Can Medicaid still come back later with a claim even if I was told the benefits were closed? – North Carolina

Short Answer

Yes. In North Carolina, “benefits closed” usually means Medicaid coverage stopped during life, not that the State gave up its right to seek repayment from the estate after death. If the decedent received Medicaid services that trigger estate recovery, the North Carolina Department of Health and Human Services (DHHS) can still present an estate claim after death, but it must follow North Carolina’s estate creditor-claim deadlines and notice rules.

Understanding the Problem

Under North Carolina probate law, the question is whether DHHS can still act as an estate creditor after a Medicaid case was “closed,” and whether a personal representative must still look for and address a Medicaid estate recovery claim. The key trigger is the recipient’s death, because estate recovery is tied to what Medicaid paid during life and what property is part of the probate estate. The practical issue is how to confirm whether a claim was filed in the estate file and whether any deadline has started running based on the estate’s creditor notices.

Apply the Law

North Carolina runs a Medicaid Estate Recovery program through DHHS. If the decedent received certain Medicaid-covered services, DHHS may seek repayment from the decedent’s “estate” after death, up to the amount Medicaid paid for covered services. In probate, DHHS is treated like a creditor and generally must present its claim within the time limits that apply to creditor claims against estates, unless a specific exception applies.

Key Requirements

Medicaid services that trigger estate recovery: Estate recovery is tied to specific categories of Medicaid-paid services (often long-term care-related services and certain services for recipients age 55+), not simply the fact that someone had Medicaid at some point.
A claim presented to the estate: DHHS typically must present a written claim in the estate administration (often filed in the estate file and/or delivered to the personal representative) to be paid from estate assets.
Compliance with estate claim deadlines and notice rules: Whether DHHS can “come back later” often turns on whether the estate properly published notice to creditors and mailed notice to known creditors, and whether DHHS presented its claim within the applicable deadline.

What the Statutes Say

N.C. Gen. Stat. § 108A-70.5 (Medicaid Estate Recovery Plan) – Establishes North Carolina’s Medicaid estate recovery program and explains what may be recovered and how DHHS is treated as an estate creditor.
N.C. Gen. Stat. § 1-22 (Actions involving a decedent’s personal representative) – Ties certain post-death actions to the estate claim presentment deadlines in Chapter 28A.

Analysis

Apply the Rule to the Facts: Here, the estate administration is trying to confirm whether the decedent received Medicaid and whether DHHS filed a claim. Even if someone said the Medicaid “benefits were closed,” DHHS may still have an estate recovery claim if the decedent received Medicaid services that qualify for recovery and the claim is presented within the probate claim deadlines. The most reliable confirmation usually comes from (1) the estate file with the Clerk of Superior Court and (2) direct confirmation from DHHS’s estate recovery/third-party recovery unit, rather than relying only on mail being collected by someone else.

Process & Timing

Who files: DHHS (as a creditor) presents an estate claim. Where: the estate administration file maintained by the Clerk of Superior Court in the county where the estate is being administered. What: a written creditor claim (often filed in the estate file and/or delivered to the personal representative). When: generally within the estate creditor-claim deadlines triggered by the estate’s notice to creditors (including any mailed notice to known creditors).
Personal representative’s notice steps: The personal representative typically publishes notice to creditors and also mails notice to known creditors. When Medicaid estate recovery may apply, it is important that notice be sent to DHHS so the shorter “known creditor” deadline can start running.
After a claim is received: The personal representative reviews the claim and either pays it in the proper priority order, negotiates/compromises where appropriate, or rejects it. If a claim is rejected, the creditor generally must take the next step within the time allowed after rejection or risk being barred.

Exceptions & Pitfalls

Confusing “case closed” with “estate recovery closed”: A Medicaid coverage closure during life does not necessarily mean DHHS has waived estate recovery after death.
Not treating DHHS as a known creditor when appropriate: If the personal representative has reason to believe Medicaid benefits were received, failing to mail notice to DHHS can leave uncertainty about whether DHHS had to meet a shorter deadline.
Relying only on mail collection: A claim may be filed in the estate file even if mail is missed or delayed. Checking the estate file with the Clerk of Superior Court is often the fastest way to confirm whether a claim was filed.
Paying and distributing too early: Distributing estate assets before the creditor period ends (or before resolving a known Medicaid issue) can create avoidable problems if a valid claim later appears.

For more background on probate claim deadlines, see our article on how long creditors have to file claims against an estate.

Conclusion

In North Carolina, Medicaid benefits being “closed” does not automatically prevent DHHS from later presenting a Medicaid estate recovery claim after the recipient’s death. The key questions are whether the decedent received Medicaid services that trigger estate recovery and whether DHHS presented its claim within the probate creditor-claim deadlines that apply to estate creditors. The next step is to check the estate file with the Clerk of Superior Court and confirm whether notice to DHHS was sent, because that notice can control the claim deadline.

Talk to a Probate Attorney

If dealing with a possible Medicaid estate recovery claim while administering an estate, our firm has experienced attorneys who can help clarify what notices were sent, what deadlines apply, and what to do next. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.