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Title 8: Medicaid Page 28 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Estate Recovery Revised July 10, 2026 When Estate Recovery is Waived When Estate Recovery Is Waived Legal reference: 441 IAC 75.28(7) Waiver of collection from the estate based on undue hardship is determined on a case-by-case basis. Collection of the debt from the estate of a Medicaid member is waived when collection of the debt would result in:  Reduction in the amount received from the member’s estate by a surviving spouse, or by a surviving child who is under age 21, blind, or permanently and totally disabled at the time of the member’s death, or  Other undue hardship. Undue hardship exists when all of the following are true: • The household that claims hardship has gross monthly income, as defined by Family Investment Program (FIP) policy, of less than 200% of the poverty level for a household of the same size. • The household that claims hardship has total resources, as defined by FIP policy, that do not exceed $10,000. • Application of estate recovery would deprive a person of food, clothing, shelter, or medical care such that the person’s life or health would be endangered. When a person claims undue hardship, refer the person to the program manager for Estate Recovery at the Iowa Medicaid. If collection of all or part of a debt is waived for a surviving spouse or child, or for hardship, the amount waived creates a debt due from:  The estate of the member’s surviving spouse or blind or disabled child, upon the death of the spouse or child,  A surviving child who was under 21 years of age at the time of the member’s death, or upon the child reaching age 21,  The estate of a surviving child who was under age 21 at the time of the member’s death, if the child dies before reaching age 21, or  The person who received the hardship waiver if the hardship no longer exists or from the estate of the person, whichever is first. The debt owed by the surviving spouse, child, or person who received the hardship waiver will not exceed the amount in which recovery was waived.