Quick answer: AHCCCS, Arizona's Medicaid agency, seeks repayment from the estate of a person who got ALTCS nursing home or home- and community-based benefits at age 55 or older. The claim covers ALTCS payments made from age 55 on, for benefits paid on or after January 1, 1994.
Arizona law directs the AHCCCS director to write rules allowing claims against a deceased member's estate to recover benefits paid, and separately entitles AHCCCS to place a lien on a member's property — both consistent with federal law. A personal representative has to notify AHCCCS about the estate or property within three months of the death of a member who was 55 or older, unless AHCCCS has already filed its claim in the probate proceeding.
AHCCCS policy applies estate recovery whenever a deceased person received ALTCS nursing-home or home- and community-based benefits at 55 or older, for benefits paid on or after January 1, 1994. The claim covers the total ALTCS payments made on that person's behalf from age 55 onward, and the recoverable categories include capitation payments, qualifying fee-for-service payments, reinsurance, and certain older Medicare-related costs. AHCCCS files against property subject to probate or a small-estate affidavit, and its policy separately spells out deferment, partial-recovery or reduction, grievance, and hearing options.
Questions and answers
Who is subject to estate recovery in Arizona?
A person who got ALTCS nursing home or home- and community-based benefits at 55 or older, for benefits paid on or after January 1, 1994.
What does AHCCCS recover?
The total ALTCS payments made on the person's behalf from age 55 on. These include capitation payments, qualifying fee-for-service payments, reinsurance and certain older Medicare-related costs.
Does the estate have to notify AHCCCS?
Yes. The personal representative must notify AHCCCS within three months of the death of a member who was 55 or older, unless AHCCCS has already filed its claim in probate.
Can recovery be deferred or reduced?
AHCCCS policy includes deferment, partial recovery or reduction, and grievance and hearing options.
Sources and official resources
- AHCCCS: ALTCS coverage for long-term care needs
- U.S. Code: 42 U.S.C. § 1396p (liens, estate recovery, transfers of assets, Partnership disregard)
Rules and figures change. Confirm current details with the agency before you act.