Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney for guidance on your specific situation.
Detailed Answer
When you inherit an estate in Illinois and discover a Medicaid claim, you need to gather and review all relevant documents to determine the validity and amount of the claim. Follow these steps to obtain a clear picture of the estate’s obligations:
1. Identify the Medicaid Case and Notice
Locate any notice of estate recovery sent by the Illinois Department of Healthcare and Family Services (HFS). This notice typically includes the decedent’s Medicaid case number, dates of service, and total amount HFS seeks. If you have not received a notice, the case may still exist in HFS records.
2. Request Records from HFS
Submit a Freedom of Information Act (FOIA) request to HFS to obtain the decedent’s case file, including application forms, payment records, and correspondence related to the claim. Address your request to:
Illinois Department of Healthcare and Family Services
Freedom of Information Office
822 South Riverside Plaza, 4th Floor
Chicago, IL 60606
Allow up to 5 business days for an acknowledgment and up to 21 days for a response.
3. Obtain Probate Court Filings
Check with the clerk’s office in the county where probate is open. Request a copy of the estate’s inventory, creditor claim docket, and any filed Medicaid recovery claim. Under the Probate Act, creditors must file claims within six months of the first publication of notice to creditors (755 ILCS 5/18-3).
4. Review the Notice of Claim
Once you have the notice and supporting records:
- Compare dates of service and patient eligibility periods.
- Verify that claimed amounts match HFS payment ledgers.
- Check for errors or duplicated charges.
5. Understand the Statutory Basis
Illinois law authorizes HFS to recover Medicaid benefits from an estate under the Public Aid Code. See 305 ILCS 5/4-11 (Recovery from estates). Recovery applies to estates of Medicaid recipients age 55 or older or disabled individuals.
6. Prepare to Dispute or Negotiate
If you identify discrepancies or wish to challenge the claim, you may:
- Request an administrative hearing with the Illinois Office of Administrative Hearings within 30 days of the notice.
- Submit additional medical records or affidavits to contest eligibility periods or billing inaccuracies.
- Negotiate a settlement or installment plan with HFS.
Helpful Hints
- Mark deadlines on your calendar—missed deadlines can waive rights to challenge the claim.
- Keep organized digital and paper copies of all correspondence and filings.
- Speak with a probate or elder-law attorney to understand complex issues or large claims.
- Verify if any property is exempt under Illinois law before HFS recovery.
- Use certified mail for all formal requests to establish proof of delivery.