Wyoming Medicaid's Estate Recovery Program

What costs will be recovered?

 Nursing home services;

 Home and community based services;

 Hospital services;

 Prescription drug services;

 All other services covered by the state

Medicaid plan/program.

How is estate recovery handled?

Recovery is made by filing a claim against

the recently deceased Medicaid client’s es-

tate in an amount equal to, but not to exceed,

the medical expenses paid by Medicaid

while the client was residing in the commu-

nity or in a medical facility. By filing the

claim, the state becomes a creditor in probate

court. The state also ensures that the proper-

ty passing to the heirs either through probate

or summary distribution is subject to the

state’s claim. During these legal processes

the state will closely work with the estate’s

attorney and heirs.

If the client’s estate includes real estate such

as a home or real property, the Department

will file a lien on the home or real property.

The lien is the amount of Medicaid payments

made on behalf of the person and/or persons

receiving care. If a lien exists, the property

holder must first pay off the lien before title

to the property may be sold or transferred.

What is a lien?

A lien is a security device that secures prop-

erty to debt and puts a party on notice that

someone besides the owner has an interest in

What is Estate Recovery?

Estate recovery is a federally mandated pro-

gram. According to the Omnibus Budget

Reconciliation Act of 1993, states are re-

quired to seek repayment of costs for medical

assistance from the estates of certain de-

ceased clients.

Estate recovery helps save State of Wyoming

taxpayer dollars by recovering funds from

clients’ estates which were sufficient to reim-

burse in full or in part their medical care

costs, thus partially offsetting the amount of

monies needed for new Wyoming Medicaid

clients.

What is an estate?

An estate is the property, both real property

and personal property, owned by the Medi-

caid client at the time of their death, such as:

 Real estate (home)

 Savings bonds

 Stocks

 Capital credits through a co-op

 Unused burial funds from a burial

contract

 Unused balances in the Medicaid client’s

savings or checking accounts (whether

solely-owned, joint or payable on death

to the beneficiary).

Note: This includes such assets as tr ans-

ferred to a survivor, heir, or assign of the de-

ceased individual through joint tenancy, ten-

ancy in common, survivorship life estate, liv-

ing trust or other arrangement which would

include tenants by the entireties.

Wyoming Medicaid’s

Estate Recovery

Program

A Publication of the

Wyoming Department of Health

Division of Healthcare Financing

March 2022

Please be advised that the Department

of Health does not give legal advice.

This brochure is not all encompassing.

Wyoming Department of Health

Division of Healthcare Financing

122 W. 25th Street, 4th Floor West

Cheyenne, WY 82002

Phone (307) 777-7531

If you have questions regarding eligibility

for Medicaid benefits please contact the

Wyoming Department of Health, Long

Term Care Processing Unit at (855) 203-

2936.

If you have questions regarding the Estate

Recovery Program, please contact the Di-

vision of Healthcare Financing at the tele-

phone number referenced below. Ask for

the Program Integrity Unit.

Undue Hardship Waiver Continued:

Estate recovery is subject to Chapter 35 of

the Medicaid rules.

Note: Medicaid will not r eview a re-

quest for an undue hardship waiver from

estate recovery until the Medicaid client

passes away.

 They must provide a copy of the financial

and health care power-of-attorney, a com-

parative market analysis of the property,

and a current deed to the property;

 They enter into an agreement with the

Department for placement of a lien

against the property. The agreement must

be signed by all parties prior to putting

the property up for sale;

 The family begins to actively sell the

property;

 Sale price of the property may not be less

than eighty percent (80%) of its compara-

tive market value;

 Net proceeds from the sale are paid to the

Department to the extent that Medicaid

benefits were paid on the client’s behalf;

 If the net sale proceeds exceed the

amount of Medicaid benefits paid on be-

half of the client, Medicaid will be paid.

Due to excess funds, Medicaid eligibility

will be re-determined.

Are there times when estate recovery does

not take effect after the client’s death?

Yes. The Department cannot begin recovery

during the life of a surviving spouse, or while

a surviving child is under 21, or blind or disa-

bled.

May a client’s heirs keep the property

from the estate and pay the State the

amount they intend to recover?

Yes. If the heirs wish to receive the property

that is in the estate, they may do so, as long

 If the client who was single or the surviv-

ing spouse of a married couple is survived

by a brother or sister who resided in the

client’s home at least one (1) year prior to

their admittance to a medical institution

and has equity interest in the property.

 If there is a child of the client who resided

with the client for at least two (2) years

before they entered a medical care facility

and provided care to the client. The care-

giver child will need to prove s/he provid-

ed care for the client.

What is an undue hardship?

Under special circumstances, Wyoming Medi-

caid allows for an undue hardship waiver from

estate recovery. The property must be part of

a working farm or ranch, be the sole source of

income for the heirs, and provide food, shelter

for the heirs. If the heirs believe they may

qualify, contact the Division of Healthcare Fi-

nancing at the telephone on the back of this

brochure.

as they agree to pay the amount the State

was going to recover.

Does the program require a client to sell

his/her home?

No. The program does not require a client

receiving medical assistance to sell his/her

home.

Does the State retain ownership of prop-

erty when a client passes away?

No. The Department does not take owner-

ship of property. However, the state will

pursue foreclosure.

Does the Department pursue estate recov-

ery if the client was only eligible for a

Medicare cost savings program?

No.

The Department will not immediately

pursue recovery:

 While a surviving spouse is living in the

home. Upon the death of the spouse, the

Department will pursue recovery from

the estate, specifically addressing the

deceased client’s interest, regardless of

whether or not the surviving spouse was

a Medicaid client.

 Upon the death of a client, Wyoming

Medicaid will review its laws and poli-

cies to determine what action to take, if

a client, who was single or the surviving

spouse of a married couple, is survived

by a minor child under twenty-one (21)

or by a blind or a disabled child.

Medicaid will delay estate recovery:

the property. The lien gives notice to the

public that the property is encumbered. A

lien hinders an asset from being sold or

transferred.

Does a lien affect ownership of property?

No. A lien does not change ownership of

the property. It represents a debt that must

be satisfied whenever property is sold. The

lien limits the ability to transfer clear title of

the property until the lien is released by the

Department.

Other Recovery - TEFRA

Wyoming Statute § 42-4-207 allows the

Department to place a lien (pre-death lien)

as authorized by the Tax Equity Fiscal Re-

sponsibility Act of 1982 on the home of a

client, in the amount of benefits paid on

their behalf if:

 The client has been admitted to a

medical care facility or nursing home;

 It has been determined by notice and an

opportunity for a hearing that the client

is not likely to return home.

What is a bona fide effort to sell?

If a client, a family member, a power of

attorney, a guardian, etc. determines that it

is necessary or they choose to sell the cli-

ent’s home, the client may continue to re-

ceive Medicaid benefits, if they enter into

an agreement with the Department. The fol-

lowing conditions must be met:

 The client has been eligible for Medi-

caid for at least six (6) months;