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Medicaid Claims Against a Florida Estate

| Jun 8, 2016 | Elder Law, Estate Planning, Probate |

As is commonly known, Medicaid is a federal program which provides healthcare benefits to certain persons with low income. The program is administered at the state level. Section 1917 of the Federal Social Security Act (42 USC § 1396(p)), and 42 CFR 433.36, require that States recover medical assistance payments made to, or on behalf of, a Medicaid recipient from the assets in the estate of that deceased recipient. 

Florida Statutes Section 409.9101, entitled “Recovery for payments made on behalf of Medicaid-eligible persons”, provides that a debt is owed to the Florida Agency for Healthcare Administration (also known as AHCA) in the total amount paid to or for the benefit of the recipient for medical assistance after the recipient reached 55 years of age. Payment of benefits to a person under the age of 55 years does not create a debt.

There are some notable exceptions to enforcement. The debt created cannot be enforced if the recipient is survived by:

(a) A spouse;

(b) A child or children under 21 years of age; or

(c) A child or children who are blind or permanently and totally disabled pursuant to the eligibility requirements of Title XIX of the Social Security Act.

In order to comply with this law, probate attorneys are required to place the Agency–or its subcontractor handling collections–on notice of the pending estate. Most often, this is done by mailing to the Agency by certified mail a copy of the Notice to Creditors and the Petition for Administration. If the Agency, has a claim, it must then file the claim in the estate.

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