Under what circumstances does Medicaid require repayment?

Medicaid may require repayment under the estate recovery program, which typically occurs when a Medicaid recipient passes away and has received long-term care services. States can pursue recovery from the deceased's estate for benefits paid after the age of 55, including nursing home care and certain home and community-based services. Additionally, repayment may be sought if the recipient was not eligible for Medicaid or if benefits were obtained through fraud. However, states have discretion in how they implement these recovery efforts, and there are exemptions for surviving spouses and certain dependents.