Can Medicare Recover From An Estate?

Posted by Mary Skinner

Question:
My mother just recently passed away and has left a small estate of 3 properties and some amount of CD's to me and my 2 bothers. I just learned from an Arkansas Lawyer that our estate will go into probate for all creditors to be paid including Medicare. Can Medicare make a claim? We spend our whole working lives paying into Medicare and now I am hearing that after my mother dies she now has to repay for the services she needed while disabled. Where can I find this federal or state law that states that Medicare can take an estate?

Arkansas Attorney

Answer:
Medicare does not have a right to recover from the estate unless your mother or her estate has filed a claim against another party for injuries sustained as a result of their wrongdoing and received a settlement. The only time that Medicare can assert a claim (lien) against the estate is IF your mother was injured and as a result there was a claim initiated against a third party who was responsible for the injury and received a settlement. If Medicare made payments for claims (conditional payments) that were for the treatment of the injury then Medicare can recover those payments from the settlement and the estate.

The regulations regarding Medicare's right to reimbursement on conditional overpayments in liability situations can be found under 42 CFR s411.23, 411.24,411.26,411.37,411.50,411.52, and 411.54. It is important to note at this point that "liability insurance" means insurance (including a self-insured pan) that provides payment based on legal liability for injury or illness or damage to property. It includes, but is not limited to automobile liability insurance, uninsured motorist insurance, underinsured motorist insurance, homeowners' liability insurance, malpractice insurance, product liability insurance and general casualty insurance. These regulations also established that Medicare would be secondary to no-fault insurance, which is defined as "insurance that pays for medical expenses for injuries sustained on the property or premises of the insured." This insurance includes, but is not limited to automobile, homeowners, and commercial plans. This insurance is sometimes called "medical payments coverage", "personal injury protection", or "medical expense coverage". 42 CFR ss411.50

I hope this helps.
Mary Skinner