Ohio Medicaid estate recovery
Last checked: May 18, 2026
Ohio Medicaid estate recovery can seek repayment after a Medicaid member dies. It can matter when Medicaid paid for nursing home care, home care, waiver care, managed care, or other covered services for a person age 55 or older, or for a person of any age who was permanently institutionalized.
The house can be at risk in some cases. But Ohio has important protections for a surviving spouse, certain children, some siblings, some adult children who provided care, and people who can prove undue hardship.
Quick answer
Yes, a house may be subject to Ohio Medicaid estate recovery after the Medicaid member dies. Ohio uses a broad estate rule, so recovery may reach probate assets and some non-probate property interests, such as survivorship property, life estates, and living trusts.
Recovery is not automatic in every case. Ohio generally cannot recover while there is a surviving spouse, or while there is a surviving child who is under age 21, blind, or disabled. Other home protections and hardship waivers may also apply, but the facts and deadlines matter.
Start here
- Find out where you are in the process. Are you applying for Ohio Medicaid now, using home care now, dealing with a nursing home stay, or handling an estate after death?
- Call the right office. For an estate recovery claim, ask for the Ohio Attorney General Medicaid Estate Recovery Unit. For Medicaid benefits or home care, call the Ohio Medicaid Consumer Hotline, your county Job and Family Services office, or your Area Agency on Aging.
- Save every notice and deadline. If a claim notice was mailed, ask in writing how to request an undue hardship waiver or prove that an asset is exempt.
If you are planning care now, use the care cost calculator and the caregiver checklists to list care needs, bills, and documents before you call.
Ohio warning
Rules can change. Counties, managed care plans, waiver contractors, and agencies may use different names for the same route. Before selling property, transferring a home, closing an estate, or skipping a deadline, confirm the rule with an official Ohio source or a qualified Ohio elder law or probate lawyer.
Main Ohio routes that can connect to estate recovery
| Program or route | Who it may help | Where to start |
|---|---|---|
| Ohio Medicaid long-term care in a nursing facility | People who need nursing facility care and meet Medicaid rules. | Call the Ohio Medicaid Consumer Hotline or your county Job and Family Services office. Ask about long-term services and supports. |
| PASSPORT waiver | Medicaid-eligible older Ohioans who need a nursing home level of care but may be able to stay at home or in the community. | Call 1-866-243-5678 and ask for the Area Agency on Aging or PASSPORT Administrative Agency for your county. |
| MyCare Ohio | People who have both Medicare and Medicaid, including some who need long-term services in the community, assisted living, or a nursing facility. | Call your MyCare plan, the Ohio Medicaid Consumer Hotline, or your Area Agency on Aging if waiver services are involved. |
| Ohio Home Care Waiver | People with physical disabilities and unstable medical needs who may receive services at home instead of in a nursing facility, hospital, or rehab facility. | Call the Ohio Medicaid Consumer Hotline and ask about the Ohio Home Care Waiver and long-term services and supports. |
| Structured Family Caregiving | Some waiver members age 18 or older on PASSPORT, MyCare Ohio, or Ohio Home Care Waiver who live with a caregiver and choose this service. | Ask the waiver case manager or managed care plan whether Structured Family Caregiving is in the person-centered service plan. Also see Can I get paid to be a caregiver? and the caregiver pay quiz. |
| Non-Medicaid help | Families who need respite, VA benefits, tax help, or a care plan that may reduce unpaid costs. | See respite care, VA Aid and Attendance, and caregiver tax deductions. |
Estate recovery is a Medicaid issue. Medicare is different. VA benefits are different. But many families use more than one program, so it helps to keep a simple list of who paid for what.
What Medicaid estate recovery means
Medicaid estate recovery means the state tries to get paid back after a Medicaid member dies.
In Ohio, the Ohio Attorney General acts for the Ohio Department of Medicaid. The Attorney General may present a claim against the estate after death.
This does not mean the state walks in and takes a house the day someone goes on Medicaid. It means the state may later seek repayment from assets the person owned or had a legal interest in when they died.
Ohio recovery can include Medicaid benefits correctly paid. Ohio rules also mention managed care capitation payments. A capitation payment is a set amount Medicaid pays to a managed care plan for a member. It can count even if the family thinks only one doctor visit or one home care service was used that month.
If your loved one is applying for home care or a waiver now, read Medicaid HCBS waivers explained. If the person has income or asset issues, also read Medicaid spend-down and the Medicaid look-back period before moving money or property.
When estate recovery may apply in Ohio
Ohio may seek estate recovery in two main situations.
The person was permanently institutionalized at any age
This can include a person in a nursing facility, ICF/IID, or medical institution when Medicaid rules treat the person as unable to return home. Ohio law has a definition for this. A long stay can raise a presumption, but families should not guess. Ask the county or Medicaid office how the person was classified.
The person was age 55 or older
Ohio may seek recovery for Medicaid benefits correctly paid after the person turned 55. Ohio rules include home- and community-based waiver services, nursing facility care, and managed care payments. Ohio’s estate recovery information also notes a special rule for certain Medicare premium assistance payments after January 1, 2010.
The person responsible for the estate has a duty to notify the Ohio Attorney General if the person who died was age 55 or older or was permanently institutionalized at death. Ohio probate Form 7.0(A) is used for notice to the Medicaid estate recovery program in probate cases.
Do not assume the county probate court, the nursing home, or a managed care plan will handle every notice for you. Ask in writing who has sent the notice and keep proof.
Is the house at risk?
Sometimes, yes.
Ohio defines an estate broadly for Medicaid estate recovery. It includes real and personal property that goes through probate. It also includes other property or assets in which the person had legal title or an interest at death, to the extent of that interest.
Ohio law gives examples. These can include property passing by joint tenancy, tenancy in common, survivorship, life estate, living trust, or another arrangement. This is why a deed, trust, or transfer-on-death plan should be checked by a qualified Ohio lawyer before the family assumes the home is safe.
Probate estate vs. expanded estate
A probate estate is the property handled by probate court. Ohio Medicaid estate recovery can also look at some non-probate property interests. This is often called an expanded estate rule.
Can Ohio put a lien on the home before death?
Ohio law says no lien may be imposed before death for Medicaid services, except in a limited situation. Ohio Medicaid may impose a lien against real property of a permanently institutionalized Medicaid recipient, and against real property of the recipient’s spouse, including jointly held real property.
But Ohio law also says no such lien may be imposed against the home if certain people lawfully live there. These include the spouse, a son or daughter under age 21, a son or daughter considered blind or disabled under Social Security rules, or a sibling with an equity interest who lived in the home for at least one year before the institutional admission.
If a lien was placed because the person was permanently institutionalized, the lien dissolves if the person is discharged from the institution and returns home.
Can Ohio force a sale after death?
It depends. If there is a valid claim, no protection applies, no hardship waiver is granted, and the estate has no other way to pay, the home may need to be sold or the claim may need to be paid another way.
Ohio rules also allow the Attorney General to set a payment schedule, promissory note, or lien when the person responsible for the estate asks to satisfy the claim without selling a non-cash asset. Do not count on this. Ask early and get the terms in writing.
Common protections and exemptions
These protections are important, but they are fact-specific. Keep proof. Ask the Ohio Attorney General Medicaid Estate Recovery Unit or the Ohio Department of Medicaid how to submit it.
Surviving spouse
Ohio recovery is delayed while the Medicaid member has a surviving spouse. The claim may still matter later, so the family should keep Medicaid and estate papers.
Child under age 21
Ohio recovery is not made while there is a surviving son or daughter under age 21.
Blind or disabled child
Ohio recovery is not made while there is a surviving son or daughter who is blind or disabled under the rule used by the Social Security Act. Ask what proof is needed.
Sibling in the home
For a permanently institutionalized person, recovery against the home may be blocked while a qualifying sibling lawfully lives there. The sibling must have lived in the home for at least one year before the institutional admission and continuously since then. The lien rule also looks at equity interest for a sibling.
Adult child who provided care
For a permanently institutionalized person, recovery against the home may be blocked while a qualifying son or daughter lawfully lives there. The child must have provided care that delayed institutionalization, lived in the home for at least two years before admission, and lived there continuously since then.
Qualified long-term care partnership
Ohio rules allow a recovery disregard for certain qualified long-term care insurance partnership resources. If your loved one had this type of policy, ask the Medicaid office or a lawyer to review the policy and Medicaid file.
Ohio rules also list some protected assets, including certain government reparation payments and certain American Indian and Alaska Native income and resources. If this may apply, ask for the exact exemption process in writing.
Hardship waivers
An undue hardship waiver is a request asking Ohio Medicaid not to recover, or to delay or limit recovery, because recovery would cause serious hardship to a survivor.
Ohio hardship waivers are case-by-case. Ohio rules say the Medicaid director or designee may grant a waiver when there are compelling circumstances.
Examples Ohio rules list
- The estate asset is the survivor’s only income-producing asset, such as a family farm or family business.
- Without the estate proceeds, the survivor would become eligible for public assistance.
- Recovery would deprive the survivor of necessary food, shelter, or clothing.
- The survivor can prove major personal financial contributions that created an equity interest in the property.
- The survivor is age 65 or older and financially dependent on the estate proceeds.
- The estate proceeds are preserved for a survivor who is totally and permanently disabled and financially dependent on the proceeds.
What is usually not enough by itself
Ohio rules say it is not enough, by itself, that heirs will lose an expected inheritance. It is also not enough, by itself, that recovery lowers a prior standard of living or prevents a new source of support that did not exist before death.
Deadlines
Ohio rules say an undue hardship waiver may be requested within 30 calendar days after the Ohio Attorney General mailed the estate recovery claim notice. Ohio Medicaid should notify the applicant of its decision within 60 calendar days after receiving the request, but missing that 60-day response time does not mean automatic approval.
If the request is not fully approved, or is approved only for a limited time, the applicant may request review by the Medicaid director or designee within 30 calendar days. The review decision also has a 60-day response time in the rule, but no automatic approval if that time is missed.
Do not wait. If you got a claim notice, write the date it was mailed and the date you received it. Ask for the hardship waiver instructions the same day.
Documents to gather before you call
- Estate recovery claim notice, if one arrived.
- Death certificate.
- Medicaid card, Medicaid ID, managed care plan cards, and waiver paperwork.
- Letters from Ohio Medicaid, county Job and Family Services, the Area Agency on Aging, MyCare plan, or case manager.
- Probate case papers, if probate has been opened.
- Deed, transfer-on-death affidavit, life estate deed, trust papers, mortgage, tax bill, and homeowners insurance.
- Proof of surviving spouse, minor child, blind child, or disabled child status, if this applies.
- Proof of residence for a sibling or caregiver child, such as mail, tax records, licenses, lease records, or utility bills.
- Caregiver child proof, if it applies: dates moved in, care notes, doctor letter, level-of-care records, service agency records, and work or school history.
- Hardship proof: income, bank statements, benefits letters, food costs, housing costs, medical bills, tax returns, and proof of any financial contributions to the property.
Use phone scripts to track who you called, what they said, and the next deadline.
What families should not do
- Do not ignore a claim notice. The hardship waiver timeline can be short.
- Do not give away or sell the house without advice. Transfers can affect Medicaid eligibility and may not stop estate recovery.
- Do not empty estate accounts before checking for claims. The person responsible for the estate may need to protect estate funds until creditor and Medicaid issues are handled.
- Do not assume a living trust, joint deed, survivorship deed, or transfer-on-death deed avoids recovery. Ohio’s estate recovery definition can include some non-probate interests.
- Do not assume home care avoids estate recovery. PASSPORT, MyCare Ohio waiver services, Ohio Home Care Waiver, and other HCBS routes are still Medicaid.
- Do not rely on a quick phone answer for a legal choice. Ask for the rule, form, or notice in writing.
Who to contact in Ohio
If the person is alive and needs care
Call the Ohio Medicaid Consumer Hotline at 1-800-324-8680. Ask for help with Medicaid, long-term services and supports, and which office handles the person’s case.
For older adults and PASSPORT, call 1-866-243-5678 and ask to be connected to the Area Agency on Aging that serves the county.
If a waiver or plan is already involved
Call the case manager, waiver service coordinator, or MyCare plan. Ask whether the person is on PASSPORT, MyCare Ohio waiver, Ohio Home Care Waiver, Assisted Living Waiver, or another Medicaid route.
If the person died or a claim arrived
Contact the Ohio Attorney General Medicaid Estate Recovery Unit. Ohio’s estate recovery notice lists: 30 E. Broad Street, 14th Floor, Columbus, Ohio 43215-3130, and 1-614-779-0105.
If probate is open
Ask the county probate court or estate lawyer about Ohio probate Form 7.0(A), Notice to Administrator of Medicaid Estate Recovery Program. Do not file that notice in the public probate case unless the court or lawyer tells you to do so.
Phone script for an estate recovery claim
“Hello. I am helping with an Ohio Medicaid estate recovery matter. The Medicaid member has died, and we need to know whether a claim exists. Please tell me the claim amount, the date the claim notice was mailed, the deadline to respond, and how to request an undue hardship waiver or prove an exemption. Can you send the instructions in writing?”
Phone script before choosing Medicaid home care
“Hello. My loved one may need long-term care at home. We are asking about PASSPORT, MyCare Ohio, Ohio Home Care Waiver, or Structured Family Caregiving. We also need the current Ohio Medicaid estate recovery notice and want to know who can explain how it may affect a home after death.”
If the first answer is no
- Ask for the decision in writing.
- Ask which rule, notice, or form controls the decision.
- Ask for the deadline to submit more proof, request review, or appeal.
- Ask for a supervisor if you cannot get the deadline or form.
- Talk with a qualified Ohio elder law, Medicaid, or probate lawyer if a home, lien, hardship waiver, trust, deed, or estate distribution is involved.
When to get legal help
Get legal help before signing a deed, selling a house, distributing an estate, changing a trust, paying one creditor over another, or filing a hardship waiver with large assets at stake.
Legal help is also important if an adult child cared for a parent at home and wants to claim the caregiver child protection. Ohio rules list proof requirements, and the family may need medical and care records.
FAQ
Does Ohio Medicaid estate recovery apply only to nursing homes?
No. Ohio recovery can also involve Medicaid home- and community-based services, such as waiver services. It may include managed care capitation payments.
Does PASSPORT count?
Yes. PASSPORT is a Medicaid waiver. If Medicaid paid for services after age 55, estate recovery may matter after death.
Does Structured Family Caregiving count?
Structured Family Caregiving is a Medicaid waiver service for some people enrolled on PASSPORT, MyCare Ohio, or Ohio Home Care Waiver. Because it is tied to Medicaid, ask the waiver case manager how estate recovery notices apply to the person receiving care.
Can Ohio recover if there is a surviving spouse?
Ohio recovery is delayed while there is a surviving spouse. This does not always erase the issue forever. Keep the papers and ask what happens after the spouse dies.
Can Ohio recover if there is a disabled adult child?
Ohio recovery is not made while there is a surviving son or daughter who is blind or disabled under the rule used by the Social Security Act. Ask what proof Ohio needs.
What if an adult child lived with the parent and gave care?
There is a caregiver child protection for a permanently institutionalized person’s home in some cases. The child must have lived in the home for at least two years before institutional admission, provided care that delayed institutionalization, and lived there continuously since then. Ohio rules also list proof that may be needed.
Does a transfer-on-death deed avoid Ohio estate recovery?
Do not assume that. Ohio’s estate recovery definition can include property interests that pass outside probate, including survivorship, life estate, living trust, and other arrangements. Ask an Ohio lawyer before relying on a deed plan.
Is Medicare estate recovery the same thing?
No. This page is about Medicaid. Medicare does not work the same way. Some people have both Medicare and Medicaid, especially in MyCare Ohio, so check which program paid the bill.
Can VA Aid and Attendance cause Ohio Medicaid estate recovery?
VA Aid and Attendance is not Medicaid. But if the person also received Ohio Medicaid, Medicaid estate recovery may still apply to Medicaid payments. See VA Aid and Attendance if you are comparing care payment routes.
About this guide
This guide was written for Ohio caregivers and family members who need to understand the first calls, deadlines, and documents for Medicaid estate recovery. It is based on official Ohio and federal sources listed below.
Disclaimer
This is general information, not legal, tax, medical, or financial advice. For legal or tax questions, talk with a qualified professional in your state.
Official sources used
- Ohio Department of Medicaid: Ohio Medicaid Estate Recovery, ODM 07400
- Ohio Administrative Code Rule 5160:1-2-07, Medicaid: estate recovery
- Ohio Revised Code Section 5162.21, Medicaid estate recovery program
- Ohio Revised Code Section 5162.211, liens as part of estate recovery
- Medicaid.gov: Estate Recovery
- Ohio Department of Medicaid: Home- and Community-Based Services
- Ohio Department of Aging: PASSPORT
- Ohio Administrative Code Rule 5160-44-33, Structured Family Caregiving
- Supreme Court of Ohio: Probate Form 7.0(A), Notice to Administrator of Medicaid Estate Recovery Program
- Ohio Medicaid Consumer Hotline contact page
- Ohio Department of Aging: Find local services and Area Agency on Aging help
