What to Do With Medicare and Medicaid After Someone Dies

Two Programs, Two Sets of Rules

Medicare and Medicaid are often confused — and the steps you need to take after a death are different for each. Most people over 65 had both, or one, and each program has its own notification requirements, its own paperwork, and its own potential financial implications for the estate.

This can feel overwhelming when you're already grieving. The most important thing to know upfront: the financial impacts are manageable if you act promptly and know what to expect. Nothing here should blindside you if you approach it step by step.

Notifying Medicare

You do not need to contact Medicare yourself in most cases. When you notify the Social Security Administration of a death (which you should do as soon as possible — call 1-800-772-1213), SSA automatically notifies Medicare, since they are administered together. The Medicare coverage ends the month of death.

However, there are a few things you do need to handle directly:

Return any Medicare-issued equipment. If the deceased received durable medical equipment (a wheelchair, hospital bed, oxygen equipment, CPAP machine, etc.) under Medicare Part B, some items are owned by Medicare and must be returned. Contact the equipment supplier — their contact information should be on any paperwork or delivery documents. Suppliers are legally required to pick up rented equipment.

Watch for overpayments. If Medicare or Medicare Advantage made any payments for services provided after the date of death, those payments will be recouped from the provider, not from the estate. You typically don't need to take action, but keep an eye on any Explanation of Benefits (EOB) documents that arrive after the death.

Cancel Medicare supplemental (Medigap) policies. These private policies (Plan G, Plan N, etc.) require separate cancellation. Contact the insurance company directly with a copy of the death certificate to stop premium payments and request any refund of premiums paid beyond the date of death.

Medicare Advantage (Part C) Plans

If the deceased was enrolled in a Medicare Advantage plan (marketed as "Medicare Part C" — these are private plans that bundle Parts A and B), you need to contact the plan administrator directly in addition to notifying SSA. Advantage plans handle their own claims processing and premium billing separately from traditional Medicare.

Call the plan's member services number, report the death, and request that the account be closed and any automatic premium payments stopped. If premiums were paid by automatic bank draft, stop that payment from the bank side as well once you've confirmed the plan has been notified.

Medicaid: Understanding Estate Recovery

Medicaid is the program that provides healthcare coverage for people with limited income and assets. For many elderly individuals, Medicaid covered the cost of long-term care — nursing home care, assisted living, or home health aides. This is where estate recovery can become a significant issue.

What is the Medicaid Estate Recovery Program (MERP)?

Federal law requires states to attempt to recover costs paid by Medicaid for certain long-term care services from the estates of deceased Medicaid recipients age 55 or older. The state files a claim against the estate — essentially asking to be repaid for what Medicaid spent on the deceased's care before assets are distributed to heirs.

This is not a penalty or a surprise charge — it is a standard part of how Medicaid long-term care funding works. But it can be significant. Long-term nursing home care can cost $7,000–$10,000 per month or more, and Medicaid pays those costs when a recipient has limited assets. If the estate includes a house or other assets, the state may have a substantial claim.

Which states can recover?

All states have MERP programs, but the scope varies considerably. Some states limit recovery to nursing home and home health costs; others recover from a broader range of Medicaid expenditures. Some states pursue recovery aggressively; others have limited staff resources and may not pursue smaller estates.

What assets are subject to recovery?

Typically, the estate's probate assets are subject to MERP — assets that go through the probate process. Some states have expanded their definitions to include certain non-probate assets. A home is the most common asset subject to recovery.

Exemptions and hardship waivers:

Most states exempt the home from immediate recovery if a surviving spouse is still living there, if a disabled or blind child lives there, or if a sibling who has an equity interest lived in the home for at least one year before the deceased entered care. If recovery would cause undue hardship, you may be able to apply for a hardship waiver — the state's MERP office can tell you about the process.

What to do:

• Contact your state's Medicaid agency or MERP office as soon as you take on the executor role
• Ask for a statement of what, if anything, the state intends to claim against the estate
• Do not distribute estate assets until you understand the state's position
• If the claim seems incorrect or excessive, you have the right to request an administrative review

Getting help:

Estate recovery disputes can be complex, especially when the deceased's home is involved. An elder law attorney — one who specializes in Medicaid and estate issues — is worth consulting if the potential claim is significant. Many offer free or low-cost initial consultations for estate matters.

Medicaid Notification Process

Notify your state Medicaid agency directly. A certified death certificate and the deceased's Medicaid ID number (found on their Medicaid card) are the starting point. The state will then determine what, if any, recovery it intends to pursue.

Every state has a different process and timeline — but acting promptly protects you as executor from being caught off guard by a state claim after you've already distributed assets.