Medi-Cal Estate Recovery in California: What the State Can and Cannot Claim

The Department of Health Care Services (DHCS), which runs Medi-Cal, says the program must seek repayment from the estates of certain members who have died. Repayment applies only to benefits received on or after the member's 55th birthday, and only when the member owned assets at death. In DHCS's words, if a deceased member owns nothing when they die, nothing will be owed.

Estate recovery is not an eligibility rule. DHCS states that the asset limits used to decide who qualifies are not the same as the rules for estate recovery. A home that was not counted while a person was alive can still be part of the estate later. The eligibility side is in our guide to Medi-Cal asset and income rules.

The state also cannot collect more than was left. Welfare and Institutions Code section 14009.5 sets the claim at the amount Medi-Cal paid for the covered services or the value of the property, whichever is less.

A 2016 law, Senate Bill 833, narrowed the program for anyone who dies on or after January 1, 2017. DHCS publishes a one-page comparison. The main differences are:

For deaths in 2017 or later, DHCS limits repayment to payments made, including managed care premiums, for nursing facility services, home and community-based services, and related hospital and prescription drug services received while the person was a nursing facility inpatient or was getting home and community-based services.

California Advocates for Nursing Home Reform (CANHR), a nonprofit that publishes consumer fact sheets, explains what that means in practice. In its fact sheet updated May 14, 2026, it says the state can no longer recover for basic health services such as ordinary doctor visits. It lists the Medi-Cal Assisted Living Waiver among the home and community-based programs whose costs can be recovered. It also says payments for personal care under In-Home Supportive Services are exempt, and that a separate rule covers people of any age who have been found to be permanently institutionalized.

A member who was 55 or older when the services were received, or an authorized representative, can find out what has built up. DHCS accepts a Request for Medi-Cal Expenses Subject to Estate Recovery, form DHCS 4017, once per calendar year for a $5 processing fee. The statute gives the department 90 days to answer.

Section 14009.5 bars a claim when the member is survived by:

• A spouse or registered domestic partner.
• A child who is under 21.
• A child of any age who is blind or disabled under the Social Security definition.

The other limit is the definition of estate. For deaths in 2017 or later it means property in the person's probate estate. CANHR explains that property that does not go through probate, such as a home held in a living trust, is not subject to a claim, and that retirement accounts and life insurance with a named beneficiary are not reached either.

How a home or account is titled is a legal decision. CANHR warns that any transfer of real property can have tax consequences that outweigh an estate claim. This guide does not tell you what to do with property: ask an elder law attorney or a legal aid program for older adults. For the house itself, see selling a house to pay for assisted living. For couples, Medi-Cal spousal protection explains what the spouse at home keeps during life.

DHCS may waive its claim when paying it would cause substantial hardship. The steps and deadlines it publishes are:

1. 1

   Send the notice of death

   DHCS says the person handling the member's affairs must give notice of death to the Director of DHCS within 90 days, with a copy of the death certificate. There is an online form on the Estate Recovery Program page. CANHR points out that telling the county Medi-Cal office does not count as this notice.

2. 2

   Read the claim letter and the itemized bill

   CANHR says the state must send an itemized billing with a claim, and advises checking it for services that are not recoverable.

3. 3

   Apply for a hardship waiver within 60 days

   The Application for Hardship Waiver, form DHCS 6195, must be submitted within 60 days of the date on the claim letter. DHCS waives the applicant's proportionate share of the claim when one or more of its hardship criteria apply, so each heir applies for his or her own share.

4. 4

   Check the homestead of modest value rule

   For deaths on or after January 1, 2017, the statute requires a waiver when the estate is a homestead of modest value: a home whose fair market value is 50 percent or less of the average price of homes in the county on the date of death. DHCS asks for a probate appraisal or a licensed appraiser's report.

5. 5

   Ask about the caregiver criterion and appeal rights

   CANHR describes a waiver for an heir who lived in the home and gave care for two or more years that delayed the member's move to an institution. It adds that a denied applicant can request an estate hearing within 60 days of the decision.

Hamssa Benrekia is a senior living placement specialist in Torrance who works with families in the South Bay and Harbor area of Los Angeles County. Estate recovery is a legal matter, and she does not advise on it or on Medi-Cal eligibility. What she can do is help you find a licensed home that fits your relative's care needs and budget, including a board and care home. If paying for care is the worry, our guide to what happens when the money runs out may help. To talk it through, contact Hamssa. The full series is in the California Assisted Living Placement Guide.