Estate Recovery (ER) Program
The Medi-Cal program pays for medical services and premiums, including payments to managed care plans, for people who are unable to pay for their own care. Upon death, the decedent’s estate or any recipient of the decedent’s estate may have to pay the costs of care back under federal and state law. Repayment will come from the assets of the deceased Medi-Cal member and will not exceed the asset value. Specific limitations or exemptions (PDF) may apply. The Department of Health Care Services (DHCS) may waive its claim if payment of the claim would cause a substantial hardship. Any request for a substantial hardship waiver must be submitted to DHCS within 60 days of the date on the DHCS Estate Recovery claim letter.
If you are the person handling the affairs of the deceased Medi-Cal member, you must provide “Notice of Death” to the Director of DHCS within 90 days of the date of death with a copy of the death certificate. To satisfy the “Notice of Death” requirement and for fastest processing, complete and submit online the “Notice of Death” form with a copy of the death certificate. You may also mail “Notice of Death” with a copy of the death certificate to DHCS at: Department of Health Care Services, Estate Recovery Section, MS 4720, P.O. Box 997425, Sacramento, CA 95899-7425.
Certain income and resources of American Indians and Alaska Natives are exempt from Estate Recovery. Please be sure to inform DHCS if the decedent’s property is on or near a federally recognized reservation, Pueblo, or Colony. A collection representative will contact you to clarify if DHCS can or cannot collect against these assets. For specific details on what assets are exempt from Estate Recovery please see the State Medicaid Manual, Section 3810 (7) and (8).
For general information, please email Estate Recovery at email@example.com, or call (916) 650-0590. If you have questions about a Special Needs Trust, click here.
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