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MassHealth Estate Recovery

May 14, 2021

Federal law requires MassHealth to have an estate recovery program. This program requires MassHealth to recover assets from the estates of certain MassHealth members after their death, unless exceptions apply. Estate Recovery applies to members who are:

  • 55 years old or older
  • Any age and living in a long-term care or other medical facility

Note: Estate recovery may apply to MassHealth members whether or not they enrolled in a health plan, such as a Managed Care Organization, Accountable Care Organization, Senior Care Options (SCO), PACE, or One Care.

MassHealth is amending its regulations at 130 CMR 501.000 and 515.000 to update and expand its definition of undue hardship for when a member’s estate may qualify for estate recovery to be waived by MassHealth. These regulations take effect on May 14, 2021. The regulation changes include:

  • During the COVID-19 Public Health Emergency, MassHealth stopped filing estate recovery claims on probate estates valued at $25,000 or less. This change will be made permanent with this regulation update.
  • An expansion of the existing criteria for undue hardship
  • The addition of two new hardship waivers. Two new forms were created for estate recovery hardship waivers and will be available at after May 14th.
    • MassHealth Estate Recovery Hardship Waiver Request Form (ERWA)
      • Must be completed to request a waiver for one of the three hardship waivers.
    • MassHealth Estate Recovery Application Form for Exemption of Certain Assets for American Indians and Alaska Natives (ERWNA1)
      • Must be completed to inform MassHealth when the AI/AN estate recovery exemption applies.

Throughout the month of May, MassHealth will notify the following members who are subject to estate recovery of the new estate recovery requirements and exceptions:

  • Members 55 or older; and
  • Members of any age, who are in a long-term care or other medical facility for at least 30 consecutive days.

To learn more and review the MassHealth Estate Recovery FAQ, go to MassHealth members with questions about Estate Recovery can call MassHealth at 1-800-841-2900 (TTY: (800) 497-4648).