317.03 Reimbursement - Medical Assistance, QMB, QDWI, SLMB AND SLMB135 SR 98-35, 08/98 (AAM-A)

Inform applicants (age 55 or older) for medical assistance under the OAA, APTD, and QMB, QDWI, SLMB and SLMB135 programs of DHHS’s right to recover from their estate or the estate of their spouse. Recovery is limited to all medical assistance received by the recipient from age 55 and up. A lien can be filed on real property owned by the recipient or spouse, and a claim can be made against the estate of a deceased recipient when the estate is probated.

The lien cannot be filed on occupied real property nor can reimbursement be pursued against real property until after the deceased recipient has no surviving:

• spouse,

• child who is under age 21,

• child who is blind or permanently and totally disabled,

• child who has continuously resided in the individual’s home for a period beginning at least 2 years immediately before the date of the individual’s admission to a nursing facility or other medical institution and who establishes that he or she provided care which permitted the individual to reside at home rather than in an institution, or

• sibling who has continuously resided in the individual’s home at least 1 year immediately prior to the individual’s admission to a medical institution.

No recovery can be pursued from the estate of the individual’s surviving spouse until the recipient has no surviving child who is under age 21 years, is blind or is permanently and totally disabled.

Exception: If a court decides that benefits were incorrectly paid, reimbursement can be required while the recipient is alive or regardless of whether the above criteria are met.

Inform the individual of this potential action with Form 770, Reimbursement Agreement and Acknowledgment. Failure or refusal to complete Form 770 does not result in denial or termination from assistance. Reimbursement is automatic under NH State Law, RSA Chapter 167:16-a.