DHCF is required to seek repayment from the estates of deceased Medicaid beneficiaries for services Medicaid paid on their behalf. Its published fact sheet defines an 'estate' for this purpose as all real and personal property — including a home — that the beneficiary owned and that does not pass to someone else at death. The District's Medicaid state-plan attachment mirrors that same probate-law framing: property that doesn't transfer at death by will, trust, or operation of law. Based on the materials DHCF has published, this reads as a probate-focused definition rather than an expanded-recovery rule that would reach every non-probate asset a person owned.
DHCF applies recovery to anyone who received covered Medicaid services at age 55 or older. That lines up with the federal floor set by CMS: states must pursue recovery for nursing-facility care, home- and community-based services, and related hospital and prescription-drug costs for beneficiaries 55 and up, while recovery for other Medicaid services is left to each state's discretion. Because DHCF's fact sheet on this topic dates back to 2015, families should treat the current Notice of Proposed Recovery — not the older fact sheet — as the authoritative word on exactly which services and amounts are being claimed in a specific case.
The District does build in protections: surviving spouses and certain children are shielded from recovery, and DHCF sends an exemption or undue-hardship application along with its recovery notice. That notice comes with a real deadline — families get 30 calendar days to respond — so acting quickly when a notice arrives matters more than it might seem.