There are other circumstances that may create a hardship.The person who died received services because he or she was a crime victim.The heirs could stop getting financial help from the government if the state did not file a MERP claim.The heirs would need financial help from the government if the state filed a MERP claim to get money back.The estate property was a family business, farm, or ranch for at least 12 months before the person on Medicaid dies, and is the main source of income for the heirs.The state may consider it a hardship when: How does the state define undue hardship? The cost of selling the property is more than the property is worth.Īlso, the state will not ask for money when this would cause an undue hardship for the heirs.There is an unmarried adult child who lived full-time in the Medicaid person's home for at least one year before this person died.The amount of Medicaid costs is $3,000 or less.The value of the estate is $10,000 or less.There is a child of any age who is blind or permanently and totally disabled under Social Security requirements.There is a child under 21 years of age.Yes, the state will not ask for money when: Bank accounts that are paid on death to another person.Īre there times when the state will not ask for money back?.Life insurance policies that name a person to receive the payment.MERP does not apply to all property that a person may own.Įxamples of property that the state will not collect on include: What is an estate?Īn estate is property, such as money, a house, or other things of value that a person leaves to family members or others (heirs) when he or she dies. The notice will ask the representative for information so the state can decide whether to file a MERP claim. When the person dies, the state sends a different notice to the estate representative or heirs to let them know that the state intends to file a claim. When a person applies for Medicaid and long-term services and supports, the state provides a notice that explains MERP. Medicaid managed care enrollees should contact their health plan service coordinator for further information. If you are not sure whether MERP applies to the services you currently receive or will be receiving, you should ask your Health and Human Services case manager. Primary Home Care (PHC) is not affected by MERP. MERP also affects the costs of certain hospital and prescription drug services you receive. Home and Community-based Services (HCS).Deaf-Blind with Multiple Disabilities (DBMD).Community Living Assistance and Support Services (CLASS).The following Medicaid waiver programs:.Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (ICF/IID).The following services and programs are affected by MERP: If you were on an interest list for services before that date but did not complete an application for services until after March 1, 2005, MERP does affect you. If you applied for these services before March 1, 2005, MERP does not affect you. This program will affect only long-term care services and supports you receive after the age of 55, and only if you first applied for these services after March 1, 2005. The program is administered by Texas Health and Human Services (HHS).
In some cases, the state may not ask for anything back, and the state will never ask for more money back than it paid for your services. If you received Medicaid long-term services and supports, the state of Texas has the right to ask for money back from your estate after you die. To help pay for these long-term services, every state must have a Medicaid Estate Recovery Program (MERP). It also pays for people to move to a nursing home, if that is what they need. Medicaid pays for services that help people stay in their own homes.
Some of these services are provided to people as they grow older. Medicaid is a government program that pays for healthcare for people with limited incomes. MERP will work with each caller on a case-by-case basis to attempt to accommodate specific needs. If you have received a letter from the Texas Medicaid Estate Recovery Program and have been affected by COVID-19, please call 80 to provide an update.
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