Can Medicaid Take Your House After You Die in Pennsylvania?
It can make a claim against it. Pennsylvania's Estate Recovery Program seeks repayment of Medical Assistance paid for nursing facility care, home and community-based services and related hospital and prescription drug services for people who were 55 or older when they received that care. Under 55 Pa. Code § 258.1, and 62 P.S. § 1412(a) directs the Department of Human Services to recover from the probate estate, which includes a home held in the person's name alone.
The executor has a legal duty here, and a deadline that runs against the state. Under 62 P.S. § 1412(b), the executor or administrator of anyone who reached age 55 must find out whether the person received Medical Assistance during the five years before death and, if so, notify the Department to get a statement of its claim. The Department then has 45 days after receiving that notice to submit its claim, or the claim is forfeited. 55 Pa. Code § 258.8 adds the other side: a personal representative who distributes estate property without paying or protecting the claim can become personally liable for it. This guide explains who is covered, which assets the state can reach, when collection waits, and what executors should do. It describes how the program generally works and is not legal advice.
Who Is Subject to Estate Recovery in Pennsylvania?
Estate recovery is the process by which the state seeks repayment of certain Medical Assistance costs from a deceased recipient's estate. It applies after death, not during the person's life.
Under 55 Pa. Code § 258.1, the program covers the estates of people who received Medical Assistance for:
Nursing facility services
Home and community-based services
Related hospital and prescription drug services
The person must have been 55 or older when the assistance was received, and only services provided on or after August 15, 1994, count. The regulation does not apply to someone who received Medical Assistance before age 55 and whose eligibility ended before 55.
Which Assets Can the State Reach?
The regulation draws clear lines. Under 55 Pa. Code § 258.3, all estate property is subject to the claim, meaning all real and personal property of the decedent that is subject to administration by a personal representative, whether or not it is actually administered. A house in the decedent's name alone falls on that side of the line.
Several things fall outside it:
Property held with another person as joint tenants with right of survivorship, or as tenants by the entireties
Life insurance paid directly to a named beneficiary (life insurance payable to the estate is subject to the claim)
Assets placed in a trust before death, including irrevocable burial reserves, if they are not payable to the estate
Assets left to a testamentary trust, one created by the decedent's will, are subject to the claim. Our guide to which assets are subject to probate in Pennsylvania explains how to tell estate property from non-probate property.
When Does the State Wait to Collect?
Sometimes the claim exists but collection is postponed. Under 55 Pa. Code § 258.7, the Department postpones collection until the last of these events occurs:
The death of a surviving spouse
The death of a child who is blind or totally and permanently disabled under Supplemental Security Income standards
The date any surviving child turns 21
The death, property transfer or move-out of a sibling who has an equity interest in the home and lived there for at least one year before the decedent's death
Postponement is not forgiveness. The personal representative has a duty to protect the claim during that period, and if the estate includes real estate, the regulation calls for a mortgage or other recorded encumbrance in the Department's favor.
What Is an Undue Hardship Waiver?
A waiver is a request to have the Department give up some or all of its claim. The Department's Estate Recovery Program brochure describes criteria that include a primary residence where the person living there resided continuously for at least two years, provided at least two years of care or support to the decedent, and has no other place to live. It also describes a waiver for an income-producing asset that is the family's main source of income, where losing it would drop household income below 250 percent of the federal poverty level.
The brochure tells families to request a waiver by letter sent by certified mail to the Estate Recovery Program, and says a waiver form is available by calling 1-800-528-3708. The Department's program page lists P.O. Box 8486, Harrisburg, PA 17105-8486, and the email address RA-PWESTATERECOVERY@pa.gov.
What Does the Executor Have to Do?
The duty is specific. 55 Pa. Code § 258.4 requires the personal representative to find out whether the decedent received Medical Assistance services in the five years before death and, if so, send the Department a request for a statement of claim by certified mail return receipt, fax or email. The request includes the decedent's name, last address, date of birth, date of death and Social Security number, the representative's contact information, and written documentation of the gross value of the estate.
The five-year window is for notice only. It does not limit how far back the Department's claim can reach.
Liability is what makes this step important. Under § 258.8, the representative is personally liable if property subject to the claim is transferred to an heir or other lower-priority person without paying or protecting it. A decree of distribution discharges the representative only if, among other conditions, the Department was served with the proposed distribution at least 30 days before court approval. Our post on whether an executor can be held personally liable in Pennsylvania covers the broader risks, and our page on executor responsibilities explains how the firm helps.
Can Planning Protect the Family Home?
Planning before care begins generally leaves more options open, but it has to account for two separate sets of rules: eligibility for Medical Assistance and recovery after death. A step that helps with one can hurt with the other.
Our firm's page on transferring a home to your children explains that deeding a home to children may protect it only if the transfer happens at least five years before the need for Medicaid, and that it exposes the home to the children's creditors. For a family member with a disability, our post on what a special needs trust is explains another tool. The right plan depends on the family's health, timing and assets, which is why these decisions should be made with an attorney before a Medical Assistance application is filed.
FAQ
Does estate recovery apply if my parent received Medicaid before age 55?
Not for assistance received before 55 if eligibility ended before 55, under 55 Pa. Code § 258.1. Care received at 55 or older is covered.
Can the state take a house that was jointly owned?
Property held as joint tenants with right of survivorship, or as tenants by the entirety, is not subject to the Department's claim under § 258.3(b).
Does estate recovery reach life insurance?
Only when the policy is payable to the estate, proceeds paid directly to a named beneficiary are not subject to the claim.
How long does the Department have to make its claim?
Under 62 P.S. § 1412(b), the Department must submit its claim within 45 days after receiving the executor's notice, or the claim is forfeited.
My brother lived with Mom and has part ownership of the house. Does that matter?
It can. Collection is postponed while a sibling with an equity interest who lived in the home for at least a year before the death continues to live there.
Is estate recovery the same as filial responsibility?
No. Estate recovery is a claim against the deceased person's estate. Filial responsibility under 23 Pa.C.S. § 4603 is a separate law that can make relatives liable for an indigent person's care.
Medicaid Planning and Estate Administration in Greensburg
David K. Lucas & Associates PLLC, at 140 South Main Street, Suite 301, in Greensburg, handles Medicaid planning, estate planning, and estate administration for families in Westmoreland County and the surrounding counties. Attorney David K. Lucas has been a member of the Pennsylvania Bar Association's Elder Law Division since 2000 and handles estate administration and probate. Whether you are planning ahead for a parent's care or serving as an executor now, we can help you understand where the family stands.
Visit David K. Lucas & Associates or call 724-836-3300 today. Contact us for more information.
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