Detailed answer — how Delaware’s Medicaid recovery works and what you can (and cannot) be forced to do

Medicaid’s estate recovery program can seek repayment of certain long‑term care costs from the estate of a deceased Medicaid recipient. This is driven by federal law (42 U.S.C. §1396p) and implemented by each state’s Medicaid program. Delaware operates an estate recovery program through its Division of Medicaid & Medical Assistance (DMMA) and follows federal rules on recovery and look‑back periods.

Key points under Delaware law and federal Medicaid rules you need to know:

• Medicaid generally cannot force a living person to sign over a deed. If your mother is alive, Medicaid cannot lawfully compel you to sign her deed or transfer property. Any coerced signature may be voidable and could be illegal. If someone pressures you, stop and seek legal help immediately.
• Estate recovery usually applies after the Medicaid recipient dies. After death, the state can file a claim against the recipient’s estate to recover paid long‑term care benefits and certain home‑and‑community‑based services. That claim can include the deceased person’s interest in real estate.
• Federal law sets the floor; Delaware sets procedures. Federal law (42 U.S.C. §1396p) requires states to seek recovery for long‑term care costs for beneficiaries 55 or older. Delaware’s DMMA administers recovery. See the federal rules at the U.S. Government’s site: https://www.govinfo.gov/content/pkg/USCODE-2018-title42/html/USCODE-2018-title42-chap7-subchapX-sec1396p.htm and the state Medicaid program at https://dhss.delaware.gov/dhss/dmma/.
• There is a 60‑month federal look‑back period for transfers. Transfers of assets for less than fair market value during the look‑back can cause a Medicaid penalty period. This means giving away a house to qualify for Medicaid may not prevent recovery and can create disqualification for benefits during the penalty.
• Some persons and situations are exempt from recovery. Federal law requires exemptions for a surviving spouse, surviving minor or disabled child, and in some cases certain other relatives or hardship situations. States can also offer additional hardship waivers. Check Delaware’s rules and DMMA policies for specific exemptions and claim procedures.
• Medicaid can file a claim or lien against the estate; this often happens in probate. After death, DMMA can file a claim against the probate estate for recovery. If the home is owned solely by the deceased and becomes part of the estate, it can be used to satisfy Medicaid’s claim subject to lawful claims and exemptions.

For official federal guidance on estate recovery, see the Centers for Medicare & Medicaid Services (CMS) page: https://www.medicaid.gov/medicaid/finance/long-term-services-supports/estate-recovery/index.html. For Delaware-specific program information, start with the DMMA site: https://dhss.delaware.gov/dhss/dmma/ and review Delaware law at the Delaware Code home page: https://delcode.delaware.gov/.

Practical examples (hypotheticals)

1) If your mother is alive and on Medicaid and someone asks you to sign her deed over to avoid recovery: do not sign. You can’t be forced to sign, and signing may create legal problems including penalties for improper transfers.

2) If your mother died and her house passed through probate to her heirs: DMMA may file a claim against the estate for long‑term care costs paid on her behalf. The claim follows normal probate priority rules; certain family members and exemptions may protect part or all of the property’s equity.

3) If your mother transferred the house before applying for Medicaid within the five‑year look‑back: the transfer may trigger a period of Medicaid ineligibility and may not prevent a later recovery claim. Planning must be done early and carefully.

What you can do now — concrete steps to protect rights and property in Delaware

1. Do not sign or transfer property under pressure. If anyone — a family member or a government worker — tries to force you to sign a deed, stop and get legal counsel.
2. Gather documents. Collect deeds, titles, bank statements, Medicaid notices, hospital and care records, and any written communications from DMMA. These help an attorney evaluate options.
3. Ask DMMA for written notice and explanation. If DMMA claims against an estate or files a lien, request written notice that explains the basis and the amount. Agencies must follow notice and appeal procedures.
4. Consider an immediate consult with a Delaware elder‑law or probate attorney. An attorney can explain exemptions, possible hardship waivers, and appeal rights. If cost is an issue, contact Delaware legal aid organizations or local bar referral services.
5. Explore hardship waivers and exemptions. If recovery would cause undue hardship to heirs or surviving dependents, DMMA may allow exemptions or waivers — an attorney can prepare the needed submissions.
6. Think ahead for others in your family. If long‑term care is possible in the future, talk with an elder‑law attorney about Medicaid planning strategies that comply with federal and state rules (and avoid problematic transfers within the federal look‑back period).

Helpful hints

• Never sign a deed or financial document while under pressure. Pause and get legal advice.
• Understand the 60‑month (five‑year) look‑back: gifts or transfers during that time can affect Medicaid eligibility and recovery.
• Keep an inventory of who holds title to the home and how title was acquired (wills, joint tenancy, life estate, trust).
• If your relative has a surviving spouse, child under 21, or a dependent disabled adult, notify DMMA — these relationships often limit recovery.
• Ask for all communications in writing from DMMA and carefully note deadlines for appeals.
• Free or low‑cost legal help can be available through Delaware legal aid or local bar associations; contact those organizations early.