How to Obtain and Review Documentation of a Medicaid Claim Against an Inherited Estate in North Carolina

Quick Answer

In North Carolina, you can obtain documentation of a Medicaid Estate Recovery claim by (1) checking the probate file at the Clerk of Superior Court in the county where the estate is being administered and (2) contacting the NC Division of Health Benefits – Estate Recovery Section for an itemized claim summary. Once you have the paperwork, compare each charge to the limits in N.C. Gen. Stat. §108A-70.5 and the probate priority rules in §28A-19-6 to confirm that the amount is enforceable and correctly classified.

Why the State Files a Medicaid Claim

Under the federal Medicaid Estate Recovery mandate and North Carolina’s enabling law, the state must try to recover certain benefits paid to a Medicaid recipient who (a) was 55 or older when the services were provided or (b) lived in a nursing facility on a permanent basis. The claim is filed like any other creditor claim in probate, but it enjoys a high priority under §28A-19-6(a)(5).

Step-by-Step – How to Obtain the Paperwork

1. Identify the Personal Representative

Only the executor (named in a will) or an administrator (appointed for an intestate estate) has the legal duty to deal with creditors. If you are the personal representative, you have an automatic right to the claim file. If you are an heir or devisee, the representative must give you a copy when you reasonably request it.

2. Retrieve the Claim in the Probate File

1. Go to the Estates Division of the Clerk of Superior Court in the county where probate was opened.
2. Ask for the estate file by the decedent’s name and estate number (e.g., “21 E 123”).
3. Look for a creditor’s claim titled “NC Division of Health Benefits Estate Recovery Claim” or a similar caption. The document will list a dollar amount and a certification of mailing to the personal representative.
4. Purchase a certified copy for your records.

3. Request an Itemized Statement from the Estate Recovery Section

1. Call the Estate Recovery Section at 919-855-4082 or email estate.recovery@dhhs.nc.gov. Have the decedent’s Medicaid ID or Social Security # ready.
2. Complete Form DHHS-2204 (Authorization to Disclose) if you are not the personal representative. Fax or mail it as instructed on the form.
3. The Section will mail or email an Itemized Statement of Services that lists each date of service, provider, and amount paid.

4. Confirm the Claim’s Legal Standing

With the statement in hand, review each charge against these checkpoints:

• Age Limit – Services must be provided after the recipient turned 55 (§108A-70.5(b)).
• Service Type – Recovery is limited to nursing‐home, home- and community-based, and related hospital or prescription costs.
• Date of Death + Probate Timeline – The State must file its claim within the 3-month creditors’ period that starts when the personal representative publishes “Notice to Creditors” (§28A-19-3).
• Hardship Waiver – Heirs may request a waiver (e.g., if the heir provided caregiver services) within 30 days of receiving the claim notice (§108A-70.5(c)).

Practical Example

Maria’s mother, age 79, received nursing-home Medicaid from 2019 to 2022 and passed away in Wake County. Maria opens probate and publishes Notice to Creditors. Within two months, she receives a $72,000 claim from the Estate Recovery Section. Maria requests an itemized statement, then sees that $8,000 of the charges pre-date her mother’s 55th birthday. She sends a written objection to the Estate Recovery Section and files a “Notice of Dispute” with the Clerk. The State amends its claim to $64,000.

Helpful Hints for Heirs and Personal Representatives

• Keep every billing statement; you have only 90 days to dispute inaccuracies once the claim is filed.
• If real estate passes outside the estate (e.g., joint tenancy with right of survivorship), Medicaid can still place a lien in some cases—consult counsel before transferring the deed.
• The Medicaid claim is a Class 4 claim under §28A-19-6; funeral costs and administrative expenses get paid first.
• You may negotiate a payment plan with the State once the final amount is set.
• Always notify the Estate Recovery Section before distributing assets—personal representatives are personally liable for wrongful distributions.

Need Help Protecting Your Inheritance?

A Medicaid claim can drain the estate if handled incorrectly. Our North Carolina probate attorneys routinely review, dispute, and resolve Estate Recovery claims. Call us today at (919) 341-7055 for a free consultation.