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Minnesota Department of Human Services MA Estate Recovery Manual
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Understanding Medical Assistance claims

II. Limitations on claims

Certain circumstances delay recovery of an MA claim, and the costs of certain program-specific services must be excluded from the claim entirely as a result of 2016 legislation.

A. Surviving spouse

If an MA member is survived by a spouse, recovery is delayed until the spouse dies. When the spouse dies, you must file a claim against marital property in the probate proceeding of the deceased MA member’s spouse’s estate. Cite Minnesota Statutes, section 256B.15, for statutory authority.

Moreover, if the spouse of an MA member did not receive MA during his or her life, there is a limit on how much a claim can recover from the spouse’s estate for MA paid on behalf of the deceased MA member. The claim cannot be more than the value of the spouse’s estate property that was jointly owned or the value of marital property at any time during the marriage.

Specifically, an MA claim can be made against the estate of a spouse from assets of the estate that were jointly owned property at any time during the marriage, and the recovery is allowed on the entirety of any property that was owned in joint tenancy at the time of the MA member’s death and has passed into the estate of the spouse.

See Minnesota Statutes, section 256B.15, subdivision 1a, paragraphs (b)–(d), and subdivision 2; In Re Estate of Jobe, 590 N.W.2d 162; In Re Estate of Gullberg, 652 N.W.2d 709; In Re Estate of Barg, 752 N.W.2d 52 (Minn. 2008); In re Estate of Grote, 766 N.W.2d 82 (Minn. Ct. App. 2009); and Laws of Minnesota, 2009, chapter 79, article 5, sections 37–43 and 72.

B. Surviving children

No recovery can be made against the estate of the deceased MA member or the estate of his or her spouse when the MA member is survived by a child who is:

  • • under 21 years old,
  • • blind or
  • • totally and permanently disabled under Supplemental Security Income (SSI) criteria.
  • However, after all children turn 21 years old, and, if applicable, after all children who are blind or permanently disabled have passed away, you can pursue your MA claim, as the surviving children exception no longer applies.

    See Minnesota Statutes, section 256B.15, subdivision 3.

    C. Homestead exclusion

    In certain circumstances, a homestead exclusion applies, which means that an MA member’s home must be the last asset from the estate that an MA claim recovers from. If the estate cannot pay the entire MA claim without applying the value of the home, then place a lien on the home for the unpaid balance.

    A homestead exclusion applies in these circumstances:

    1. Sibling residing in the home

    A homestead exclusion applies if a sibling resided in the decedent MA member’s home at least one year before the decedent’s institutionalization and has continuously lived in the home since the date of institutionalization. See Minnesota Statutes, section 256B.15, subdivision 4, paragraph (a).

    2. Children or grandchildren residing in the home

    A homestead exclusion applies if a child or grandchild resided in the decedent MA member’s home for at least two years immediately before the decedent’s institutionalization and has continuously lived in the home since the date of institutionalization and the child or grandchild establishes that:

  • • he or she provided care to the MA member,
  • • he or she provided this care before the MA member’s institutionalization, and
  • • the care allowed the MA member to live at home rather than become institutionalized.
  • See Minnesota Statutes, section 256B.15, subdivision 4, paragraph (a).

    The child or grandchild homestead exclusion does not automatically apply under the law.

  • • The child or grandchild must assert the exemption and prove that it applies.
  • • For example, a doctor’s note may demonstrate that the requisite care was provided.
  • • The child’s or grandchild’s tax forms may demonstrate the required residence duration.
  • • The exemption does not apply if the child or grandchild stops living at the property at any time after the decedent became institutionalized and before the court grants the exemption.
  • Note: When considering a homestead exclusion, the term “institutionalization” does not mean only a stay in a nursing home. “Institutionalization” can mean receiving care:

  • • in a nursing facility, swing bed, or intermediate care facility for people with developmental disabilities or
  • • through home and community-based services.
  • In other words, an MA member does not have to have left the home before he or she died for the homestead exclusion to apply. Receiving home and community-based services in the home counts as “institutionalization” for the homestead exclusion. See Minnesota Statutes, section 256B.15, subdivision 4, paragraph (b).

    Also, if a homestead exclusion applies, you can reassert your MA claim later if the sibling, child, or grandchild no longer resides in the home.

    D. Exclusion of expenses

    Exclude the following program-specific expenses when preparing an MA claim for recovery:

  • • payments for Alternative Care services received before July 1, 2003
  • payments for MA services other than long-term services and supports (LTSS) if the member did not permanently reside in a medical institution
  • payments for Medicare cost-sharing services made under major program QM, SL, or WD
  • Review the claims history to see whether it shows that these services have been removed from the claim. If the services appear incorrectly, subtract the amounts paid for these services from the reimbursement amount.

    These expenses should already be excluded from any claims history reports you receive, but double-check the reports to ensure that they have been. See How to request an MA claims history for more information.

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