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Medicaid Planning · North Carolina

North Carolina Medicaid estate recovery

Medicaid estate recovery rules for North Carolina.

Published: September 4, 2026. Last checked: September 2, 2026.

Recovery scope

North Carolina files a claim against the deceased recipient's estate for covered long-term-care and related services: for permanently institutionalized recipients under 55 and for recipients 55 or older who received covered nursing-facility, CAP or other specified HCBS, personal-care, related hospital, or prescription services under the manual's rules.

Source: North Carolina Medicaid Manual MA-2285, Estate Recovery [state-medicaid-agency] — Revised May 22, 2023 — Change No. 08-23

Controlling authority

North Carolina General Statutes § 108A-70.5, administered through Medicaid Manual MA-2285.

Source: North Carolina Medicaid Manual MA-2285, Estate Recovery [state-medicaid-agency] — Revised May 22, 2023 — Change No. 08-23

Exemptions and deferrals

DHB waives recovery when total estate assets are under $50,000 or total Medicaid benefits paid are under $10,000, and defers while a spouse survives, a child is under 21, or a child of any age is blind or disabled.

Source: North Carolina Medicaid Manual MA-2285, Estate Recovery [state-medicaid-agency] — Revised May 22, 2023 — Change No. 08-23

Hardship-waiver path

A hardship claim must be filed within 60 days of notice. Grounds include qualifying sole-income-producing estate property with household income below 200% of the federal poverty level, or forced sale of a qualifying heir's residence under the manual's residency, income, ownership, and asset tests.

Source: North Carolina Medicaid Manual MA-2285, Estate Recovery [state-medicaid-agency] — Revised May 22, 2023 — Change No. 08-23

Lien practice

North Carolina estate recovery is a post-death estate claim; MA-2285 expressly states that estate recovery does not include placing a lien on the property. DHB may take legal measures to secure a deferred claim against estate property.

Source: North Carolina Medicaid Manual MA-2285, Estate Recovery [state-medicaid-agency] — Revised May 22, 2023 — Change No. 08-23

Sources

Methodology & sources

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

General information, not legal advice.