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Title 8: Medicaid Page 27 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Estate Recovery Revised September 13, 2024 Amount Due Amount Due Legal reference: 441 IAC 75.28(7) The debt due the Department from the member’s estate is equal to all medical assistance provided on the member’s behalf on or after:  The date the person attained age 55, or  The date a person under age 55 entered a medical institution with no reasonable expectation of returning home. However, no debt is due for assistance provided before July 1, 1994 (the beginning of the estate recovery program). Effective January 1, 2010, Medicaid payments for Medicare cost-sharing benefits are excluded from estate recovery for the following members:  Qualified Medicare Beneficiaries (QMB)  Specified Low-Income Medicare Beneficiaries (SLMB)  Expanded Specified Low-Income Medicare Beneficiaries (E-SLMB)  Qualified Disabled Working People (QDWP)  Dually eligible for a full Medicaid coverage group and QMB  Dually eligible for a full Medicaid coverage group and SLMB Medicare cost-sharing benefits include Medicaid payments for Medicare Part A and Part B premiums, copayments, coinsurance, and deductibles. If a member under the age of 55 is discharged from the facility and returns home before six consecutive months, no debt is assessed for Medicaid payments made on the member’s behalf for the time of the institutionalization. A claim against the estate of a member who was eligible for Medicaid because resources were disregarded under the Long-Term Care Asset Preservation program is computed differently. The amount of the assets disregarded under this program is not subject to estate recovery. EXCEPTION: Medicaid paid before the member attained eligibility due to long-term care asset preservation is still recovered from the estate. Interest accrues on a debt due beginning six months after the death of a Medicaid member, surviving spouse, or surviving child, or upon the minor child reaching age 21. The Department does not use liens in the estate recovery program.