Will Medicaid or Medicare seek reimbursement from my mother’s estate and how do I handle it? - Pennsylvania
The Short Answer
Medicaid may seek repayment from your mother’s probate estate in Pennsylvania for certain benefits paid, especially long-term care-related Medical Assistance. Traditional Medicare generally does not “estate recover” the way Medicaid does, but Medicare (or a Medicare Advantage plan) can sometimes assert other types of repayment rights depending on the situation.
What Pennsylvania Law Says
In Pennsylvania probate, government reimbursement claims are treated like other estate debts and must be handled as part of the estate administration. If your mother received public assistance/Medical Assistance, the Commonwealth may assert a claim against estate assets, and the personal representative has to account for valid claims before distributing inheritances.
The Statute
The primary law governing this issue is 23 Pa.C.S. § 4604.
This statute establishes that certain personal property of an indigent person may be liable for expenses incurred by a public body/agency for support, maintenance, assistance, and burial, and that such claims can be pursued and collected against a decedent’s estate like other debts (with important limits on liens against a primary residence).
Separately, Pennsylvania law also sets out how estate claims get paid when there isn’t enough money to pay everyone. The payment priority rules are in 20 Pa.C.S. § 3392, which includes a specific category for certain medical and Medical Assistance services provided within six months of death.
Why You Should Speak with an Attorney
Even when the general rule is clear, estate recovery and government claims can become high-stakes quickly—especially if the estate includes a home, jointly owned assets, beneficiary-designated accounts, or recent transfers. Legal outcomes often depend on:
- Strict Deadlines: Pennsylvania probate has time-sensitive rules for creditor claims and distributions. For example, distributing too early can expose the personal representative to risk if a known claim later surfaces. See 20 Pa.C.S. § 3532.
- Burden of Proof: The estate may need to verify what benefits were paid, what period they cover, and whether the claim is properly calculated and legally enforceable against the estate.
- Exceptions and protected interests: Whether recovery is allowed (and from what assets) can turn on facts like a surviving spouse, disabled beneficiaries, the nature of the assets (probate vs. non-probate), and statutory limits on liens against a primary residence under 23 Pa.C.S. § 4604.
If you are the executor/administrator, the safest approach is to treat Medicaid/Medi-Cal-type recovery letters and claims as formal estate matters—because paying the wrong party, paying in the wrong order, or distributing too soon can create personal liability or force costly claw-backs from heirs.
If you want more background on how creditor claims work in PA estates, see: What Is the Creditor Claim Period in Pennsylvania Probate, and What Happens After It Ends?
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Disclaimer: This article provides general information under Pennsylvania 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.