Will Medicaid try to recover money from a 55-year-old patient?

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Q. Does the Medicaid recovery program pertain only to individuals who enter a nursing home at or after age 55, or does it also pertain to just health insurance coverage received, such as doctor visits, hospitalization for surgery, blood work, X-rays, after age 55 when not in a nursing home while receiving Medicaid benefits under NJ Family Care?
— Relative

A. We’re glad you’re asking.

Understanding Medicaid, and when it has to try to get money back from patients, can be complicated.

Under federal and New Jersey law, the New Jersey Division of Medical Assistance and Health Services (DMAHS) is required to recover funds from the estates of Medicaid recipients or former Medicaid recipients, said Shirley Whitenack, an estate planning attorney with Schenck, Price, Smith & King in Florham Park.

The recovery attempts would be for all payments made by Medicaid for services received after age 55, she said.

“Estate recovery is not limited to nursing home residents,” she said.

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This story was originally published on Feb. 1, 2023.

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