Estate Recovery FAQs

What laws govern the Estate Recovery Program? Answer: The rights and responsibilities of DHCS, health care providers, Medi-Cal beneficiaries and their representatives are outlined in the California Code of Regulations (CCR), Title 22, §50960-50966; California Medical Assistance Program, Division 3, Subdivision 1, Article 19; Welfare and Institutions Code (W&IC) §14009.5; Probate Code § 215, 9202, and 9203; the United States Code (USC) § 1396; and Senate Bill 833.

How is the obligation to repay MC for health care services established?                                                                                      Answer: California law requires that the estate attorney, executor, administrator, heir(s), or anyone who receives assets from a deceased MC client, must provide written notice and a copy of the death certificate to DHCS within 90 days of the beneficiary’s death. Notice of death should be forwarded to:

Director, c/o Department of Health Care Services, Estate Recovery Section, MS 4720, P.O. Box 997425, Sacramento, CA 95899-7425.

Notice to the County or Social Security Administration does not satisfy this requirement. DHCS can present a claim within four months of receiving the notice of death.

What if the survivor or heir cannot afford to pay the Estate Recovery claim?                                                                              Answer: DHCS may waive or reduce its claim if payment of the claim would cause a substantial hardship. An application for Hardship Waiver is included with each claim.

Is an allowance made for estate debts and expenses? Answer: The value of the estate is reduced by the amount of outstanding debts and certain expenses, including burial expenses.

The client currently receiving MC benefits wants to start paying off the debt now so that the surviving spouse and family are not burdened later.  Answer: DHCS does not have a claim until after the MC client’s death and the death of the surviving spouse. Nothing is owed during a client’s or surviving spouse’s lifetime.

The survivor or heir believes that there is an error in the amount of services reflected on the bill. What should they do? Answer: If the survivor believes there is an error on the bill related to the claim amount or the services provided, the survivor/heir should contact the collection representative indicated on the claim letter.

 The survivor or heir wants to pay the claim, but the only estate asset is a home. The survivor/heir would like to keep the home. Answer: A lump sum payment is not possible. Whether the estate consists of a home, bank account or other asset, payment options are available. The survivor/heir may contact the collection representative indicated on the claim letter for assistance.

Will the State take the house? Answer: If the estate does not have sufficient other resources to repay Medi-Cal, DHCS may allow a voluntary lien to be placed on the house to ensure payment of its claim.

 Where should questions regarding Probate and Estate Recovery, including Hardship Waiver Requests, be directed to?    Answer: All questions regarding Probate and Estate Recovery, including Hardship Waiver Requests, are to be referred to the DHCS Estate Recovery Unit.

Department of Health Care Services Estate Recovery Unit, MS 4720

P.O. Box 997425

Sacramento, CA 95899-7425

Phone: (916) 650-0490

Fax: (916) 650-6584