For Medi-Cal members who die on or after January 1, 2017, the Department of Health Care Services can only recover from assets that were subject to probate and that the person owned at death. Even within that pool, recovery is capped to nursing-facility services, home- and community-based services, and connected hospital or prescription costs tied to qualifying LTC or HCBS care (DHCS Estate Recovery Program).
That's considerably narrower than the pre-2017 rules, which DHCS describes as having reached essentially all assets owned at death and most Medi-Cal services. It still fulfills the federal baseline requirement to pursue recovery for specified services provided to people 55 and older (DHCS Estate Recovery Program; Medicaid.gov, Estate Recovery).
Some survivors get an absolute pass. Welfare and Institutions Code Section 14009.5 instructs DHCS not to pursue an age-55 recovery claim when there's a surviving spouse or registered domestic partner, a surviving child under 21, or a surviving blind or disabled child — this is a flat bar, not just a delay in collection (California Welfare & Institutions Code § 14009.5).
DHCS's own materials spell out which LTC-related service categories are recoverable, and CANHR notes that IHSS personal-care payments and certain Medicare Savings Program costs are exempt — worth distinguishing from the broader set of Medi-Cal services that can be recovered (CANHR Medi-Cal Recovery FAQ). The statute also directs DHCS to waive all or part of a claim in cases of substantial hardship, including a federally contingent modest-homestead waiver; families facing a claim file Form DHCS 6195 within 60 days of the notice (DHCS Hardship Waiver Application; California Welfare & Institutions Code § 14009.5).
It's worth separating planning from disclosure: a current or former Medi-Cal member can request a statement of potentially recoverable expenses once a year using Form DHCS 4017 for a $5 fee, and DHCS asks to be notified of a death within 90 days along with a death certificate (DHCS Estate Recovery Program). Even with probate-only recovery, questions of title, creditor claims, trusts, and transfers still need individual legal review — California's rules aren't a substitute for that.