Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult an attorney for guidance specific to your situation.
Detailed Answer
Under federal law, states must seek recovery of Medicaid benefits paid for long-term care and related services from the estates of deceased beneficiaries (42 C.F.R. §433.36). Connecticut implements its estate recovery program through the Department of Social Services (DSS) under Connecticut General Statutes §17b-97 (C.G.S. §17b-97). However, both federal and state rules allow a hardship waiver when recovery would impose undue hardship on heirs or surviving family members.
1. Grounds for a Hardship Waiver
A hardship waiver may apply if recovering against an inherited home or other property would deprive an heir of basic needs. Typical factors DSS reviews include:
- The heir’s income and expenses.
- Whether the heir resides in the property.
- Potential loss of shelter or unsafe living conditions.
- Other special circumstances (e.g., disability of the heir).
2. Timeline and Notice
After the Medicaid recipient’s death, DSS mails a notice of estate claim to the personal representative of the estate. You generally have 90 days from the date of that notice to request a hardship waiver. Failing to respond may result in recovery of the full estate value.
3. How to Apply
- Obtain the waiver application: Contact DSS or download the waiver form from the DSS website.
- Complete the form: Provide details about the estate, your relationship to the decedent, and the property in question.
- Gather supporting documents: Include proof of income, asset statements, monthly expense records, and any medical or disability documentation if applicable.
- Submit on time: Mail or deliver the completed form and attachments to the DSS address on the notice. Keep a copy and proof of mailing.
4. DSS Review and Decision
DSS will review your request, often within 60 days. They may ask for additional information. If DSS denies the waiver, you have the right to request an administrative hearing under C.G.S. §4-177 (C.G.S. §4-177).
5. Alternatives and Planning
If a waiver looks unlikely, consider these strategies early in the beneficiary’s life:
- Transfer property to a life estate or trust.
- Purchase long-term care insurance or a Medicaid-compliant annuity.
- Gifts or other asset protection techniques, mindful of look-back rules under 42 U.S.C. §1396p (42 U.S.C. §1396p).
Helpful Hints
- Track deadlines: Note the 90-day waiver request period on your calendar immediately.
- Keep thorough records: Organized financials strengthen your waiver case.
- Respond promptly: Answer any DSS requests for more information without delay.
- Consider professional help: An elder law attorney can guide you through complex rules.
- Review estate plans early: Proper planning can avoid or minimize DSS estate recovery later.