Detailed Answer
Overview of Illinois Medicaid Estate Recovery
Illinois participates in Medicaid estate recovery to recoup costs paid for long-term care services. Under 42 U.S.C. §1396p and Illinois Public Aid Code Section 5-7.6 (305 ILCS 5/5-7.6), the state can place a claim on a Medicaid recipient’s estate after death. That claim can include inherited real property.
Hardship Waiver Eligibility
A hardship waiver allows heirs to retain inherited property when estate recovery would cause undue hardship. Illinois rules recognize undue hardship when enforcement would deprive heirs of basic shelter or force them into financial ruin. To qualify, you must:
- Be the named heir or personal representative of the decedent’s estate.
- Inherit real property subject to an estate recovery lien.
- Demonstrate that forced sale or lien enforcement would cause undue hardship—such as loss of primary residence or severe financial distress.
Application Process
1. Obtain the Notice of Estate Recovery. After a Medicaid recipient’s death, the Illinois Department of Healthcare and Family Services (HFS) issues a recovery notice to the estate’s personal representative or heirs. It will list the value of services to be recovered and describe appeal rights.
2. Complete the Hardship Waiver Request. Submit a written request to HFS within 60 days of the notice. Include:
- Decedent’s name, Medicaid ID, and date of death.
- Your name, relationship, and contact information.
- Description of the property and its fair-market value.
- Detailed explanation of undue hardship—attach supporting documentation (e.g., income statements, mortgage statements, medical bills).
3. File Supporting Documents. Provide proof of inheritance (e.g., will, letters testamentary), property deed, and appraisal. Submit at least two independent property valuations if possible.
4. Mail to HFS Estate Recovery Unit:
Illinois Department of Healthcare and Family Services
Estate Recovery Unit
P.O. Box 19417
Springfield, IL 62794-9417
5. Request Confirmation. Send your application via certified mail and ask for return receipt. This creates a record of timely filing.
Review and Decision Timeline
HFS reviews your waiver request within 90 days. They may ask for clarifications or additional documents. If approved, HFS will remove the lien or reduce it to avoid undue hardship. If denied, you can file an administrative appeal under 89 Ill. Adm. Code 120 (89 Ill. Adm. Code 120).
Key Statutes and Resources
• Illinois Public Aid Code, Estate Recovery: 305 ILCS 5/5-7.6
• Federal Estate Recovery Rule: 42 U.S.C. §1396p
• Illinois Medicaid Programs: HFS Medical Programs
Disclaimer: This article provides general information on Illinois Medicaid hardship waivers. It does not constitute legal advice. Consult a qualified attorney for guidance tailored to your situation.
Helpful Hints
- Start the application promptly—missing the 60-day window can forfeit your appeal rights.
- Include clear, organized documentation to support your hardship claim.
- Consult with an elder‐law attorney if you encounter complex inheritance or valuation issues.
- Keep copies of all forms and correspondence for your records.
- Ask family members to help gather financial records if needed.