Section 405 IAC 2-8-1 - Claims against estate for benefits paidAuthority: IC 12-13-5-3; IC 12-15-1-10
Affected: IC 12-15-9; IC 12-15-39.6-10
Sec. 1.
(a) Upon the death of a Medicaid member fifty-five (55) years of age or older, the office of Medicaid policy and planning (office) shall seek recovery from the member's estate for Medicaid paid on behalf of the member after the member became fifty-five (55) years of age or older. Recovery shall be made for benefits provided prior to October 1, 1993, only if the member was sixty-five (65) years of age or older at the time the benefits were provided.(b) As used in this section, "estate", with respect to a deceased member, shall include all of the following: (1) All real and personal property and other assets included within the member's estate as defined for purposes of state probate law.(2) Any interest in real property owned by the individual at the time of death that was conveyed to the individual's survivor through joint tenancy with right of survivorship, if the joint tenancy was created after June 30, 2002.(3) Any real or personal property conveyed through a nonprobate transfer. As used in this section, "nonprobate transfer" means a valid transfer, effective at death, by a transferor who immediately before death had the power, acting alone, to prevent transfer of the property by revocation or withdrawal and:(A) use the property for the benefit of the transferor; or(B) apply the property to discharge claims against the transferor's probate estate. The term does not include a transfer of a survivorship interest in a tenancy by the entireties real estate or payment of the death proceeds of a life insurance policy.
(c) If the member is survived by a spouse, recovery shall be made after the death of the surviving spouse. Only those assets that are included in the member's estate as defined in subsection (b) are subject to recovery.(d) If the member is survived by a child, no recovery shall be made while the child is either:(1) under twenty-one (21) years of age; or(2) blind or disabled as defined in 42 U.S.C. 1382c.(e) A claim may not be enforced against the following assets:(1) Personal effects, ornaments, or keepsakes of the deceased.(2) Assets of an individual who purchases a long term care insurance policy that are disregarded pursuant to IC 12-15-39.6-10.(3) Nonprobate assets that were determined exempt or unavailable for purposes of the decedent's Medicaid eligibility prior to May 1, 2002.(4) Assets that the decedent transferred through a nonprobate transfer prior to May 1, 2002.(f) The office may waive the application of this section in cases of undue hardship pursuant to section 2 of this rule. Office ofthe Secretary of Family and Social Services; 405 IAC 2-8-1; filed May 1, 1995, 10:45 a.m.: 18 IR 2226; filed Feb 15, 1996, 11:20 a.m.: 19 IR 1563; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; filed Oct 10, 2002, 10:55 a.m.: 26 IR 731; filed Jul 21, 2004, 5:15 p.m.: 27 IR 3984; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFAReadopted filed 11/13/2019, 11:54 a.m.: 20191211-IR-405190487RFAFiled 6/11/2021, 2:35 p.m.: 20210707-IR-405190602FRA