Estate Recovery Claim Estimator

Estimates the potential Medicaid estate recovery claim against a deceased beneficiary's estate. Enter the total Medicaid benefits paid, the value of probate estate assets, and any applicable exemptions to calculate the estimated recoverable amount.

Total amount paid by Medicaid on behalf of the deceased beneficiary (age 55+).
Total fair market value of assets subject to probate (real property, bank accounts, etc.).
Total secured debts, mortgages, and prior liens against estate assets.
Funeral expenses, attorney fees, court costs, and other allowable administration expenses.
Assets passing outside probate (joint tenancy, POD accounts, IRAs) or protected by hardship waiver.
Recovery is deferred (and often waived) when a surviving spouse or qualifying blind/disabled child exists.
Most states claim 100 % of benefits paid; some states cap recovery or apply a proportional rate.

Formula

Net Recoverable Estate = Gross Probate Estate − Liens & Mortgages − Administration Costs − Exempt Assets

Maximum Medicaid Claim = Total Medicaid Benefits Paid × (State Recovery Rate ÷ 100)

Estimated Recoverable Claim = min(Maximum Medicaid Claim, Net Recoverable Estate)

Remaining Estate = Net Recoverable Estate − Estimated Recoverable Claim

Unrecovered Amount = max(Maximum Medicaid Claim − Net Recoverable Estate, 0)

Effective Recovery Rate = Estimated Recoverable Claim ÷ Net Recoverable Estate × 100

Assumptions & References

  • Recovery applies only to beneficiaries who were age 55 or older when Medicaid was received, or who were permanently institutionalized, per 42 U.S.C. § 1396p(b)(1).
  • Federal law prohibits recovery while a surviving spouse is alive, or while a surviving child who is blind or permanently disabled resides in the home.
  • Recovery is limited to probate assets under minimum-estate-recovery states; expanded-estate-recovery states may also reach non-probate transfers (joint tenancy, trusts).
  • Priority deductions (liens, mortgages, funeral and administration costs) are subtracted before the Medicaid claim is applied, consistent with standard probate priority rules.
  • States may apply a recovery rate below 100 % or cap claims; enter the applicable rate in the "State Recovery Rate" field.
  • Hardship waivers may reduce or eliminate the claim; consult the state Medicaid agency.
  • This tool does not account for TEFRA liens placed on property prior to death, which are separate from post-death estate recovery.
  • References: 42 U.S.C. § 1396p; OBRA 1993; CMS State Medicaid Manual § 3810.

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