Yes, the government can take your home after a Medicaid recipient dies. Here’s how to protect yourself.

Medicaid estate recovery is a federal requirement, not a state option. Under law, states must seek reimbursement from the estates of deceased Medicaid recipients who received certain long-term care services or who were age 55 or older at the time of death. When a recipient passes, the state files a claim against the probate estate, and if the only significant asset is real estate, that property can become the source of repayment. This is why a family home is often sold to settle the claim.

The crucial detail is that exemptions and hardship waivers exist, but they are not automatic. States have flexibility in how aggressively they pursue recovery, yet they are still mandated to make the attempt. Surviving spouses, minor children, and some low-income heirs may qualify for deferral or relief, but those protections must be actively claimed through the proper channels—silence on the part of the estate can be interpreted as consent.

For those concerned about exposure, the practical takeaway is that planning must happen before a claim is filed. Estate structures, proper documentation, and understanding your state's specific recovery rules are the relevant variables to watch. Given how much variation exists across jurisdictions, the specifics of your location will ultimately determine the available options.