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Title 8: Medicaid Page 25 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Estate Recovery Revised July 10, 2026 Establishing Whether a Member Under Age 55… Refer questions from members about estate recovery to the Iowa Medicaid Estate Recovery Unit at the toll-free number 1-888-513-5186 or in the Des Moines area, at (515) 246-9841. You may also give members Comm. 266, Iowa’s Estate Recovery Law, which gives detailed information about estate recovery procedures. Establishing Whether a Member Under Age 55 Can Return Home Legal reference: 441 IAC 75.28(7) Presume that a member in a medical institution who is under age 55 is unable to return home. You are required to inform members of this policy by manually issuing form 470-2980, Estate Recovery Notice for New Approvals, to all members who are under age 55 and a resident of a medical institution at the time of Medicaid approval. If a member under age 55 is discharged before six months has elapsed, no further action is necessary. Estate recovery will not be pursued because the member was not permanently institutionalized. A member in a medical institution who is under age 55 has the right to rebut this presumption. To do so, the member must make a written request to the Department after being in the institution for six months. If a member dies before six consecutive months of institutionalization, the family or another interested party may submit a written request to the Department to rebut the presumption that the member could not have been reasonably expected to be discharged. Inform members who are under age 55 of their rebuttal rights by manually issuing them form 470-3209, Estate Recovery Six-Month Follow-Up six months after their admission into the medical institution. If the member dies in the medical institution after a stay of less than six months, issue the form to the family or someone acting on the member’s behalf. Send all rebuttal requests to the Medical Services Unit at the Iowa Medicaid either by using the local mail or by U.S. mail to PO Box 36478, Des Moines, Iowa 50315. The Medical Services Unit determines whether the member can reasonably be expected to return home and sends a copy of its decision to you and to the member.