If you receive Medicaid coverage for long-term care services, federal law requires states to recover the amount Medicaid spent on your behalf from your estate after you die. Your state's probate law generally defines what an estate includes, but for the most part it includes all of the real and personal property you own when you die, such as your home and other assets. The state is required to recover the cost of long-term care services, including nursing home care and home and community-based services. But, states can choose to recover the cost of all the services Medicaid paid for if they wish to do so.

Estate recovery happens after the death of a Medicaid recipient who was either permanently institutionalized or age 55 and older when he or she received Medicaid services. Some estates are exempt from estate recovery. For example, if your spouse is still alive, your estate is exempt from recovery. In these cases, states may recover from the spouse's estate after his or her death. Your heirs can also seek a hardship waiver from estate recovery.