Medicaid estate recovery: what the state can take back

Updated 2026-10-16 · Expert review in progress

The short answer

Medicaid can't take your house while you live there. After death, the state can seek repayment from your estate, including the home, for long-term care it paid for once you were 55 or older. In Washington, recovery waits while a spouse, a child under 21 or a blind or disabled child survives you, and heirs can ask for a hardship delay.

The question usually comes out quietly: if Medicaid pays for my care, will the state take my house after I die? It is one of the most common worries we hear, and the honest answer has more room in it than people expect.

This post explains how Medicaid estate recovery works, with Washington as the worked example. It is part of our guide to paying for care and protecting what you leave.

Can Medicaid take my house after I die?

It can seek repayment from your estate, and a house is often the largest thing in an estate. But it is repayment of a debt, not a seizure, and it comes with real limits.

Federal law requires every state to seek repayment from the estates of people who were 55 or older when Medicaid paid for certain care. That means nursing facility care, home and community-based care, and related hospital and prescription drug services (Medicaid.gov).

States may recover for other Medicaid services too, and each state sets its own rules within that framework. States may not recover while a spouse, a child under 21, or a blind or disabled child of any age survives you.

Who handles estate recovery in Washington

In Washington, the laws are RCW 43.20B.080 for the Department of Social and Health Services (DSHS) and RCW 41.05A.090 for the Health Care Authority (HCA). The detailed rules are in chapter 182-527 WAC.

The DSHS Office of Financial Recovery does the work. Its estate recovery line is 800-562-6114 (DSHS 14-454).

What counts as your estate in Washington

Many states recover only from what passes through probate. Washington reaches further.

For deaths on or after September 14, 2006, Washington's estate includes everything that passes under a will or without one. It also includes nonprobate assets and any life estate interest you held just before death (WAC 182-527-2730).

Nonprobate assets are things that pass outside a will. Washington's definition includes survivorship joint accounts, transfer on death deeds, payable on death accounts, IRAs, and a trust you can change until death (RCW 11.02.005).

That means a revocable living trust, useful as it is for avoiding probate, does not keep assets out of recovery in Washington. A few more limits apply (WAC 182-527-2746):

Joint tenancy: the state's lien is limited to your share, the property's value divided by the number of joint tenants on the day you died.
Life estate: the lien is limited to the value of your life estate, figured from your age and a standard table.
Older property rights: the state can't enforce against joint tenancy or life estate rights that vested before July 1, 2005.

What isn't part of your estate

Property you don't own isn't part of your estate. DSHS gives the example of property owned solely by your spouse, parents or child (DSHS 14-454).

DSHS also lists assets that are exempt: certain tribal assets, certain government reparation payments, and assets protected by a qualified long-term care partnership plan. If you have no assets at death, there is no estate recovery.

Which costs the state seeks to recover

Washington's pamphlet sets out what is included and what isn't (DSHS 14-454):

Included	Not included
Federally funded long-term services and supports paid after age 55	Costs paid under a federal Medicare Savings Program
State-funded costs paid at any age (with a short list of exceptions, such as Adult Protective Services)	Medical costs paid when you were not also getting long-term services and supports
Hospital and prescription drug services received while getting long-term care services (WAC 182-527-2742)	Tailored Support for Older Adults services

In plain words: if Apple Health paid only your doctor visits and you never needed long-term care, Washington does not seek those costs back.

When recovery waits

Recovery is delayed, not cancelled, while any of these people survive you (WAC 182-527-2738):

A spouse.
A child age 20 or younger.
A child who is blind or disabled under the state's definition.

Undue hardship

An heir can also ask DSHS to delay recovery for undue hardship. Washington allows it only in three situations (WAC 182-527-2750):

The property is the heir's only income-producing asset.
Recovery would leave the heir without shelter, and they can't afford another place to live.
You are survived by a state registered domestic partner.

Hardship doesn't exist if anyone created the situation to avoid recovery. If a delay is granted, the heir must live on the property, pay its taxes and utilities, and not sell or borrow against it. They must also keep insurance on it for its full value, with the State of Washington named as primary payee.

Liens: before and after death

During your lifetime

A lien during life is narrow. Washington can file one only if you live in a nursing facility or similar institution and aren't expected to return home (WAC 182-527-2734).

That means a doctor confirms you won't return, or you've lived there six months or longer. No lien is filed if a spouse, a child 20 or younger, a blind or disabled child, or a qualifying sibling lives in the home.

DSHS says only people who must pay toward their cost of care can have a pre-death lien placed on their home (DSHS 14-454). If you go home, the lien is released.

After death

Before filing a lien after death, the state sends notice by mail. It goes to your personal representative, the executor in everyday words, or to known heirs if there isn't one (WAC 182-527-2738).

The notice states the amount the state seeks and how to request an administrative hearing. Once recorded, a lien becomes past-due debt after nine months, and interest of one percent a month then accrues. The state may waive interest if reasonable efforts to sell the property have failed.

If you are the executor and a letter arrives

Here is a typical case, a composite. Linda's mother spent her last two years in a nursing home on Apple Health. Six weeks after the funeral, a letter from the Office of Financial Recovery arrives.

Linda's first step is simply to read it calmly. It says what the state seeks and how to ask for a hearing. Her own checklist looked like this:

Note how to request a hearing, and any date the letter gives.
Check whether a surviving spouse, a child under 21 or a disabled child means recovery must wait.
Ask whether any heir qualifies for a hardship delay.
Call CLEAR, Washington's free legal aid line, at 1-888-201-1014, or an elder law attorney (DSHS 14-454).
Keep paying the house's taxes and insurance while it is sorted out.

Our executor checklist covers the rest of the job.

Planning ahead

The rules that matter most happen years before any letter. Gifts within five years of applying can delay Medicaid, which our post on the Medicaid look-back period explains. Our post on how to protect assets from Medicaid, legally covers the planning concepts an elder law attorney might raise.

If you'd like help with routine bills and paperwork while you are well, see daily money managers. For how a standing plan keeps an agent and an executor ready, see how it works.

Common questions

Can Medicaid take my house after I die?

The state may seek repayment from your estate, including your home, for long-term care it paid for after you turned 55. In Washington, recovery waits while a spouse, a child under 21, or a blind or disabled child survives you. Heirs may also ask for an undue hardship delay.

Does a living trust protect my house from estate recovery in Washington?

No. Washington's estate for recovery includes nonprobate assets, and a trust you can change until death is a nonprobate asset under RCW 11.02.005. A revocable trust helps avoid probate, not recovery.

Will the state take my house while I'm still living in it?

No. A lien during life is possible only if you live in a nursing facility and aren't expected to return home. Even then, none is filed if a spouse, a young or disabled child, or a qualifying sibling lives there, and it's released if you go home.

What medical costs does Washington not recover?

Washington doesn't recover costs paid under a Medicare Savings Program, or medical costs paid when you were not also getting long-term services and supports. Tailored Support for Older Adults services are also not included.

Who do I call about a Washington estate recovery letter?

The DSHS Office of Financial Recovery answers estate recovery questions at 800-562-6114. For free legal help, CLEAR is at 1-888-201-1014, or you can consult an elder law attorney.

Sources

This page is general information, not legal or financial advice. Laws vary by state.

Keep reading

Money, Medicaid and feesHow to protect assets from Medicaid (legally)How to protect assets from Medicaid legally: the planning concepts elder law attorneys use, how each works under Washington's rules, and what tends to backfire.Money, Medicaid and feesDaily money managers: who pays your bills when you can'tWhat a daily money manager does and doesn't do, how they differ from a financial power of attorney or trustee, how they charge, and how to check one out.Money, Medicaid and feesPaying for care and protecting what you leaveHow to pay for long-term care in plain words: savings, long-term care insurance, Medicare's limits, Medicaid spend-down, the look-back and fees.