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California Probate Estate Planning Trusts

How California Families Can Protect Their Loved Ones from Medicaid Estate Recovery: A Complete Guide for 2026

Source: Justice in Aging – Mitigating the Harmful Effects of Medicaid Estate Recovery

Who This Guide Is For

If you’re a California resident who has a loved one receiving Medicaid benefits—or you’re planning for your own future long-term care—you need to understand Medicaid estate recovery. This policy allows the state to recover costs from a deceased beneficiary’s estate, potentially forcing families to sell their homes or deplete inheritances meant for children and grandchildren.

This guide is designed for:

  • Adult children whose aging parents are on Medi-Cal (California’s Medicaid program)
  • Seniors and disabled individuals who rely on Medicaid for healthcare or long-term care
  • Estate planning attorneys and advocates working to protect vulnerable California families
  • Anyone concerned about preserving their family home after receiving government healthcare assistance
  • What Is Medicaid Estate Recovery and Why Does It Matter?

    Medicaid estate recovery is a federal requirement that allows states to recoup money spent on certain Medicaid services after a beneficiary passes away. In California, this means the state can place liens on homes, bank accounts, and other assets to recover costs for:

  • Nursing home care
  • Home and community-based services
  • Hospital and prescription drug costs for individuals age 55 and older
  • The problem: Many families don’t learn about estate recovery until after a loved one dies—when it’s too late to plan. The family home, which may have been in the family for generations, can be seized or forced into sale to satisfy the state’s claim.

    Real-World Example: How Estate Recovery Affects California Families

    Consider Maria, a 78-year-old Sacramento resident who received Medi-Cal benefits for in-home care services over five years. When Maria passed away, the state filed a claim against her estate for $180,000. Her adult daughter, who had been living in and maintaining the family home, was forced to either buy out the state’s interest or sell the property—despite having no other place to live.

    Cases like Maria’s happen thousands of times each year in California. Without proper planning, families lose their financial security and generational wealth.

    5 Proven Strategies to Protect Your Family from Medicaid Estate Recovery

    1. Establish a Living Trust Before Receiving Medicaid

    Placing your home and other assets into a properly structured living trust before applying for Medicaid can shield those assets from estate recovery. However, timing is critical—transferring assets within five years of applying for Medicaid can trigger penalty periods.

    Key considerations:

  • Work with an experienced California estate planning attorney who understands Medi-Cal rules
  • Ensure the trust is irrevocable for maximum protection
  • Plan early—ideally 5+ years before needing long-term care
  • 2. Use Exemptions and Hardship Waivers

    California law provides several exemptions from estate recovery, including:

  • Surviving spouse exemption: No recovery if a spouse survives the Medicaid recipient
  • Disabled or blind child exemption: No recovery if the deceased has a disabled or blind child of any age
  • Child caregiver exemption: If an adult child lived in the home for at least two years and provided care that delayed nursing home placement
  • Undue hardship waiver: Available when recovery would cause significant financial distress to surviving family members
  • Important: These exemptions must be actively claimed—they don’t happen automatically. Families need to file proper documentation with the California Department of Health Care Services (DHCS).

    3. Consider Life Estate Deeds

    A life estate deed allows a Medicaid recipient to retain the right to live in their home for life while transferring ownership to their children or other beneficiaries. This can remove the home from the probate estate subject to recovery.

    Pros:

  • Property passes outside of probate
  • Can potentially avoid estate recovery if structured correctly
  • Preserves the home for family members
  • Cons:

  • Subject to the five-year Medicaid look-back period
  • May have capital gains tax implications for beneficiaries
  • Can complicate future property sales or refinancing
  • 4. Advocate for Policy Changes at the State Level

    California advocates have successfully pushed for reforms to limit estate recovery. Recent changes include:

  • Elimination of recovery for community-based services (as of January 2017)
  • Expanded hardship waiver criteria
  • Improved notice requirements to families
  • Continuing advocacy efforts focus on further limiting recovery to only nursing home care and improving transparency in the recovery process.

    5. Work with Specialized Legal Counsel

    The intersection of Medicaid planning, estate planning, and probate law is complex. Generic online documents or non-specialized attorneys may miss critical protections that could save your family hundreds of thousands of dollars.

    What to look for in an attorney:

  • Specific experience with California Medi-Cal estate recovery cases
  • Understanding of both estate planning and elder law
  • Transparent fee structures and clear communication
  • A track record of successfully protecting family assets
  • How Can I Prepare If My Loved One Is Already Receiving Medicaid?

    Even if a family member is currently receiving Medi-Cal benefits, there are still steps you can take:

  • Document caregiving: If an adult child is providing care, keep detailed records of care activities and living arrangements
  • Understand exemption eligibility: Review whether your situation qualifies for any of California’s exemptions
  • Request a hardship waiver: Begin gathering financial documentation to support a hardship claim
  • Consult with an attorney immediately: Even late-stage planning can sometimes reduce or eliminate estate recovery exposure
  • What Happens During the Estate Recovery Process in California?

    Understanding the timeline helps families prepare:

  • Notice period: DHCS must send notice of its intent to recover within a certain timeframe after death
  • Claim filing: The state files a claim against the estate during probate
  • Asset evaluation: The estate’s assets are assessed to determine what can be recovered
  • Exemption review: Families can submit exemption claims or hardship waiver requests
  • Settlement or payment: The estate must either pay the claim or negotiate a settlement
  • Critical timing note: Families typically have 30-90 days to respond to estate recovery notices. Missing deadlines can forfeit your rights to exemptions.

    Common Questions About Medicaid Estate Recovery

    Can the state take my house while I’m still alive?

    No. Medicaid estate recovery only occurs after the beneficiary’s death. Your home is protected while you’re living, and if your spouse still lives there.

    Does estate recovery apply to all Medicaid benefits?

    In California, recovery is limited to:

  • Nursing facility services
  • Home and community-based services for individuals age 55+
  • Related hospital and prescription drug services
  • Regular Medi-Cal benefits for doctors’ visits and basic healthcare are generally not subject to recovery.

    What if the estate has no assets?

    If there are no probate assets, there’s typically nothing for the state to recover. However, the state may still file liens against real property.

    Can I appeal an estate recovery claim?

    Yes. Families have the right to:

  • Challenge the amount of the claim
  • Assert exemptions
  • Request hardship waivers
  • Dispute the state’s valuation of assets
  • Why California Families Choose California Probate and Trust, PC for Estate Recovery Protection

    At California Probate and Trust, PC, we’ve helped hundreds of California families navigate the complex intersection of Medicaid planning, estate planning, and asset protection. Our approach combines:

  • Proactive planning: We help clients structure their estates before Medicaid becomes necessary, maximizing protection
  • Crisis intervention: Even when a loved one is already receiving benefits, we identify available protections and exemptions
  • Family-centered advocacy: We understand the emotional and financial stress of these situations and provide compassionate, clear guidance
  • Transparent pricing: Our estate planning packages are clearly structured with no hidden fees
  • With offices in Fair Oaks, Sacramento, and San Francisco, we’ve served thousands of California families facing these exact challenges.

    Take Action Now: Protect Your Family’s Legacy

    Medicaid estate recovery doesn’t have to mean losing your family home or depleting your children’s inheritance. With proper planning and knowledgeable legal guidance, you can protect what you’ve built while still accessing the healthcare benefits you need.

    Next steps:

  • Schedule a free consultation: Contact California Probate and Trust, PC at (866) 674-1130 for a no-obligation discussion of your situation
  • Gather your documents: Bring information about current assets, Medicaid benefits, and family circumstances
  • Explore your options: Learn about trusts, exemptions, and other strategies specific to your family’s needs