Medicaid can help pay for long-term care, but the state may seek repayment from a recipient’s estate after death. In Houston, understanding when Medicaid Estate Recovery Program (MERP) claims apply—and how to respond—can save families time, money, and stress. With a methodical approach, you can confirm what is owed, preserve protected assets, and close the estate cleanly.
Confirm Whether MERP Applies at All
MERP generally targets Medicaid benefits paid for long-term-care services after age 55. Start by requesting an itemized claim from the program once you have letters testamentary or administration. Verify the coverage types, dates, and amounts, and compare them to facility records and Explanation of Benefits. Sometimes charges are misattributed or fall outside the recoverable categories. If the decedent never received long-term-care Medicaid, you may be able to dismiss the claim quickly.
Identify Exemptions and Hardship Waivers
Even when MERP applies, exemptions can shield the homestead or other assets. A surviving spouse or a minor or disabled child can block recovery entirely. Hardship waivers may also apply if recovery would force heirs below certain income levels or if a family business or farm would be lost. Gather tax returns, pay stubs, medical records, and proof of residence to support your waiver request. Submitting a complete packet the first time keeps the review moving.
Separate Probate and Non-Probate Assets
MERP typically focuses on probate assets. Non-probate assets—like accounts with valid beneficiary designations, transfer-on-death deeds properly recorded, or assets held in certain trusts—may pass outside the estate’s reach. Build a clear inventory that labels each asset as probate or non-probate, with supporting documents. Presenting a clean map prevents overreach and reduces negotiation time with the recovery contractor.
Manage the Homestead and Estate Recovery
If a surviving spouse or qualifying child remains in the home, recovery is off the table. If not, determine whether an enhanced life-estate deed (Lady Bird deed) or transfer-on-death deed was recorded. Those tools can avoid probate recovery, but only if executed correctly before death. If neither exists, evaluate whether the estate should sell the property and use proceeds to satisfy claims, or whether a hardship waiver can preserve the home for family members.
Respond to the Claim with Documentation, Not Guesswork
Do not ignore MERP letters. A missed deadline can cement an inflated balance. Send your authority documents, asset inventory, copies of deeds, and any exemption or hardship evidence with a cover letter that ties facts to the program’s rules. Keep a log of calls and emails. A paper trail and a professional tone speed decisions and reduce back-and-forth.
Coordinate With Creditors and Timelines
Publish notice to unsecured creditors and maintain a claims ledger. If the MERP claim is valid, you still want to verify priority and amounts before paying. In independent administration, you can negotiate interest or payment timing to avoid fire sales of estate assets. If other medical creditors appear, resolve overlaps to ensure you are not double-paying for the same service dates.
Close the Loop After Resolution
When the program confirms an exemption, waiver, or reduced claim, obtain written acknowledgment and place it in your file. If you sell a home, deliver the letter to title so the escrow can close without last-minute demands. Keep beneficiaries informed; transparency eases difficult conversations and prevents suspicion.
Handle Medicaid recovery with facts, not fear. For a Houston-focused plan to assess MERP exposure, assert exemptions, and protect family assets, contact McCulloch & Miller, PLLC at (713) 936-9073 and get a clear path from claim to closure.