California can attempt to recoup certain Medi-Cal costs after an enrollee's death. Learn who could be subject to estate recovery and under what circumstances.
Estate Recovery Under Medi-Cal (323 K)
California's Medi-Cal estate recovery program has received renewed attention from policymakers because of reports that some individuals newly eligible for Medi-Cal as expanded under the Affordable Care Act may not enroll for fear that their house and assets could later be seized. The purpose of this issue brief is to describe Medi-Cal estate recovery and to clarify who could be subject to it and under what circumstances.
Different estate recovery rules apply for those in the new Medi-Cal "expansion" population and those in one of the traditional Medi-Cal eligibility categories such as seniors and persons with disabilities.
The existing rules include limitations on estate recovery and protections for individuals in certain situations. State lawmakers may act to further restrict recoveries by limiting the costs that could be subject to the rules.
California Senate Bill 1124, passed by the Legislature in August 2014, proposes to limit estate recovery for both expansion Medi-Cal and traditional Medi-Cal to Long Term Services and Supports (LTSS) costs. The measure also would prohibit any recovery from the estate of a surviving spouse, even after the surviving spouse’s death. Analysis for the Assembly Committee on Appropriations predicted that, if the bill were enacted, the amount recovered through estate recoveries would be reduced by approximately $17 million; half of this reduction would be to the State General Fund, with the other half to the federal government. The governor has until September 30, 2014, to sign or veto the bill.
The complete issue brief is available under Document Downloads.
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