Short answer
Usually you cannot be forced to sign over a deed while the Medicaid recipient is alive. However, under federal law New Hampshire must pursue Medicaid estate recovery in many situations after the recipient dies. That can mean a claim against the deceased person’s estate and sometimes a lien on real property. The exact timing, exceptions, and relief options depend on whether the property was owned jointly, whether a spouse or dependent child survives, and whether state rules apply. This article explains how the program works in New Hampshire and what practical steps you can take.
Detailed answer — how Medicaid recovery works in New Hampshire
1. Federal framework
The federal Medicaid statute requires states to seek recovery from the estates of certain Medicaid beneficiaries for long‑term care and related Medicaid benefits paid on their behalf. See the federal estate recovery law at 42 U.S.C. § 1396p(b): https://www.govinfo.gov/uscode/text/42/1396p. States implement estate recovery programs under their Medicaid plans.
2. What “recovery” typically means
- Recovery normally occurs after the Medicaid recipient dies. The state may file a claim against the decedent’s probate estate to recover Medicaid payments for long‑term care (and in many states, certain home‑and‑community based services).
- In some circumstances, states may establish a lien on real property—often when the beneficiary is permanently institutionalized or when other conditions in state law are met. Liens and collections follow the state’s procedures.
- Medicaid cannot generally force a family member to transfer title (i.e., make you sign over a deed) as a condition of providing benefits while the recipient is alive. Coercing a transfer would raise serious legal and ethical issues.
3. Common New Hampshire considerations
New Hampshire administers Medicaid through the Department of Health and Human Services (DHHS). Like other states, New Hampshire must comply with the federal estate recovery requirement. The state’s DHHS office publishes information on estate recovery, claim filing, and any exemptions or hardship policies. For state guidance, start with the DHHS website: https://www.dhhs.nh.gov/.
4. Exceptions and protections that commonly apply
- Surviving spouse: Most states (and federal rules) protect a surviving spouse. If a spouse survives, the state normally delays recovery until after the spouse’s death.
- Minor or disabled children: Recovery is typically suspended if the decedent is survived by a child who is under age 21 or who is blind or disabled.
- Primary residence and hardship policies: Many states offer exemptions or hardship waivers that protect a home if recovery would cause undue hardship to heirs or dependents who live in the house. Check New Hampshire DHHS policies for available relief.
- Joint ownership and transfer timing: How the house is titled matters. A home titled as joint tenants with right of survivorship may pass outside probate and may reduce the estate subject to recovery. However, if the state determines a transfer was made to avoid Medicaid recovery, it may pursue remedies. Also, transfers within Medicaid’s look‑back period (typically five years for transfer penalties) can trigger penalties or recovery in some contexts.
5. Can the state force you to sign a deed?
No. The state cannot lawfully force a family member to sign over the deed while the Medicaid recipient is alive. Medicaid lawful remedies focus on estate recovery after death and, where allowed by state law, liens or claims against the decedent’s estate or real property. Attempts to coerce a transfer should be resisted and raised with counsel or by filing a complaint with appropriate state agencies.
6. Practical implications and risks of voluntary transfers
Signing over the deed (transferring the property) to avoid future estate recovery can backfire. Transfers for less than fair market value may be scrutinized. If a transfer looks like an attempt to defeat Medicaid’s recovery or eligibility rules, the state may seek to void the transfer or impose penalties. Also, transfers can affect eligibility for benefits now (through transfer penalty rules) and later.
7. What you can do now
- Confirm what benefits were paid and why. Ask DHHS in writing for an itemized statement of Medicaid payments and any existing claims or liens on the property.
- Check title and survivorship rights. Confirm whether the property is solely in your mother’s name, jointly owned, or subject to a life estate.
- Learn the state’s estate recovery policies. Contact New Hampshire DHHS to ask about estate recovery rules, exemptions, hardship waivers, and the process for contesting a claim.
- Do not sign or transfer the deed without legal advice. Voluntary transfers can trigger penalties or be reversed.
- Consider asking for a hardship waiver or negotiating repayment terms if the state files a claim. States often allow payment plans or accept less than full amount in hardship cases.
- Talk to an elder‑law attorney. An attorney who handles Medicaid planning and estate recovery in New Hampshire can explain options, including whether legitimate planning (done well before Medicaid need) can protect the home.
- If a claim or lien appears, follow administrative appeal deadlines. You may have the right to an administrative hearing to contest a claim or raise defenses.
For federal law on estate recovery: 42 U.S.C. §1396p. For New Hampshire DHHS information and to request specifics about an account or claim, visit: New Hampshire DHHS.
Helpful hints
- Gather documents: title/deed, mortgage records, Medicaid application details, notices from DHHS, birth/marriage certificates, and beneficiary designations.
- Don’t sign anything under pressure. If a DHHS worker or anyone suggests you must sign a deed, ask for written authority and consult a lawyer first.
- Ask DHHS in writing for a full explanation of any claim—what benefits are being recovered, the legal basis, and how they calculated the amount.
- If the property is jointly owned, get a certified copy of the deed to confirm survivorship language; that may change the estate exposure.
- Explore hardship waivers early. If heirs live in the home or would suffer extreme hardship, apply promptly for relief.
- Be wary of quick “solutions” from non‑attorneys (companies or promoters offering to transfer property to avoid Medicaid). These schemes can be illegal and ineffective.
- If you can’t afford an attorney, contact your county’s legal aid or elder law clinic for low‑cost help.
Next steps — who to contact
1) New Hampshire Department of Health and Human Services for account and policy information: https://www.dhhs.nh.gov/.
2) Find a New Hampshire elder‑law attorney (look for attorneys experienced in Medicaid and estate recovery). If you need low‑cost help, search for New Hampshire legal aid or elder law clinics.
Disclaimer
This is general information, not legal advice. Laws change and every situation is different. Consult a licensed New Hampshire attorney to evaluate the specific facts, deadlines, and legal options available to you.