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The State of Texas and other states are often a creditor entitled to collect from the decedent’s estate. This often involves claims for Medicaid payments made for in-home care or nursing home services paid for the decedent. Each state has some process for this. In Texas, these claims are handled by the Texas Health & Human Services’ Medicaid Estate Recovery Program (“MERP”).
The following services and programs are affected by MERP:
MERP also affects the costs of certain hospital and prescription drug services. Primary Home Care (PHC) is not affected by MERP.
The MERP may seek recovery from the decedent’s estate if (1) Medicaid paid for the decedent’s nursing home care and (2) the decedent applied for benefits on or after March 1, 2015 and was 55 or older when the services were received.
There are several circumstances in which Texas will not seek recovery, including the following:
Texas may also reduce the amount of the MERP claim if the decedent or someone else spends money to (1) maintain the decedent’s home while he is in a qualified home or (2) pay for care that helps the decedent live at home longer before entering a nursing home and those costs for such care provided on or after the decedent become eligible for Medicaid.
The state may allow deductions from an estate recovery claim for necessary and reasonable expenses, such as:
Since MERP may be one of the larger debts, care should be taken to confirm whether a claim has or will be filed.
To determine whether a MERP claim has or will be filed:
Within 30 days after notification of the decedent’s death, MERP will provide the representative written notice of its intent to file a claim.
The estate can then file a request for a hardship waiver. There are several circumstances for granting a hardship waiver, such as where:
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