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Medicaid Planning · Massachusetts

Massachusetts Medicaid estate recovery

Medicaid estate recovery rules for Massachusetts.

Published: September 4, 2026. Last checked: September 5, 2026.

Recovery scope

For deaths on or after August 1, 2024, recovery is limited to federally required nursing-facility, HCBS, and related hospital and prescription services received at age 55 or older, plus the federally required permanently institutionalized category.

Source: MassHealth estate-recovery overview [state-medicaid-agency] — Service-scope rules apply to deaths on or after August 1, 2024 Additional authority: Massachusetts General Laws chapter 118E, section 31 [state-legislature] — Current statute amended effective June 12, 2026

Controlling authority

Massachusetts General Laws chapter 118E, section 31

Source: Massachusetts General Laws chapter 118E, section 31 [state-legislature] — Current statute amended effective June 12, 2026

Exemptions and deferrals

Recovery waits until there is no surviving spouse and no surviving child under 21 or blind or disabled.

Source: Massachusetts General Laws chapter 118E, section 31 [state-legislature] — Current statute amended effective June 12, 2026 Additional authority: MassHealth estate-recovery overview [state-medicaid-agency] — Service-scope rules apply to deaths on or after August 1, 2024

Hardship-waiver path

The appointed personal representative or public administrator must submit the waiver request and supporting documents within 60 days after notice of the claim. MassHealth provides residence-based, care-provided, and income-based waiver paths; reducing an inheritance alone is not hardship.

Source: MassHealth general-policy regulations 130 CMR 515.011 and 515.012 [state-medicaid-agency] — Transmittal by Eligibility Letter 255; revised February 13, 2026

Lien practice

A pre-death lien requires institutionalization, no protected relative in the home, and a determination that the member cannot reasonably return home, with notice and fair-hearing rights. Collection is deferred for a qualifying one-year sibling or two-year caregiver child, and the lien is discharged if the member returns home.

Source: MassHealth general-policy regulations 130 CMR 515.011 and 515.012 [state-medicaid-agency] — Transmittal by Eligibility Letter 255; revised February 13, 2026

Sources

Methodology & sources

Checked at least annually and whenever recovery statutes, waivers, liens, or agency practices change.

General information, not legal advice.