California Medi-Cal estate recovery
Last checked: May 18, 2026
Medi-Cal is California Medicaid. Estate recovery is the state process that may ask for repayment from a Medi-Cal member’s estate after the member dies.
This guide explains when the house may be at risk, when DHCS says it will not pursue recovery, how hardship waivers work, and who to call first.
Quick answer
California does not take a house just because someone used Medi-Cal, but after a Medi-Cal member dies, DHCS may seek repayment from the member’s probate estate for certain long-term care costs.
For deaths on or after January 1, 2017, DHCS says recovery is limited to probate estate assets and to certain services, such as nursing facility services, home- and community-based services, and related hospital and prescription drug services.
DHCS also says it will not pursue recovery if there is a surviving spouse or registered domestic partner, a surviving child under 21, or a surviving child of any age who is blind or disabled.
Do not guess based on what happened to another family because the deed, probate status, date of death, family situation, and DHCS claim letter all matter.
Start here
- If the Medi-Cal member died: submit the DHCS Notice of Death within 90 days of the date of death, with a copy of the death certificate.
- If you received a claim letter: check for an exemption first. Then check the 60-day deadline for a hardship waiver.
- If a house is involved: do not sell, transfer, sign a lien, or pay a claim until you understand whether the house is part of the probate estate and whether an exemption or waiver applies.
Main routes and who to contact
| Route | Who it helps | Where to start |
|---|---|---|
| DHCS Estate Recovery Program | Families handling a deceased Medi-Cal member’s estate | Ask for the Estate Recovery Program, Third Party Liability and Recovery Division |
| Notice of Death / Estate Recovery Questionnaire | Executor, administrator, heir, attorney, or person handling affairs after death | Use the DHCS Estate Recovery online forms page or mail notice to DHCS |
| Estate Recovery Exemptions Form | Families with a surviving spouse, registered domestic partner, child under 21, or blind or disabled child | Submit proof listed on the DHCS exemption form |
| Hardship Waiver, DHCS 6195 | Heirs or applicants who may meet DHCS hardship rules | Submit within 60 days of the date on the DHCS claim letter |
| California probate help | Families unsure if the house or other assets must go through probate | Use California Courts self-help and talk with a probate or elder-law attorney if real property is involved |
| County Medi-Cal office or Area Agency on Aging | Families planning care while the person is still alive | Ask about Medi-Cal, long-term care, home care, caregiver support, and legal-help referrals |
What Medicaid estate recovery means
Medicaid estate recovery means the state tries to get paid back after a Medicaid member dies. In California, Medicaid is called Medi-Cal.
Estate recovery is not a monthly bill sent to family members while the person is alive. It is a claim after death. The claim is tied to the deceased person’s estate.
An estate means property and assets owned by the person who died. In California estate recovery cases for deaths on or after January 1, 2017, DHCS says recovery is limited to assets in the probate estate.
Probate is a court process used to transfer some property after death. A house in the person’s name alone often needs probate. Some property can pass outside probate, such as some trust property, some joint ownership property, and some transfer-on-death property. These details are legal details. Get help before you act.
For families, the main question is simple: did the Medi-Cal member leave property that is part of a probate estate? If not, DHCS says nothing will be owed if the person owned nothing when they died.
When estate recovery may apply in California
For a Medi-Cal member who died on or after January 1, 2017, DHCS says recovery is limited. It may apply when these facts line up:
- The person received Medi-Cal benefits on or after their 55th birthday, or the person was determined permanently institutionalized at any age.
- The services were nursing facility services, home- and community-based services, and related hospital or prescription drug services.
- The payments may include fee-for-service payments and managed care premiums or capitation payments tied to covered services.
- The person owned real property, personal property, or other assets at death that are part of the probate estate.
- No exemption or waiver stops recovery.
DHCS says it will never collect more than the value of the probate estate or the amount DHCS paid for the covered Medi-Cal benefits, whichever is less.
Important date warning
Different rules apply if the Medi-Cal member died before January 1, 2017. Older California rules were broader. If the death was before that date, contact DHCS and a California probate or elder-law attorney before relying on this guide.
Rules can change. Counties, managed care plans, waiver contractors, and agencies may use different names for care programs. Always confirm with DHCS or another official California source before making a money or property decision.
Is the house at risk?
The house can be at risk if it is part of the Medi-Cal member’s probate estate and a valid DHCS estate recovery claim applies.
The house is less likely to be part of the recoverable estate if it passed outside probate. DHCS says that, for deaths on or after January 1, 2017, it will not recover the value of property that transfers to a different owner by survivorship, trust, or payment or transfer on death.
That does not mean every family should move a house into a trust or change a deed. Those steps can affect taxes, family rights, probate, Medi-Cal rules, mortgages, and future disputes. Talk with a qualified California professional before changing ownership.
If children or other heirs live in the house, DHCS says the state would not force children to move and that other payment arrangements may be available. Still, do not wait. A claim letter has deadlines.
What about liens?
A lien is a legal claim against property. Estate recovery after death is different from a lien placed during life.
Federal Medicaid rules say states may place liens on real property during the lifetime of a Medicaid member who is permanently institutionalized. Federal rules also list protections when certain people live in the home, including a spouse, a child under 21, a blind or disabled child of any age, or a sibling with an equity interest in the home.
California DHCS also says the state may collect from Medi-Cal members of any age who have been determined permanently institutionalized. If someone is alive, in a nursing facility, and a house is involved, ask DHCS and a California elder-law attorney about lien rules before you sign anything.
Common protections and exemptions
Some protections stop DHCS from pursuing repayment. Others may support a hardship waiver. Do not mix them up.
DHCS exemptions listed for estate recovery claims
DHCS says it will not pursue repayment if the deceased Medi-Cal member is survived by:
- A spouse.
- A registered domestic partner.
- A child who was under age 21 at the time of death.
- A child of any age who is blind or disabled, as defined by the federal Social Security Act, as of the date of the estate recovery claim.
The DHCS exemption form asks for proof. That may include a death certificate or marriage documents for a spouse, a Declaration of Domestic Partnership for a registered domestic partner, birth or adoption papers for a child, and Social Security proof or other proof of disability for a blind or disabled child.
Sibling protection
I did not find a current DHCS estate recovery exemption that applies only because the heir is a sibling. Federal Medicaid lien rules do mention a sibling with an equity interest who lives in the home in certain lifetime lien cases.
A sibling may still have a hardship waiver argument if they meet one of the DHCS hardship criteria. For example, they may be aged, blind, or disabled and living in the home, or they may have provided care and lived in the home. Ask DHCS and get legal help before assuming a sibling is protected.
Caregiver child or caregiver relative
California’s hardship waiver form has a caregiver-related criterion. It is not worded as a child-only rule.
DHCS says an applicant may seek a hardship waiver if the applicant provided care to the deceased person for two or more years, the care prevented or delayed admission to a medical or long-term care institution, the applicant lived in the home during that care, and the applicant still lives in the home.
DHCS also asks for written medical proof from a licensed health care provider. The proof must clearly say the care prevented or delayed placement in a medical or long-term care institution.
American Indian and Alaska Native resources
DHCS says certain income and resources of American Indians and Alaska Natives are exempt from estate recovery. Tell DHCS if the property is on or near a federally recognized reservation, Pueblo, or Colony, or if you think tribal resource rules may apply.
Hardship waivers
A hardship waiver asks DHCS to waive all or part of an estate recovery claim because payment would create a hardship under DHCS rules.
The deadline is strict. DHCS says a hardship waiver request must be submitted within 60 days of the date on the DHCS Estate Recovery claim letter.
Use DHCS form 6195, Application for Hardship Waiver. DHCS says hardship waiver documents may be submitted by email to HW@DHCS.CA.GOV or by mail. The hardship form also says to call the collection representative assigned to the case or the Estate Recovery mainline listed on the form for questions.
Hardship reasons listed by DHCS
- The inheritance would let the applicant stop getting public assistance or medical assistance.
- The estate property is part of an income-producing business, farm, or ranch, and recovery would cause the applicant to lose their main income source.
- The applicant is aged, blind, or disabled, lived in the home for at least one year before death, still lives there, and cannot get financing to repay the state.
- The applicant provided care for two or more years that prevented or delayed placement in a medical or long-term care institution, lived in the home during that time, and still lives there.
- The applicant transferred the property to the deceased person for no payment.
- The home equity is needed to make the property habitable.
- The home equity is needed for necessities of life, such as food, clothing, shelter, or medical care.
- For deaths on or after January 1, 2017, the estate subject to recovery is a homestead of modest value. DHCS defines this as a home with fair market value of 50% or less of the median price of homes in the county where the home is located, as of the date of death.
DHCS may ask for proof. This can include an appraisal, probate inventory and appraisal, mortgage statement, bank statements, utility bills, proof of disability, public benefits proof, medical letters, repair estimates, income proof, and expense proof.
Documents to gather before you call
- Death certificate.
- Medi-Cal member’s full name, date of birth, and Medi-Cal ID if you have it.
- Any DHCS Estate Recovery claim letter, questionnaire, or account number.
- Deed, trust, transfer-on-death deed, will, or other property papers.
- Mortgage statement, tax bill, appraisal, or probate Inventory and Appraisal if there is a house.
- Marriage proof, domestic partnership proof, birth certificate, adoption papers, or disability proof if an exemption may apply.
- Proof you can act for the estate, such as letters from probate court, power of attorney while the person is alive, conservatorship papers, or attorney documents.
- Receipts for funeral costs, estate costs, mortgage payments, taxes, insurance, repairs, and legal fees.
- Proof of care you gave, if you are asking for a caregiver hardship waiver. Ask the doctor or licensed provider for a clear letter.
What to say on the phone
Call DHCS Estate Recovery first if the person has died.
“My family member died on [date]. They had Medi-Cal. I am helping with the estate. I need to submit the Notice of Death and ask whether there is an estate recovery claim, exemption, or hardship waiver. Can you tell me what forms you need and what deadlines apply?”
If you received a claim letter:
“I received a DHCS Estate Recovery claim letter dated [date]. I need to ask about exemptions and the hardship waiver deadline. There may be a surviving [spouse / registered domestic partner / child under 21 / blind or disabled child], or a hardship because [short reason]. What proof should I send, and where should I send it?”
If the person is still alive:
“My family member is on Medi-Cal or may need Medi-Cal long-term care. We are worried about estate recovery and a house. Which office can explain the current Medi-Cal estate recovery notice and where can we get legal help before changing any property papers?”
What families should not do
- Do not ignore a DHCS letter. The 60-day hardship waiver deadline starts from the date on the claim letter.
- Do not assume the house is safe just because the person lived there for many years.
- Do not assume the house is lost just because the person used Medi-Cal.
- Do not sell, transfer, or retitle the house without legal advice if a Medi-Cal claim, probate case, or family dispute is possible.
- Do not sign a payment plan, voluntary lien, or settlement if you do not understand it.
- Do not use rules from another state. California’s post-2017 rule is narrower than many states.
- Do not assume IHSS, waiver, nursing home, or managed care payments are treated the same in every case. Ask DHCS for the claim details.
- Do not miss probate deadlines. The estate recovery issue and probate issue often move at the same time.
Who to contact
DHCS Estate Recovery Program
Call this office first when the Medi-Cal member has died or you received a claim letter.
Ask for: Estate Recovery Program, Third Party Liability and Recovery Division.
Phone: (916) 650-0590
Email: ER@DHCS.CA.GOV
Hardship waiver email: HW@DHCS.CA.GOV
Your county Medi-Cal office
Use this route if the person is alive and needs Medi-Cal, has Medi-Cal notices, or needs help with health coverage or benefits.
Ask for: Medi-Cal eligibility or long-term care help.
California Courts self-help
Use this for probate basics, small estate questions, and court forms. Real property can make the case more complex.
Ask your county court self-help center if you are not sure whether probate is needed.
State Bar certified lawyer referral
Use this if a house, probate estate, trust, deed, lien, claim letter, or family dispute is involved.
Ask for a lawyer who handles probate, elder law, or Medi-Cal estate recovery.
Area Agency on Aging
Use this if you need local caregiver support, legal-help referrals, meals, transportation, respite, or aging services.
California lists county aging contacts and says you can call 800-510-2020 to locate your Area Agency on Aging.
If the first answer is no
- Ask for the answer in writing or ask where the rule is posted.
- Ask whether an exemption form, hardship waiver, or case update form is allowed.
- Ask for the name of the DHCS collection representative assigned to the case.
- Send proof by the deadline. Keep copies of every document.
- If real property is involved, talk with a California probate or elder-law attorney before the property is sold or transferred.
FAQ
Can California take the house while my parent is alive?
Estate recovery is a claim after death. Lifetime liens are a different issue and may arise in limited cases, such as permanent institutionalization. If your parent is alive and a nursing facility or lien issue is involved, contact DHCS and get legal help before changing property papers.
Does Medi-Cal estate recovery apply to all Medi-Cal services?
For deaths on or after January 1, 2017, DHCS says recovery is limited to payments for nursing facility services, home- and community-based services, and related hospital and prescription drug services. Older death dates have different rules.
What if there is a surviving spouse?
DHCS says it will not pursue repayment if there is a surviving spouse or surviving registered domestic partner. The family should still respond to DHCS and send the proof requested on the exemption form.
What if an adult child cared for the parent at home?
That may support a hardship waiver, not an automatic exemption. DHCS lists a caregiver-related hardship rule for an applicant who provided care for two or more years, lived in the home during the care, still lives there, and can show the care prevented or delayed placement in a medical or long-term care institution.
How fast do we need to act after a claim letter?
DHCS says hardship waiver requests must be submitted within 60 days of the date on the Estate Recovery claim letter. Notice of Death must be sent within 90 days of the date of death.
Resumen en español
Medi-Cal puede pedir reembolso después de la muerte de una persona, pero no en todos los casos. Para muertes desde el 1 de enero de 2017, California limita la recuperación a ciertos costos de cuidado y a bienes que pasan por probate.
DHCS dice que no buscará pago si hay cónyuge sobreviviente, pareja doméstica registrada sobreviviente, hijo menor de 21 años, o hijo ciego o discapacitado de cualquier edad. Si recibió una carta de cobro, llame a DHCS pronto y pregunte por exenciones y la solicitud de hardship waiver.
About this guide
This guide was written for California caregivers and families who need practical steps after a Medi-Cal estate recovery notice or before a long-term care decision. It uses official DHCS, Medicaid.gov, California Courts, State Bar of California, and California Department of Aging sources.
Official sources used
- California Department of Health Care Services: Estate Recovery Program
- DHCS: Important Notice Regarding the Medi-Cal Estate Recovery Program
- DHCS: Medi-Cal Estate Recovery Informational Brochure
- DHCS: Estate Recovery Online Forms
- DHCS: Estate Recovery Exemptions Form
- DHCS: Substantial Hardship Criteria
- DHCS: Application for Hardship Waiver, DHCS 6195
- DHCS: Additional Hardship Waiver Criteria
- DHCS: Request for Medi-Cal Expenses Subject to Estate Recovery, DHCS 4017
- DHCS: Medi-Cal Eligibility and Estate Recovery Standards
- Medicaid.gov: Estate Recovery
- California Courts Self-Help Guide: Wills, Estates, and Probate
- California Courts Self-Help Guide: Small Estate Affidavit
- DHCS: Find Your County Medi-Cal Office
- California Department of Aging: Find Services in My County
- State Bar of California: Find a Lawyer Referral Service
Disclaimer
This is general information, not legal, tax, medical, or financial advice. Rules can change, and facts matter. For legal or tax questions, talk with a qualified professional in your state.
