Editorial note: This page is education only. We are not a law firm, an elder-law attorney, a Medi-Cal planner, or a tax advisor. Rules change and counties apply them differently. Before you sign, transfer, or file anything after a loved one dies on Medi-Cal, work with a licensed California elder-law attorney, ideally a Certified Elder Law Attorney (CELA).
Last updated: August 15, 2026 · By Gold California Editorial
Quick answer: For Californians who died on or after January 1, 2017, Medi-Cal Estate Recovery reaches only the probate estate, and only for long-term-care services received at age 55 or older. Assets that pass by beneficiary designation, joint tenancy, transfer-on-death deed, community-property-with-right-of-survivorship title, or a living trust are outside recovery's reach. The rule is codified at Welfare and Institutions Code section 14009.5.
Short on time? The essentials
- The reform bill authored by Assemblymember Chiu as AB 1428 (2015-16) was enacted through the 2016 budget process as SB 833, Chapter 30, Statutes of 2016.
- The current rule is codified at California Welfare and Institutions Code section 14009.5.
- It applies to Medi-Cal members who die on or after January 1, 2017.
- Recovery reaches only the probate estate, not living trusts, joint tenancy, TOD deeds, or community-property-with-right-of-survivorship title.
- Recovery applies only where the member received recoverable services at age 55 or older, or was permanently institutionalized at any age.
- The state cannot recover when the member leaves a surviving spouse or registered domestic partner (a lifetime bar for that survivor).
- The state cannot recover when a surviving child is under 21, blind, or disabled under 42 USC 1382c.
- DHCS must waive the claim, subject to federal approval, when the estate is a homestead of modest value.
- A voluntary post-death lien accrues at 7 percent simple interest, or the annual Surplus Money Investment Fund rate, whichever is lower.
- A member 55 or older can request an estimate of the recoverable amount once per calendar year for a fee capped at 5 dollars.
Few California topics generate more anxious phone calls to elder-law attorneys than Medi-Cal Estate Recovery. Most of that anxiety is out of date. The rule set changed materially in 2016 for people who die on or after January 1, 2017.
This page walks through what recovery actually reaches under current California law, what the state cannot touch, who is exempt, and how a family responds to a recovery notice. Everything below traces to Welfare and Institutions Code section 14009.5, federal Medicaid law at 42 USC 1396p, and the Department of Health Care Services (DHCS) estate-recovery guidance.
What Medi-Cal Estate Recovery is
Medi-Cal is California's Medicaid program. Federal Medicaid law at 42 USC 1396p(b) requires states to recover certain payments made on behalf of members who died at age 55 or older, or who were permanently institutionalized at any age.
Recovery is a claim, filed by DHCS after the member dies, against assets that pass through the deceased member's estate. It is not a lien on your home during life for most members, and it is not a tax. It is a debt claim, subject to statutory limits and exceptions.
California went further than federal minimums for many years. The 2016 reform narrowed California's rules back to the federal floor, and in some places below it.
The 2016 reform (AB 1428, enacted via SB 833)
Assemblymember David Chiu introduced AB 1428 in the 2015-16 session to narrow Medi-Cal Estate Recovery to what federal law requires. The reform did not pass as a stand-alone bill. Its substance was folded into the 2016 state budget process and enacted as SB 833 (Committee on Budget and Fiscal Review), Chapter 30, Statutes of 2016, section 22.
The reform amended Welfare and Institutions Code section 14009.5. It applies to Medi-Cal members who die on or after January 1, 2017. Deaths before that date remain governed by the old, broader recovery rules and are outside the scope of this page.
Four changes matter most for California families today. First, the definition of "estate" was narrowed. Second, the list of recoverable services was narrowed. Third, a homestead-of-modest-value hardship waiver was added. Fourth, recovery from a member survived by a spouse or registered domestic partner was barred outright, for that survivor's lifetime.
Who Medi-Cal can recover from
Under WIC 14009.5(b), DHCS can file a recovery claim only in two situations. Both are drawn from federal Medicaid law at 42 USC 1396p(b)(1).
The first situation is a permanent institutionalization determination at any age. A member of any age who was determined permanently institutionalized in a nursing facility, intermediate care facility, or other medical institution, and who was an inpatient at death, is recoverable.
The second situation is the age 55 or older trigger. A member who received Medi-Cal-covered health-care services at age 55 or older is recoverable, subject to the survivor exceptions below.
Recovery is fully barred when any of these survivors exist
Per WIC 14009.5(b)(2)(B) and 42 USC 1396p(b)(2), DHCS cannot claim against a decedent's estate when the decedent leaves any of the following survivors:
- A surviving spouse.
- A surviving registered domestic partner.
- A surviving child under age 21.
- A surviving child, of any age, who is blind or disabled under section 1614 of the Social Security Act (42 USC 1382c).
The surviving spouse bar lasts for that spouse's lifetime. The state can later attach the surviving spouse's own estate, but only for that surviving spouse's own recoverable Medi-Cal services, not for the deceased member's. This is one of California's more protective rules and turns on documentation of the survivor relationship at the deceased member's date of death.
What counts as the recoverable estate
WIC 14009.5(a)(2) limits the definition of "estate" to what federal law requires the state to collect against. Federal law at 42 USC 1396p(b)(4)(A) uses the estate definition under state probate law. That means California recovers only against the probate estate.
Anything that passes to heirs outside probate is outside recovery's reach. Common non-probate transfer forms in California include:
- Assets held in a revocable living trust at death.
- Assets held in joint tenancy with right of survivorship (Civil Code section 683).
- Assets held in community property with right of survivorship (Civil Code section 682.1).
- Real property with a recorded transfer-on-death deed (Probate Code section 5600).
- Retirement accounts and life-insurance policies with a living named beneficiary.
- Bank and brokerage accounts with a valid pay-on-death designation.
| Asset or transfer form | Reachable by recovery? | Legal basis |
|---|---|---|
| Real property held in the decedent's sole name at death | Yes, through probate | WIC 14009.5(a)(2); Cal. Probate Code § 13100 et seq. |
| Bank account in decedent's sole name, no POD designation | Yes, through probate | WIC 14009.5(a)(2) |
| Personal property (vehicles, coins, personal items) in decedent's sole name | Yes, through probate | WIC 14009.5(a)(2) |
| IRA, 401(k), pension with a living named beneficiary | No | Beneficiary designation moves the asset outside probate under Cal. Probate Code § 5000 |
| Life-insurance policy with a living named beneficiary | No | Beneficiary designation moves the proceeds outside probate |
| Bank or brokerage account with a valid pay-on-death (POD) designation | No | Cal. Probate Code § 5140 et seq. (Multiple-Party Accounts Law) |
| Real property held in joint tenancy with right of survivorship | No | Cal. Civil Code § 683; passes outside probate to surviving joint tenant |
| Real property titled community property with right of survivorship (CPWROS) | No | Cal. Civil Code § 682.1; passes outside probate to surviving spouse |
| Real property with a recorded transfer-on-death (TOD) deed | No | Cal. Probate Code § 5600 et seq.; passes outside probate to named beneficiary |
| Any asset held in a revocable living trust at death | No | Trust assets pass by trust terms, not probate |
| Any of the above, when the decedent leaves a surviving spouse or RDP | No (fully barred) | WIC 14009.5(b)(2)(B)(i); 42 USC 1396p(b)(2)(A) |
| Any of the above, when the decedent leaves a minor, blind, or disabled child | No (fully barred) | WIC 14009.5(b)(2)(B)(ii) and (iii) |
Sources: California Welfare and Institutions Code section 14009.5; California Probate Code sections 5000, 5140, 5600, 13100; California Civil Code sections 682.1, 683; 42 USC 1396p; CANHR California's Medi-Cal Recovery Program FAQ (Fact Sheet 45). Checked August 2026.
Which services are recoverable
WIC 14009.5(a)(1) limits recovery to services that federal law requires the state to recover. Federal law at 42 USC 1396p(b)(1)(B) lists three categories: nursing-facility services, home and community-based services (HCBS), and related hospital and prescription-drug services provided while the member received the first two.
Routine primary-care visits, non-related prescriptions, dental, vision, and managed-care Medi-Cal premiums for members who never received long-term care are not recoverable under the 2017-forward rules. In practice, that means most Medi-Cal members whose only benefit was regular medical coverage generate no recovery claim at all.
In-Home Supportive Services (IHSS) hours and Medicare Savings Program cost-sharing paid by Medi-Cal are also outside recovery reach under the current rules, consistent with CMS guidance and DHCS practice.
The substantial hardship waiver
Under WIC 14009.5(c)(1), DHCS must waive its claim, in whole or in part, if enforcement would cause substantial hardship to other dependents, heirs, or survivors. The statute requires DHCS to notify individuals of the waiver right and of the opportunity for a hearing.
Subdivision (c)(2) adds a mandatory homestead-of-modest-value waiver, subject to federal approval. DHCS treats a home as "modest value" when its fair market value at the decedent's date of death is 50 percent or less of the county's average home sale price for the same period. This waiver protects a family home that would otherwise be forced into a sale to satisfy the claim.
Common substantial-hardship grounds also include the survivor's dependence on the property for shelter or income, the survivor's own age or disability, and the survivor's ability to satisfy the claim from other sources.
The voluntary post-death lien and compromise
Where survivors want to keep a family home rather than sell it to pay the recovery claim, WIC 14009.5(d) allows DHCS to accept a voluntary post-death lien. The lien accrues at the lower of the annual average rate on the Surplus Money Investment Fund for the year before the decedent's death, or 7 percent simple interest per year.
DHCS also settles many claims through a voluntary compromise, especially where the estate value is limited or the recovery cost would exceed the claim. Survivors initiate these negotiations by responding to the recovery notice and providing DHCS with the estate inventory, hardship documentation, and any survivor-status evidence.
Consider a $60,000 Medi-Cal Estate Recovery claim against a modest Sacramento County home that the surviving adult daughter wants to keep. DHCS agrees to a voluntary post-death lien under WIC 14009.5(d).
- Interest cap: 7 percent simple, or the annual Surplus Money Investment Fund rate for the year before death, whichever is lower.
- Assume the SMIF rate for the prior year averaged 4.5 percent. The applied rate is 4.5 percent, not 7.
- Annual accrual on the $60,000 principal: 60,000 × 0.045 = 2,700 dollars per year.
- The lien sits against the property until sale, refinance, or death of the survivor. The principal plus accrued interest is paid at closing.
This is an illustration only, not Medi-Cal or legal advice. Each county and each estate is different. Work with a licensed California elder-law attorney before you sign any voluntary lien or compromise agreement.
The notice process after death
California Probate Code section 215 requires the personal representative of a deceased Medi-Cal member (or, if none, the survivors or attorney handling the estate) to notify DHCS within 90 days of the death. DHCS then issues an initial notice of the potential claim.
DHCS generally issues a Notice of Estate Recovery within a few months of receiving the death notice. Survivors have a right to a copy of the itemized services claim, a right to request the substantial-hardship waiver, and a right to a hearing under WIC 14009.5(c)(3). Do not ignore a Notice of Estate Recovery. The waiver and appeal rights have deadlines.
How survivors typically respond, step by step
- Read the notice carefully. Confirm the decedent's date of death, age, and identifying information are correct.
- Assemble survivor documentation. Marriage certificate, RDP registration, adult child's SSA disability award, or birth certificate showing minor age at the date of death.
- Request the itemized claim from DHCS if it is not included. WIC 14009.5(e)(1) sets a 90-day response deadline for these requests.
- Consult a licensed California elder-law attorney (ideally a CELA) before signing any acknowledgement, waiver, lien, or compromise.
- Submit the substantial-hardship waiver request, and any survivor-bar evidence, within the notice's response window. Request a hearing if the initial waiver is denied.
How to request an estimate of the claim
Under WIC 14009.5(e), a current or former Medi-Cal member who is 55 or older, or who is permanently institutionalized, may request an estimate of the recoverable amount once per calendar year for a fee capped at 5 dollars. The request can be made through the DHCS website, by telephone, or by mail.
DHCS must provide the estimate within 90 days of receiving the request and any supporting documentation needed to identify the member. Some families use this pre-death estimate to inform planning conversations with an elder-law attorney while the member is still alive.
A worked California scenario
Consider a widowed Los Angeles County resident who died at age 82 in 2024. She had received two years of skilled nursing facility (SNF) care on Medi-Cal Long-Term Care. Total Medi-Cal SNF payments during that period were $180,000. Her estate at death consisted of these assets:
- A house in her sole name, fair market value at death $650,000, with no living trust or TOD deed.
- A traditional IRA of $120,000, naming her only adult daughter as sole beneficiary.
- A checking account of $8,000 in her sole name, no POD designation.
- A savings account of $22,000 held jointly with her adult daughter, with right of survivorship.
- Personal effects with modest resale value.
Applying WIC 14009.5 and 42 USC 1396p:
- She was 82 at death and received SNF services after 55. Trigger met.
- She left no surviving spouse, no minor child, and no blind or disabled child. The survivor bars do not apply.
- Recoverable assets are the probate assets only: the house and the sole-name checking account.
- Non-recoverable assets: the IRA passes to the daughter by beneficiary designation; the joint savings account passes to the daughter by survivorship. Both are outside probate and outside recovery reach.
- If the county's average home sale price for that period exceeded $1.3 million, the homestead is 50 percent or less of the county average and the mandatory homestead-of-modest-value waiver could apply, subject to federal approval.
- Without a waiver, the daughter can request a voluntary post-death lien on the house at the capped interest rate, or pursue a substantial-hardship waiver, rather than sell the home.
The daughter should not sign anything before consulting a licensed California elder-law attorney. This is a hypothetical for education only.
When this rule set is not the biggest concern
Estate recovery is one piece of Medi-Cal planning. It is not always the piece that matters most. A few honest cases where recovery deserves less attention than the story around it usually gets:
- The Medi-Cal member's total benefit was regular medical coverage, not long-term care. Under the 2017-forward rules, most non-LTC services are not recoverable, so a large claim is unlikely.
- The estate is small and passes under California's simplified small-estate procedures. Real property with a gross value at or below $750,000 (deaths from April 1, 2025 under AB 2016) can bypass full probate.
- The member is survived by a spouse or RDP, or by a minor, blind, or disabled child. Recovery is fully barred while any such survivor is living.
- All meaningful assets already pass outside probate through a living trust, TOD deed, CPWROS title, or beneficiary designations. There is no probate estate for the state to reach.
The right response is usually not to buy an insurance product or restructure a portfolio in a panic. It is to sit down with a licensed California elder-law attorney and confirm which of these fact patterns already fits your family.
Common questions
Does California take your house when you die on Medi-Cal?
Only when the house is in the deceased member's sole name at death and passes through probate, and only if no surviving spouse, RDP, or minor, blind, or disabled child exists. A home held in a living trust, in joint tenancy, in CPWROS title, or transferred by TOD deed passes outside probate and outside recovery reach under WIC 14009.5.
Who exactly is exempt from Medi-Cal Estate Recovery in California?
Under WIC 14009.5(b)(2)(B), recovery is fully barred when the deceased member leaves any of four survivors. Those are a surviving spouse, a surviving registered domestic partner, a surviving child under 21, or a surviving child of any age who is blind or disabled under 42 USC 1382c. The spouse or RDP bar lasts for that survivor's lifetime.
What is the age 55 trigger for estate recovery?
Under WIC 14009.5(b)(2)(A), estate recovery only applies to Medi-Cal services received at age 55 or older, unless the member was permanently institutionalized at any age. Services received before age 55 are not recoverable from the estate, even if the member later turned 55.
Can Medi-Cal recover from a living trust in California?
No. WIC 14009.5(a)(2) limits recovery to the probate estate. A revocable living trust distributes by its terms outside probate and stays outside recovery reach. Some counties initially issue notices that include trust assets; the fix is to respond with a copy of the trust and the pour-over will documenting the transfer at death.
How long does California have to file a Medi-Cal recovery claim?
California Probate Code section 9202 requires DHCS to file its claim within four months after Letters Testamentary or Letters of Administration issue, or within 60 days after DHCS receives notice from the estate under Probate Code 215, whichever is later. Late-filed claims are barred. Personal representatives should give the required notice promptly.
What is a voluntary post-death Medi-Cal lien?
Under WIC 14009.5(d), DHCS can accept a voluntary lien against a family home so the survivors can keep the property rather than sell it to pay the claim. The lien accrues interest at the lower of the annual Surplus Money Investment Fund rate or 7 percent simple interest per year. The lien is paid off at sale, refinance, or the survivor's death.
Can I find out in advance how much Medi-Cal will claim from my estate?
Yes. Under WIC 14009.5(e), a member 55 or older, or a permanently institutionalized member, may request an estimate once per calendar year for a fee of no more than 5 dollars. Requests can be submitted online, by telephone, or by mail. DHCS must respond within 90 days.
Do I need a Certified Elder Law Attorney to handle a recovery notice?
A licensed California attorney with elder-law experience is enough for many families. Certified Elder Law Attorney (CELA) status, granted by the National Elder Law Foundation and recognized by the State Bar of California, signals additional focus on this area. CANHR publishes a free Lawyer Referral Service at 1-800-474-1116 for families who need help finding local counsel.
Sources
- California Legislative Information, Welfare and Institutions Code section 14009.5. Statutory basis for post-2017 Medi-Cal Estate Recovery, added by SB 833 (Chapter 30, Statutes of 2016, section 22). Checked August 2026.
- California Legislative Information, SB 833 (2015-16 session) legislative history. Committee on Budget and Fiscal Review; approved by the Governor June 27, 2016. Checked August 2026.
- California Legislative Information, AB 1428 (2015-16 session, Chiu) legislative history. Reform bill whose substance was folded into SB 833. Checked August 2026.
- Cornell Legal Information Institute, 42 U.S.C. section 1396p (liens, adjustments and recoveries, and transfers of assets). Federal statute defining mandatory Medicaid estate recovery scope and survivor exceptions. Checked August 2026.
- California Department of Health Care Services, Estate Recovery Program. DHCS program landing page and forms. Checked August 2026.
- CANHR, California's Medi-Cal Recovery Program Frequently Asked Questions (Fact Sheet 45). Advocacy-side summary of WIC 14009.5, hardship waivers, and the notice process. Checked August 2026.
- California Probate Code section 215. Personal-representative notice-to-DHCS requirement (90 days after death). Checked August 2026.
- California Probate Code section 9202. Deadline for DHCS to file its claim; four months after Letters issue, or 60 days after Probate Code 215 notice, whichever is later. Checked August 2026.
- California Civil Code section 682.1. Community property with right of survivorship (CPWROS) title. Checked August 2026.
- California Probate Code section 5600 et seq.. Simple Revocable Transfer on Death Deed (TOD deed). Checked August 2026.
