptions.
- Review notices promptly and observe deadlines for contesting claims in probate court.
- Consult an estate or probate attorney early to address notices and objections.
- Maintain open communication with DHCS to clarify procedures and avoid delays.