Oregon Medicaid Estate Recovery 2026: House & Estate Guide

Oregon Medicaid estate recovery applies after the death of a recipient 55 or older who received long-term care through the Oregon Health Plan. When a family member received nursing-facility care or home- and community-based services through Medicaid in Oregon, the Oregon Department of Human Services may file a claim against their estate to recover what the program paid. Understanding who is at risk, what assets are reachable, and which mandatory protections apply is the foundation for every decision a family needs to make.

This guide explains how Oregon implements the federal estate recovery mandate, what the probate-only definition means for real-world asset planning, who the law shields from recovery, and how to respond if ODHS files a claim.

What Estate Recovery Is and Where the Rules Come From

Every state Medicaid program is required by federal law to operate an estate recovery program. The mandate comes from the Omnibus Budget Reconciliation Act of 1993 (OBRA-93), codified at 42 USC § 1396p(b), with the implementing regulation at 42 CFR 433.36 and operational guidance at CMS State Medicaid Manual § 3810.

The federal floor requires states to recover from two populations:

1. Any permanently institutionalized Medicaid recipient of any age who received Medicaid-paid long-term services and supports (LTSS).
2. Any recipient who was 55 or older when they received nursing-facility services, home- and community-based services (HCBS), and related hospital and prescription-drug services.

States may go further, electing to recover for all Medicaid services received after age 55 and expanding the estate definition to reach non-probate assets. Oregon's implementation follows the federal floor and uses the probate-only estate definition.

Oregon's Medicaid program is branded as the Oregon Health Plan (OHP) and administered by the Oregon Health Authority (OHA). Long-term-care eligibility is handled by the Oregon Department of Human Services (ODHS) through its Aging and People with Disabilities (APD) program. Estate recovery is handled by ODHS.

Who Is Affected in Oregon

Recovery does not apply to all Oregon Health Plan recipients. It applies only when two conditions are both met:

• The recipient was age 55 or older when they received Medicaid-funded services, and
• Those services included long-term care: nursing-facility care, HCBS waiver services, or related hospital and prescription-drug services provided as part of a long-term-care episode.

Recipients who received only standard medical coverage, primary care, hospital care, mental health services, prescriptions, without a long-term-care component are not subject to estate recovery. Children's coverage under OHP, MAGI-based adult coverage, and Medicare Savings Program enrollees are not affected.

A note on Oregon's eligibility mechanics for context: Oregon is an income-cap state. A nursing-facility or HCBS-waiver applicant whose gross income exceeds $2,982/month must establish an Income Cap Trust, Oregon's name for the Qualified Income Trust, commonly called a Miller Trust elsewhere. Oregon does not have a medically needy spend-down program for long-term-care applicants. The asset limit is $2,000 for a single applicant. Families who have been through the ODHS eligibility process are already familiar with the Income Cap Trust mechanics. The important point for estate recovery is that the trust itself does not shelter other estate assets from recovery; it is an income-management vehicle for eligibility purposes.

What Oregon Can Recover

Oregon uses the federal-default probate-only estate definition, limiting recovery to property that passes through probate at death. Oregon has not adopted the expanded estate definition under 42 USC § 1396p(b)(4)(B) that would allow recovery from non-probate assets like joint property or revocable trust assets.

Assets typically subject to recovery (pass through probate):

• Real estate held solely in the deceased recipient's name with no transfer-on-death designation
• Bank accounts held in the recipient's sole name with no payable-on-death beneficiary
• Investment accounts in the recipient's sole name with no named beneficiary
• Vehicles and personal property titled only to the deceased

Assets that typically pass outside probate (not reachable):

• Real estate held in joint tenancy with right of survivorship
• Real estate with a recorded transfer-on-death deed
• Bank accounts with a named payable-on-death (POD) beneficiary
• Investment accounts with a named transfer-on-death (TOD) beneficiary
• Life insurance policies with a living named beneficiary
• Retirement accounts with a living named beneficiary
• Property held in a properly funded irrevocable trust

Oregon recognizes transfer-on-death deeds for real property. A home with a properly recorded TOD deed passes directly to the named beneficiary at death, outside probate, and outside the reach of estate recovery.

Federal TEFRA provisions at 42 USC § 1396p(a) permit states to place pre-death liens against homes of permanently institutionalized recipients. Those liens must be lifted if a spouse, minor child, or sibling with an equity interest moves in. Oregon may use TEFRA liens in appropriate cases.

Who Is Protected

Federal law at 42 USC § 1396p(b)(2) establishes five categorical protections that block estate recovery as long as certain conditions are met. Oregon follows all five.

Mandatory federal protections, all five apply in Oregon:

1. Surviving spouse. Recovery cannot proceed at all while the recipient's spouse is alive. This is automatic, no application needed. ODHS must defer its entire claim while the spouse is living.

2. Minor child. A surviving child of the recipient who is under age 21 blocks recovery for as long as that child is alive. It doesn't matter whether the child has any connection to a specific asset.

3. Blind or disabled child of any age. A child of the recipient who is blind or permanently and totally disabled under the SSI standard (42 USC § 1382c) blocks recovery for as long as they are alive.

4. Sibling with equity interest. If a sibling of the recipient had an equity interest in the home and lived there for at least one year before the recipient was institutionalized, and continues to lawfully reside there, recovery against the home is blocked during that residency.

5. Caregiver child. If an adult child lived in the recipient's home for at least two years before institutionalization, provided care during that time that delayed or prevented institutionalization, and continued to reside in the home since institutionalization, recovery against the home is blocked during that child's residency.

None of these require a formal waiver application. When a mandatory protection applies, the estate administrator or surviving family member notifies ODHS with documentation. The state must stand down. The surviving-spouse, minor-child, and disabled-child protections block recovery entirely, not just against the home, while the protected person is alive.

Hardship Waiver

Federal law at 42 USC § 1396p(b)(3) requires every state to establish procedures for waiving recovery in cases of undue hardship. Oregon follows the CMS State Medicaid Manual § 3810.C standards.

How to Respond to a Recovery Claim

When an Oregon Health Plan long-term-care recipient dies and an estate is being administered, here is how to approach the estate recovery question:

Step 1: Contact ODHS's estate recovery unit promptly. Reach ODHS APD through their local office or the statewide contact line at 1-800-699-9075. Identify yourself as the estate administrator and ask whether a Medicaid estate recovery claim exists and what the claimed amount is.

Step 2: Check for mandatory protections first. Confirm whether there is a surviving spouse, a child under 21, or a blind or disabled child. If any of these exist, notify ODHS in writing with documentation. Recovery cannot proceed.

Step 3: Assess caregiver-child and sibling-with-equity protections. If an adult child or sibling meets the residency and caregiving requirements, document those facts and present them to ODHS. Gather records showing when the person moved in, what care they provided, and that they have continued to live there.

Step 4: Confirm which assets pass through probate. Review the estate with an eye toward what has beneficiary designations, what is jointly held, and what passes by TOD deed. Non-probate assets are outside the reach of estate recovery.

Step 5: Consider a hardship waiver if the facts support it. A modest family home, an asset the family depends on for income, or other compelling circumstances all support a written hardship request.

Step 6: Respond within the probate creditor-claim period. Oregon's probate code sets deadlines for creditors to present claims. ODHS's estate recovery claim is a creditor claim and subject to those deadlines. It does not take priority over funeral expenses and estate administration costs, which rank higher in probate.

If you believe the amount claimed exceeds what Oregon Medicaid actually paid, ask ODHS for a detailed accounting. Recovery is limited to actual payments made.

Learn More

• Oregon Medicaid Eligibility and Income Limits
• How to Apply for Oregon Medicaid
• Medicaid Estate Recovery Explained

Find personalized help understanding Oregon Medicaid estate recovery at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.