Tenncare Estate Recovery

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TennCare is the state of Tennessee's Medicaid program, serving low-income residents. During the eligible TennCare recipient's lifetime, medical and nursing home care is provided by Medicaid, but after death TennCare will initiate an estate recovery process to reimburse funds spent on the patient's care. Estate recovery is mandated under both federal and state law.

TennCare Estate Recovery

The estates of TennCare patients dying after the age of 55 are subject to TennCare estate recovery. These include persons receiving services in a nursing home facility or from the state's Home and Community Based Services. TennCare may only recover the actual amount of funds expended on the decedent's care. It does not include any interest or penalties. Any assets of the estate, unless the exemption request is deemed valid and approved, are subject to recovery.

Exemptions

Surviving spouses of TennCare patients will not have TennCare pursue recovery from the estate until after their death, if the spouse submits an exemption request. Documentation of legal marriage is required. If the decedent left a minor child or children, TennCare will not pursue recovery until the youngest child turns 18 if the child or children's representative submits an exemption request. Birth certificates including the decedent's name as parent must be submitted to prove the child's relationship to the decedent. If the decedent left a child with disabilities whose condition occurred prior to the 18th birthday, TennCare will not purse recovery until the death of the child if an exemption request is submitted, along with a copy of the Social Security Disability determination providing proof of the disability prior to age 18, along with the same birth certificate information as minor children.

Tanner Decision

In 2009, the Tennessee Supreme Court ruled regarding the estate of Martha M. Tanner. In its decision, the court ruled that estate recovery claims must be paid out of estate assets, even if TennCare does not file a probate court claim for recovery within one year of the decedent's death. All other claims against an estate must be filed within one year.

Recovery Determination

The estate's personal representative may submit a request to release form, with all required documents, to the Bureau of TennCare. This includes a certified copy of the death certificate. The bureau then determines whether or not money is owed by the estate for TennCare services. If no money is due, it will issue a release. If it determines that money is owed to TennCare by the estate, the bureau files a claim against the estate for recovery, listing the amount due. By law, personal representatives must file a statement with the probate court that TennCare does not have a claim or its has been settled and a release issued. The personal representative may be found personally liable for any estate recovery if closing the estate without the TennCare statement.

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