Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney or the Ohio Department of Medicaid for guidance.
Detailed Answer
Understanding Ohio Medicaid Estate Recovery
Under Ohio law, Medicaid covers certain long-term care services. After a beneficiary’s death, the Ohio Department of Medicaid (ODM) may seek recovery of those costs from the beneficiary’s estate per Ohio Revised Code §5164.23 and 42 C.F.R. §433.36.
What Is a Hardship Waiver?
A hardship waiver allows ODM to waive estate recovery when pursuing the claim would create undue financial hardship for heirs or dependents. Ohio Administrative Code 5160:1-2-07(C)(7) outlines waiver standards. [OAC 5160:1-2-07]
Eligibility Criteria
- Estate value largely in the decedent’s residence or other exempt assets.
- Surviving spouse, minor/disabled child, or other dependents face significant economic hardship.
- Medical or living expenses exceed available estate resources.
Step-by-Step Application Process
- Receive Estate Recovery Notice. ODM issues a notice after the beneficiary’s death.
- Obtain the Hardship Waiver Form. Request “Application for Waiver of Estate Recovery” from ODM’s website or by phone.
- Complete the Application. Include:
- Decedent’s name, date of death, Medicaid case number.
- Names and relationships of heirs or dependents.
- A financial statement: income, expenses, assets (including property appraisals).
- Supporting documents: medical records, disability proof, living costs.
- Submit Within Deadline. Federal rules under 42 C.F.R. §433.36(d)(2) require submission within 90 days of notice. Ohio may set a shorter window—confirm with ODM.
- Monitor Application. ODM may request additional information. Respond quickly to prevent denial.
- Receive Decision. If denied, you can appeal under Ohio Revised Code §119.12.
Helpful Hints
- Request a professional property appraisal promptly.
- Organize financial records: bank statements, bills, and receipts.
- Keep a timeline of all communications with ODM.
- Consider consulting a Medicaid planning attorney for complex estates.
- File appeals before the deadline; Ohio deadlines are strict.