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a. the spouse of the Medicaid beneficiary is still living; or

b. the beneficiary has a surviving child, who is under age 21; or

c. the beneficiary has a surviving child of any age who is blind or disabled according to the Social Security Administration definition.

d. a qualified undue hardship applicant continues to meet the undue hardship criteria.

2. When none of the four circumstances are present, DHB will resume estate recovery.

3. If recovery is deferred due to one of the conditions listed above, DHB may take legal measures to secure its claim against property of the Medicaid beneficiary’s estate.

D. Physician Disability Certification

A disabled surviving adult child who has reached full Social Security retirement age and for whom Social Security cannot make a disability determination because of their age, may have their disability certified by a physician.

1. Complete the “Physician Disability Certification for North Carolina Medicaid Estate Recovery Exemption for Surviving Disabled.”

a. This form is provided to the beneficiary by the HMS Estate Recovery Unit.

b. If the individual contacts the local agency, refer them to HMS Estate Recovery Unit, 1-866-455-0109.

2. Mail to the Third-Party Recovery vendor for review at:

Division of Health Benefits HMS Estate Recovery Unit PO Box 18869 Raleigh, North Carolina 27619-8869

3. Once approved, the surviving adult child will receive notification from the Third-Party Recovery vendor (HMS) that the claim has been deferred until the criteria is no longer met by the surviving adult child.

DocuSign Envelope ID: FDC5A36F-C20D-40ED-8E94-3167F2A747A6 DocuSign Envelope ID: 9CB30F35-4CFE-41A3-8663-00DA59A946C6