Estate Recovery Program
In certain situations, the MO HealthNet Division (MHD) is required to seek repayment of costs for healthcare services after a participant dies. This is called estate recovery. An estate can include assets owned by the participant such as a home, or savings or retirement account, etc. If the MO HealthNet participant has no assets at the time of death, there is nothing else MHD will do to collect any payments, and will not ask any living dependents for repayment.
The MO HealthNet Division will not seek repayment on a participant's estate if any of the following dependents are still living:
- Spouse
- Child under age 21
- Child of the participant of any age who is blind or disabled
NOTE: Authorized representatives of an individual who has passed away will receive a questionnaire from the MO HealthNet Division regarding an estate claim. Please make sure to complete the form and return it to the address listed.
Estate Claim Notification
For any estate to be settled in Missouri, a release must be obtained from the MHD. To begin this process, an Estate Notice must be completed by the representing attorney and sent to the MO HealthNet Division to verify if the decedent was a MO HealthNet participant. The completed form can be sent via fax, mail, or e-mail to:
EMAIL: MHD.COSTRECOVERY@dss.mo.gov
MAIL: ATTN: Cost Recovery Unit
MO HealthNet Division
P.O. Box 6500
Jefferson City, MO 65102-6500
FAX: 573-526-1162
The MO HealthNet Division will review the estate notice and return it to the responsible party if a claim will be asserted or waived. If MHD determines that the decedent was not a MO HealthNet participant, a release letter will be sent. If it is determined that the decedent was a MO HealthNet participant, a release letter will only be sent after payment of the estate recovery claim is made.
Personal Funds
MO HealthNet participants who are residents at a nursing home or assisted living facility, may have money held in a personal fund account to help pay for their personal needs. After the participant passes away, the MO HealthNet Division may recover the remaining balance from the account. The nursing or assisted living facility must then submit the Personal Funds Account Balance Report to the MO HealthNet Division.
Burial plan
A burial plan account is established by the MO HealthNet participant or family member through a funeral home prior to death by the purchase of a Burial Plan or Preneed contract. Any surplus funds held in this account after all funeral services have been paid may be due to the MO HealthNet Division.
Can MO HealthNet put a lien on a property?
A TEFRA lien is placed on the property owned by participants who are age 55 and older, and are receiving long-term care in a nursing facility. The lien is to be paid upon the participant's death or the sale of the property. If the participant is discharged from the long-term care facility and returns home, the lien is removed.
NOTE: The MO HealthNet Division will NOT take possession or ownership of the property at any time and will NOT seek repayment for benefits received before the participant was age 55.
What if there is an accident or injury?
If a MO HealthNet participant is involved in an accident, they or their legal representative need to notify the MO HealthNet Division (MHD) in a timely manner. In order for the MHD to speak to anyone other than the participant a HIPAA Release must be completed and sent to MHD. Notification can be sent by mail, or e-mail to:
EMAIL: MHD.COSTRECOVERY@dss.mo.gov
MAIL: ATTN: Cost Recovery Unit
MO HealthNet Division
P.O. Box 6500
Jefferson City, MO 65102-6500
FAX: 573-526-1162
Types of injuries can include, but are not limited to:
- Auto Accident: Injury in an automobile accident or struck by an automobile or any other motorized vehicle that is required to have insurance coverage
- Malpractice: Injury due to negligence committed by a professional health care provider or facility
- Worker’s Compensation: Injury on the job or development of an occupational illness
- Premises Liability: Injury occurring on a property (public or private) and the owner has not exercised responsibility to maintain the property in a reasonably safe condition
We may ask for more information when a participant gets treatment after an accident or injury. The participant may get a questionnaire in the mail. It is important that the questionnaire is completed and returned to the address listed.
Recovery from Trusts
The MO HealthNet Division also recovers funds from Special Needs Trusts and Qualified Income Trusts. If any changes occur to a trust for any reason, including change of trustee or closure due to low balance or death, MO HealthNet must be notified by the current trustee.
Questions?
For questions, please contact the Cost Recovery Unit at 573-751-2005 or email MHD.COSTREVCOVERY@dss.mo.gov. For questions about eligibility or applying for healthcare coverage through MO HealthNet, please visit mydss.mo.gov/healthcare.