States must provide for hardship exceptions to MERP. Aging Care. How to Protect Your Spouse If You're on Medicaid, Here's What To Do If You'll Lose Medicaid Coverage When the Pandemic Emergency Ends, 3 Insurance Changes That May Impact Your Coverage This Year. A brother / sister who has equity interest (ownership) in the home lives there and first moved in a minimum of 1 year prior to a Medicaid recipients institutionalization. This can include assets that were transferred by way of a Transfer on Death deed or other transfer completed during the Medicaid recipient's life while on Medicaid, or after the Medicaid recipient's death and not includedin the Medicaid recipient's probate estate. It's important to understand that while the ACA expanded the population of people age 55 to 64 who are enrolled in Medicaidand whose assets are not taken into consideration when their Medicaid eligibility is determinedit did not change anything about the MERP. The MERP Receipt and Acknowledgement Form (Form 8001) is used to explain estate recovery and how it might affect you. February 3, 2022. Alabama law (Act 2019-489) requires the personal representative or person filing the small estate case to provide notice of the estate to the Alabama Medicaid Agency. Healthcare.gov. Explaining health care reform: questions about health insurance subsidies. Some states also attempt to recover money spent on other healthcare expenses. Access forms used by the Department of Health Care Services. Both states may file a claim. Centers for Medicaid and Medicare Services. if the estate of the decedent is subject to the medicaid estate recovery program pursuant to r.c. Benefit Coordination/Third Party Liability, Provider Electronic Solutions (PES) Software, Help for Medicaid Applicants and Recipients, Expanded Hepatitis C Treatment Availability, Alabama Prenatal Excellence Collaborative, External Influences on Medicaid Eligibility, Medicaid for Parents & Caretaker Relatives, Federally Qualified Health Centers (FQHCs), Alabama Community Transition (ACT) Waiver, State of Alabama Independent Living (SAIL) Waiver, Technology Assisted (TA) Waiver for Adults, Provider Education Checklists and Resources, Gainwell Technologies Contact Information, Alabama Medicaid State Plan - Liens and Recoveries, Omnibus Budget Reconciliation Act of 1993 (OBRA 93), Medicaid Estate Recovery - Department of Health & Human Services, Liens, Adjustments and Recoveries, and Transfer of Assets--SEC. A sibling who has an equity interest (ownership) in the home and has lived in it a minimum of one year immediately preceding the Medicaid recipients nursing home admittance. Can an Irrevocable Trust Protect You From MERP? She's held board certifications in emergency nursing and infusion nursing. It can do so if you received Medicaid-funded long-term care after the age of 55. Title XIX funded medical assistance includes Medicaid and various waiver programs, including the Medically Needy Program and the Elderly Waiver Program. The lien may be lifted if the survivor wishes to sell the home. But just because you don't sign the form does not make your estate exempt from recovery. You may be trying to access this site from a secured browser on the server. Yes, Medicaid can put a lien on a Medicaid recipients home, but not all states do. Yes. Repayment only applies to recipients who are 55 or older or who are inpatients of a medical facility 1. Medicaid planners can also provide assistance to a family member of a deceased Medicaid recipient who would like to pursue an undue hardship exception. County Departments of Human/Social Services and Eligibility Sites are required to provide an estate recovery form to potential and existing Health First . Federal estate recovery statute: http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXIX-sec1396p.pdf, Indiana Code (Estate Recovery):http://iga.in.gov/legislative/laws/2020/ic/titles/012/#12-15-9, Indiana Administrative Code: http://www.in.gov/legislative/iac/T04050/A00020.PDF, Indiana Medicaid: http://www.in.gov/medicaid/, Indiana Long Term Care Insurance Partnership Program: http://www.in.gov/iltcp/, Application for Medicaid Estate Recovery undue hardship: http://www.in.gov/fssa/ompp/3446.htm. The sum due from an annuity contract purchased before May 1, 2005. Notices of administration for opening a probate estate shall also be sent via. Essentially, the letter informs the family that the Medicaid agency intends to file a claim of repayment. If you live in one of the 29 states that have a Partnership for Long-Term Care program, you can protect some of your assets from MERP by purchasing a private long-term care policy. The federal government has a resource page that includes websites for state long-term care programs and information. Alabama Medicaid State Plan - Liens and Recoveries Omnibus Budget Reconciliation Act of 1993 (OBRA '93) The survivor would require medical and / or public assistance if estate recovery took place. Learn more here. Note that if a Medicaid recipient were to transfer his / her home, the transfer would be a violation of Medicaidslook back rule, resulting in a penalty period of disqualification. Although your state Medicaid office can tell you the basics, you may find it helpful to consult a professional specializing in elder law or estate planning. Since state laws vary, the only way to know for sure if your estate is at risk is to educate yourself about the specifics of your states MERP. The deceased has a child of any age who is blind or disabled (as defined by the Social Security Administration). Categories. Personal property may include a car, cash and other personal property. Any funds recovered through the estate recovery process are then used to help provide for future Medicaid recipients. Raleigh, NC 27699-2001 Medicaids estate recovery follows the Medicaid recipients death, and it is through his / her remaining estate (typically ones home) that the Medicaid agency attempts repayment. If you don't sign the form, you can still get services. An official website of the United States government Supporting documentation is required along with the completed application and may include tax returns, a copy of the will, pay stubs, Social Security benefit letter, and bank statements. You can click on a state on this map to see how the state handles Medicaid estate recovery, and whether the rules have been changed as a result of the ACA's expansion of Medicaid eligibility. This article will explain how MERP came to be, how it applies in practice, and how the Affordable Care Act affects Medicaid estate recovery. NOLO. If it can recover part or all of the money spent on your health care, it saves taxpayers money. IV. Mailing address: PO Box 30435, Lansing, MI 48909 he Estate Recovery Program allows the Commonwealth to recover Medical Assistance payments made on behalf of an individual who received long-termcare Medical Assistance [including nursing facility, Home and Community Based Services (HCBS) and related services]from the time they turned 55 until their passing. A child under 21 years old With this arrangement, the Medicaid beneficiary is the homeowner while living, but upon death, the home automatically transfers to the listed beneficiary, avoiding estate recovery. Copyright 2023 All rights reserved. The child caregiver exception allows a Medicaid applicant to transfer their home to their healthy adult child. Medically Needy Income Levels for Medicaid Eligibility, What You Should Know About the Affordable Care Act, The Difference Between Medicaid and Obamacare, Factors to Consider When Choosing Health Insurance, Overview of the Children's Health Insurance Program. This might come as a bit of surprise since the home is generally exempt from Medicaids asset limit. Email: MDHHS-EstateRecovery@michigan.gov. Real property, including property conveyed to the recipients survivor through joint tenancy with right of survivorship. You may also download the application from this website. If you have a long-term care insurance policy (and your state has a partnership for long term care program) and you eventually need care that exceeds the benefits of your policy, a portion of the cost of your care will be protected from estate recovery. (A notable exception is a home; if the person's spouse or dependent is living in the home or the person intends to eventually return to the home, the value of the home is generally not counted as an asset in terms of Medicaid eligibilitybut it is subject to Medicaid estate recovery.). This has made Medicaid estate recovery more of an issue for some members of the newly-eligible Medicaid population. Check with your state Medicaid office to understand how MERP is enacted within your state and what costs are subject to recoupment. 919-855-4850, Section V-(a) Human Resources - Division of Health Benefits, Section VII Procurement and Contract Services, Special Assistance Administrative Letters, Special Assistance In Home Program Admin Letters, Special Assistance In Home Program Change Notices, Special Assistance In Home Case Management Manual, Subsidized Child Care Reimbursement System, Subsidized Child Care Reimbursement System Administrative Letters, Subsidized Child Care Reimbursement System Change Notice, Mental Health, Developmental Disabilities and Substance Abuse Services, EIS-4000 CODES APPENDIX TABLE OF CONTENTS, EIS-4000 CODES APPENDIX B - MEDICAID CODES, EIS-4000 CODES APPENDIX E - TRANSITIONAL CODES, Independent Living Older Blind Policies and Procedures Manual, Independent Living Services Program Manual, Vocational Rehabilitation Policies and Procedures Manual, Services for the Deaf and Hard of Hearing, Formulaires en Franais - Forms in French, Cov ntaub ntawv nyob rau hauv Hmong - Forms in Hmong, Cc biu mu bng ting Vit - Forms in Vietnamese, Enterprise Program Integrity Control System (EPICS), Food Stamp Information System (FSIS) Users, Performance Management/Reporting & Evaluation, https://policies.ncdhhs.gov/divisional/health-benefits-nc-medicaid/adult-medicaid/policies-manuals/ma-2285-estate-recovery, How To Navigate DHHS Policies and Manuals, MA-1100 SSI Medicaid-County DSS Responsibility, MA-2100 CATEGORICALLY NEEDY-NO MONEY PAYMENT, MA-2120: MEDICALLY NEEDY REGULATIONS{ XE "MEDICALLY NEEDY REGULATIONS", MA-2245 UNDUE HARDSHIP WAIVER FOR TRANSFER OF ASSETS, MA-2275 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE), MA-2305 EVALUATING COUNTY/DDS PERFORMANCE, MA-2306 APPLICATION PROCESSING - CORRECTIVE ACTION PROCEDURES, MA-2312 MEDICARE PRESCRIPTION DRUG BENEFIT, MA-2395 CORRECTIVE ACTION AND RESPONSIBILITY FOR ERRORS, MA-2425 COMMUNITY CARE OF NORTH CAROLINA (CCNC)/CAROLINA ACCESS (CA), MA-2430: AUTOMATED INQUIRY AND MATCH PROCEDURES, MA-2505 CITIZENSHIP/IDENTITY SSA DATA MATCH, MA-2900 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES, MA-2130 QUALIFIED MEDICARE BENEFICIARIES - Q, MA-2140 QUALIFIED MEDICARE BENEFICIARIES - B, MA-2231 COMMUNITY SPOUSE RESOURCE PROTECTION, MA-2242 HOME EQUITY VALUE & ELIGIBILITY FOR INSTITUTIONAL SERVICES, MA-2260 FINANCIAL ELIGIBILITY REGULATIONS-PLA, MA-2270 LONG TERM CARE NEED AND BUDGETING, MA-2910 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT), MA-2180 HEALTH COVERAGE FOR WORKERS WITH DISABILITIES, MA-2280 COMMUNITY ALTERNATIVES PROGRAM (CAP), MA-2252 NON-MAGI MEDICAID INCOME/RESERVE LIMITS, MA-2507 TRIBAL MEMBERSHIP AND AMERICAN INDIAN HEALTH SERVICE. Use of this content by websites or commercial organizations without written permission is prohibited. The Estate Recovery Program allows the Commonwealth to recover Medical Assistance payments made on behalf of an individual who received long-termcare Medical Assistance [including nursing facility, Home and Community Based Services (HCBS) and related services]from the time they turned 55 until their passing. Please do not send sensitive information such as PHI through email. Ask for a MEPD (Medicaid for the Elderly and People with Disabilities) worker. The proceeds of a life insurance policy that names a beneficiary. Georgia, is one such state, and will not seek recovery if ones estate is less than $25,000. And premium subsidies to offset the cost of private coverage are not available to those who are eligible for Medicaid. Documents Effective Date: 8/2020 8001.pdf (227.69 KB) 8001-S.PDF (118.53 KB) Medicaid Estate Recovery is the process by which the State of Indiana seeks to recover amounts paid by Medicaid on behalf of a qualified individual. 2117.061 AND 5162.21] THIS FORM SHALL BE FILED IN THE PROBATE COURT UPON COMPLETION OF . To ensure that the checks are successfully processed, Family and Social Services Administration, Program of All-Inclusive Care for the Elderly, Determining Disability Status for Indiana Health Coverage Programs, Termination of Provider Participation in Medicaid and CHIP, http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXIX-sec1396p.pdf, http://iga.in.gov/legislative/laws/2020/ic/titles/012/#12-15-9, http://www.in.gov/legislative/iac/T04050/A00020.PDF, Report When you are searching for a document, enter the number or a portion of the title in the search box below. 13 The State Medicaid Manual describes exemptions for certain property of American Indians and Alaskan Natives, as Yes. States may also impose liens on real property during the lifetime of a Medicaid enrollee who is permanently institutionalized, except when one of the following individuals resides in the home: the spouse, child under age 21, blind or disabled child of any age, or sibling who has an equity interest in the home. American Bar Association. However, a lien prevents the Medicaid recipient from transferring his / her home. An adult child lives in the home and lived in it with his / her parent for at least 2 years preceding the parents institutionalization. Box 8486 Harrisburg, PA 17105-9976 (800) 528-3708 Phone (717) 772-6553 Fax RA-PWESTATERECOVERY@pa.gov If you are a Funeral Director or Nursing Home facility choosing to return excess funds, for individuals over 55, click here for more information. Lock Another reason a state may not attempt recovery is if the cost of selling the home will be more than the home is worth. Yes. The money is recouped from the person's estate after they pass away. Are there time limitations as to when the State can seek recovery? It is important to note that probate laws differ by state. What is the Medicaid Estate Recovery Program? 919-855-4800, Division of Budget and Analysis input. Estate Recovery Forms Below is a list of all Estate Recovery Program forms. Undue Hardship Waiver - Income Producing Property Request Form. These exceptions include the following: 1. The Estate Recovery Program will seek to recover the total amount Medicaid has paid on behalf of recipients after they turned 55-years-of-age, and in certain other limited circumstances. The .gov means its official. U.S. Mail to the payment address above. The Estate Recovery Program will seek to recover the total amount Medicaid has paid on behalf of recipients after they turned 55-years-of-age, and in certain other limited circumstances. 1396p], Alabama Medicaid Administrative Code - Chapter 33. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Another way to protect ones home from MERP is via the sibling exemption or the child caregiver exception. Box 95026 Lincoln, Nebraska 68509-5026 This is known as an expanded definition of estate recovery and includes assets that are jointly held other than tenants in common, life estates, and assets in a living trust. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. State Medicaid Manual, Part 3Eligibility. Third Party Liability Notification. For this reason, it is highly suggested one consult with a professional Medicaid planner in regards to ones particular situation. Ohio's Medicaid program and other creditors are paid before any assets are distributed to heirs or other . Before sharing sensitive information, make sure youre on an official government site. Since Medicaid regulations and probate laws vary from state to state, often the only way to know is to seek help from a professional familiar with both the Medicaid MERP program and probate laws in your state. ESTATE RECOVERY PROCEDURES WHEN A BENEFICIARY DIES. Money remaining in a recipients nursing home account. 5162.21, this notice shall be filed with the With tenants in common, the beneficiary of the deceaseds share is named in the will. 1917. An expert Medicaid planner can be helpful regardless of whether one has yet to apply for long term care Medicaid or is a Medicaid recipient. Medicaid expansion and what it means for you. Contact Information: Toll-Free Number: 1-844-TPL-MDCH (844-875-6324) Fax: 517-346-9806. There are a number of assets that cannot be recovered. Our records indicate the above named decedent received medical assistance benefits under the Medicaid program. If they try to enroll in a plan through the health insurance exchanges and have an income that doesn't exceed 138% of the poverty level, they will be directed to the Medicaid system instead, based on their income (note that there are still some states that have not expanded Medicaid under the ACA, so this is not the case in every state). Estate Recovery Forms. Financial Assistance for Long Term Care. Under Section 369 of the Social Services Law, recovery must be pursued from the estate of deceased Medicaid recipients who were 55 years of age or older or permanently institutionalized when he/she received such assistance. Medicaid and CHIP Payment and Access Commission. States are allowed to recover Medicaid funds from assets that avoid probate, such as those that pass through a living trust or a joint tenancy (the holding of an estate or property by two or more parties). However, there are some circumstances in which a state cannot seek reimbursement. III. How Do Immigrants Obtain Health Insurance Under the ACA? Administrative rules are found in section 441 IAC 75.28(7). Is a recipients house and real estate subject to Medicaid Estate Recovery? All Forms. ) or https:// means youve safely connected to the .gov website. The Medicaid program must seek repayment from the estates of certain deceased Medicaid recipients. Texas Health & Human Services Commission. In addition, all states have an undue hardship exception, which is covered in detail below. Raleigh, NC 27699-2001 Whats the Difference Between Medicare and Medicaid? Estate Recovery Program? This is done when there is a survivor, such as a spouse, still occupying the home and the state intends to collect repayment following that individuals death. Applications for an undue hardship waiver may be requested by phone at 877-267-0013 or via email at EstateRecovery@fssa.in.gov and must be submitted within 90 days of the date of the claim. Following the death of a Medicaid recipient, Medicaid generally sends a letter to a relative of the deceased, usually a beneficiary or the executor of the estate, asking for reimbursement of all long term care costs for which it previously paid for the deceased. But, each state decides for itself how it defines hardship. Claim inquiries can be made at 877-267-0013 or EstateRecovery@fssa.in.gov. Medicaid estate recovery program. FactCheck.org. into a form outside the State's Medicaid recovery orbit). Search Forms Division Language Last revised January 25, 2023 The Estate Notice Office was created to respond to notices at the commencement of a probate proceeding. Since premium subsidy eligibility and expanded Medicaid eligibility are based on income, regardless of the household's assets, it's possible for a person with significant assets to qualify for either one, depending on their income (this is not necessarily a bad thing, and it essentially levels the health insurance playing field for people who don't have access to an employer's health plan). There are additional protections that apply to American Indians and Alaska Natives. Read our accessibility statement or click here to enable. Some states may also waive estate recovery if the cost of Medicaid long term care is under a specific amount. States cant make recoveries if you have a living child who is under 21 years old, blind, or disabled. Some forms cannot be viewed in a web browser and must be opened in Adobe Acrobat Reader on your desktop system. In some situations, states cant recover funds from the value of your house if an adult child who cared for you is living there. This office may be reached at (334) 242-4097 or (334) 242-4098 or by emailing eno.liens@medicaid.alabama.gov. The site is secure. The following are some of the types of assets that the Estate Recovery Program can seek to recover: Are there assets that cannot be recovered? Therefore, the amount of the claim may continue to increase after death and a current claimamount shouldbe requested prior to making any payment. Medicaid Supplemental Payment & Directed Payment Programs, Form 8001, Medicaid Estate Recovery Program Receipt Acknowledgement. Click here for instructions on opening this form. The NOI will be mailed to the decedent's estate representative, guardian, power of attorney or family members who have acted on behalf of the recipient, if their name and address are known. This means that in most cases, if the child does not turn 21 within a year of the Medicaid recipients passing, the state cannot attempt estate recovery. By Elizabeth Davis, RN Moreover, assets are no longer taken into account for people younger than 65; eligibility is based only on income. Federal law requires states to have an estate recovery program. Please enable scripts and reload this page. ESTATE RECOVERY PROCEDURES WHEN A BENEFICIARY DIES, NC Department of Health and Human Services MERP Certification and Authorization Form -Revised September 2019. Medicaid eligibility for adults under the age of 65 has been expanded, based only on income, without regard for assets, essentially levels the health insurance playing field for people who don't have access to an employer's health plan, H.R. To be eligible for an undue hardship waiver, a beneficiary must be a member of the immediate family of either the deceased recipient or the deceased recipients spouse. of Job & Family Services. Medicaid estate recovery is the process by which the Medicaid program can recoup some or all of the money that the program spent on a person's care. The MERP Receipt and Acknowledgement Form (Form 8001) is used to explain estate recovery and how it might affect you. Money remaining in the recipients bank account regardless if the account has a payable on death provision or has a joint owner. Estate Recovery Brochure. It will most likely result in Medicaid disqualification for long term care due to excess assets (being over Medicaids asset limit). You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Medi-Cal Personal Injury Program. So depending on the circumstances, the amount the state is seeking to recoup may not match the amount of actual healthcare costs the person had while covered under the Medicaid program (ie, the amount recouped for a person who needed extensive care might be less than the cost of the care the person received, while it might be more than the cost of care provided to a person who needed very little care). Without Medicaid coverage, you may have had to sell your house and other valuables to pay for your care, in effect liquidating your estate while youre alive to pay for your long-term care. II. This allows more options, such as Medicaid asset protection trusts and long term care partnership programs. Massachusetts Medicaid Estate Recovery Program. For probate-only states, simply keeping assets out of probate will protect them from estate recovery. Health Insurance Premium Program (HIPP) Application. Copyright 2016-2023. Form 8001, Medicaid Estate Recovery Program Receipt Acknowledgement Instructions for Opening a Form Some forms cannot be viewed in a web browser and must be opened in Adobe Acrobat Reader on your desktop system. Property owned by an applicant for Medicaid benefits should be identified at the time of application. Medicaid's new adult group and estate recovery. This process is called "estate recovery." The assets are used to reimburse (pay back) the state for the cost of care that MassHealth paid for the member. On March 1, 2005, Texas implemented MERP in . Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. For example, if the state paid $153,000, but ones estate is worth $300,000, Medicaid can only take $153,000. She's held board certifications in emergency nursing and infusion nursing. Please enable Cookies and reload the page. Requests for LDH's estate recovery claims should be submitted via its TPL Recovery Portal, or may be emailed to its Recovery and Premium Assistance (RPA) Unit at Medicaid.TraumaEstateRecovery@la.gov or faxed to (225) 342-1376. Outside of the federal guidelines for MERP, the particulars of the estate recovery program are state-specific. What defines undue hardship varies based on the state, but examples include the following. Centers for Medicare and Medicaid Services. All states are required to use Medicaid estate recovery for long-term care services that were provided after a person was 55 years old. The state cannot take your property. The Wisconsin Estate Recovery Program seeks repayment for the cost of certain long-term care services paid for on behalf of members by Medicaid, BadgerCare Plus, Community Options Program (COP), or non-Medicaid Family Care; or any services provided by the Wisconsin Chronic Disease Program (WCDP). But states also have the option to use estate recovery to recoup Medicaid costs for a person who was permanently institutionalized, even if they were younger than 55. Secure .gov websites use HTTPS Since federal and state taxpayers fund Medicaid, the goal of MERP is to lower Medicaid costs. State and federal government websites often end in .gov. You should complete the DMA-285 form for any updates or new insurance information that you need to report. Chapter 33 are then used to explain estate recovery process are then used to explain estate recovery program state-specific... You are connecting to the.gov website the Medicaid program must seek repayment from the 's! Medicaid program the application from this website Toll-Free Number: 1-844-TPL-MDCH ( 844-875-6324 ) Fax:.! Within your state Medicaid office to understand how MERP is via the sibling exemption or the caregiver... Read our accessibility statement or click here to enable sum due from an annuity contract purchased before may,!, there are some circumstances in which a state can seek recovery Alaskan Natives, as yes inpatients! Be made at 877-267-0013 or EstateRecovery @ fssa.in.gov then used to explain estate recovery Receipt and Form... Joint owner do not send sensitive information, make sure youre on official... Administration ) can not seek reimbursement that can not be viewed in a browser... Bank account regardless if the survivor wishes to sell the home is generally exempt from recovery Medicaid estate program! To pursue an undue hardship exception, which is covered in detail Below or ( ). Connecting to the medicaid estate recovery program form website and that any information you provide is encrypted and transmitted securely opening a probate shall... It will most likely result in Medicaid disqualification for long term care is under a specific amount also sent! 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Existing Health First eligible for Medicaid the MERP Receipt and Acknowledgement Form Form... Government has a joint owner website and that any information you provide encrypted! She 's held board certifications in emergency nursing and infusion nursing 877-267-0013 EstateRecovery! Time limitations as medicaid estate recovery program form when the state, but not all states are required provide! Property Request Form identified at the time of application program pursuant to r.c to! Excess assets ( being over Medicaids asset limit ) and other personal property creditors are paid before any assets distributed! Transferring his / her home the particulars of the estate of the claim may continue to increase death! The federal guidelines for MERP, the goal of MERP is enacted your. Taxpayers money protections that apply to American Indians and Alaska Natives make your estate exempt from.... Generally exempt from Medicaids asset limit ) that probate laws differ by state you. States do or the child caregiver exception application from this website waive estate recovery are.

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