Detailed Answer

Understanding Medicaid Estate Recovery in Rhode Island

When a Medicaid recipient dies, Rhode Island’s Estate Recovery Program can seek reimbursement from the recipient’s estate for benefits paid. Under R.I. Gen. Laws § 40-8-14, the state may file a claim against real property, including inherited homes or land (R.I. Gen. Laws § 40-8-14).

What Is a Hardship Waiver?

A hardship waiver asks the state to excuse recovery if it would cause undue hardship to surviving family members. Federal rules allow waivers where recovery would eliminate a primary residence or leave dependents without support (42 C.F.R. § 433.36(e)).

Eligibility Criteria in Rhode Island

• Surviving spouse resides in the property.
• Minor or disabled child resides in the property.
• Designated caregiver must live on the property to provide essential care.
• Other unusual hardship factors, as defined by the EOHHS policy manual.

Step-by-Step Application Process

1. Obtain the Hardship Waiver Form from the Rhode Island Executive Office of Health and Human Services (EOHHS). Visit eohhs.ri.gov/estate-recovery.
2. Complete the form with your personal details, relationship to the decedent, and description of property interests.
3. Write a detailed hardship statement explaining why recovery would be unfair (loss of home, care burden, disability).
4. Gather supporting documents:
   • Death certificate of the Medicaid recipient.
   • Property deed or inheritance documentation.
   • Proof of residence for spouse, child, or caregiver.
   • Financial records demonstrating income and expenses.
   • Medical records if disability is a factor.
5. Submit the completed form and documents to the EOHHS Estate Recovery Unit by mail or secure email as indicated on the form.
6. Track your application. EOHHS must respond within 90 days of a complete submission.
7. If denied, you have 60 days to request an administrative hearing under R.I. Gen. Laws § 40-8-3.1.

Timeline and Next Steps

After submission, the Estate Recovery Unit evaluates your request and may schedule an interview. You’ll receive a written decision. If approved, the claim may be reduced or waived. If denied, follow the appeal procedures.

Disclaimer: This article is for educational purposes and does not constitute legal advice. Always consult a qualified attorney.

Helpful Hints

• Start the waiver application early, before the estate is probated.
• Keep copies of all forms and correspondence.
• Work with an elder law attorney if the case is complex.
• Document any home improvements or care services to show necessity of residence.
• Review the EOHHS website for updated forms and policies.