Medicaid Estate Recovery

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States are required to recover long-term-care-related (LTCR) Medicaid expenses from the estates of people 55 or older when they received Medicaid, to the extent of at least probate estates. States also have the option to recover costs of all medical care for people who were 55 or older, and have a separate option to extend the recovery beyond a probate estate[1].[2] This latter option is generally called "expanded estate recovery".

When the estate recovery is applied to medical expenses, since it be a recovery of all medical expenses paid out, and not just some sort of actuarial premium equivalent[3][4][5], it can be argued that people with the Medicaid really have no health insurance at all, in our ordinary conception of insurance. The Medicaid coverage could most accurately be viewed as a "loan until death for uninsured medical expenses".

Since many states, before the ACA, elected to do Medicaid estate recovery for the costs of all medicare care for people 55 and older, and have not adjusted laws since[5], and since the ACA includes expanded Medicaid, which counts as a Medicaid for estate recovery purposes, the "health insurance" provided by Medicaid and the expanded Medicaid part of the ACA for people 55 and older in many states may not really be what we would normally think of as insurance, although it is counted as health insurance in the Census Bureau[6] and most other statistical reports of health insurance coverage.

References

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  1. ^ "Medicaid's Power to Recoup Benefits Paid: Estate Recovery and Liens". ElderLawAnswers. Retrieved 2019-08-07.
  2. ^ "Estate Recovery and Liens". www.medicaid.gov. Retrieved 2019-08-07.
  3. ^ "Affordable Care Act Problems". nasmusicsoft.com. Retrieved 2019-08-07.
  4. ^ "MN ACA application. See p. adobe p. 21, third option up before the signature. (MN seems to not do non-long-term-care estate recovery currently, but the form apparently leaves the option open for the future. It is included because it explicitly states cost of medical care, and not just premiums, may be recovered.)". 2019-08-07. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  5. ^ a b "Medicaid estate recovery", Wikipedia, 2019-08-07, retrieved 2019-08-07
  6. ^ "US Census: Health Insurance Coverage in the US: 2017" (PDF). 2019-08-07. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)