Missouri Medicaid Estate Recovery

Under Missouri law, any state-paid assistance provided after January 1, 1978 counts as a debt owed by the decedent's estate. Collection runs through Missouri's probate code, and — under RSMo §473.398 — a probate estate belonging to a MO HealthNet participant generally can't close without a MO HealthNet release, unless the agency waives that requirement.

In practice, the attorney opening an estate is expected to send an Estate Notice form to the MO HealthNet Division's Cost Recovery Unit. The Division responds with word on whether it will assert a claim or waive it, and a release follows either when the decedent wasn't actually a participant or once a recovery claim has been paid.

The beneficiary deed doesn't fully sidestep this process. A Missouri elder-law source reports a Court of Appeals decision that let the state pursue property conveyed through a beneficiary deed by pulling it back into probate specifically to collect — a reminder that "avoiding probate" and "avoiding Medicaid recovery" aren't the same thing.