The Short Answer

In Florida, Medicaid planning issues often come up in two related ways: (1) whether prior transfers can create problems with eligibility, and (2) whether the State can seek repayment after a Medicaid recipient dies. Even when someone qualifies for Medicaid, Florida law can allow the Agency for Health Care Administration (AHCA) to file a claim against the recipient’s estate for benefits paid after age 55, with important exceptions.

What Florida Law Says

Florida has a specific statute governing Medicaid estate recovery. In plain terms, if a person received Medicaid after age 55, Florida may treat those benefits as a debt and pursue repayment through the probate estate after death. Whether prior gifts or transfers affect the outcome depends heavily on what was transferred, when, how it was titled, and what assets remain in the probate estate versus passing outside probate (and whether any exemptions apply).

The Statute

The primary law governing this issue is Fla. Stat. § 409.9101.

This statute establishes that accepting Medicaid after age 55 can create a debt to AHCA, and AHCA may seek recovery by filing a claim in the deceased recipient’s probate estate—subject to key limits and exceptions (including certain surviving family members and exempt property).

Why You Should Speak with an Attorney

While the statute provides the general rule, applying it to your specific situation is rarely simple. Legal outcomes often depend on:

• Strict Deadlines: Medicaid estate recovery is pursued through a probate claim process, and AHCA can amend its claim up to 1 year after the last date medical services were rendered to the decedent under Fla. Stat. § 409.9101.
• Burden of Proof: Whether property is exempt (including whether something is protected from creditor claims) and whether a hardship waiver applies can turn on documentation and legally significant facts.
• Exceptions: Recovery is not enforced in certain situations (for example, if the recipient is survived by a spouse, a child under 21, or a blind/permanently and totally disabled child), and Florida also recognizes limits for exempt property and hardship waivers under Fla. Stat. § 409.9101.

Trying to handle Medicaid eligibility concerns and prior transfers without counsel can lead to avoidable denials, loss of benefits, or an estate recovery claim that could have been reduced or avoided with proper planning.

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Disclaimer: This article provides general information under Florida law and does not create an attorney-client relationship. Laws change frequently. For legal advice specific to your situation, please consult with a licensed attorney.