Ill. Admin. Code tit. 89, § 102.210 - Estate Claims
a)
Definitions in this Section are as follows:
1)
"Estate" - all real and personal property within an individual's estate as
provided in the Probate Act of 1975 [
755 ILCS
5 ]. For a decedent who received benefits under a
qualified long term care insurance policy in connection with which assets were
disregarded (see subsection (f), the term "estate" includes all real and
personal property in which the individual had legal title or interest at the
time of death (to the extent of that interest), including assets conveyed to a
survivor, heir or assignee of the deceased person through joint tenancy,
tenancy in common, survivorship, life estate, living trust or other
arrangement.
2) "Beneficiary" - any
person nominated in a will to receive an interest in property other than in a
fiduciary capacity.
3) "Heir" - any
person entitled under the statutes to an interest in property of a
decedent.
b) The
Department's claim against the estate of a deceased recipient or against the
estate of the recipient's deceased spouse, regardless of the order of death,
shall encompass:
1) All income maintenance
assistance paid out at any time; and
2) All medical assistance paid out:
A) at any time for a permanently
institutionalized recipient whose real property is subject to the Department's
lien; or
B) except the costs of
Community Care Program (CCP) services, prior to October 1, 1993, for a
recipient 65 years of age or older; or
C) on or after October 1, 1993, for a
recipient 55 years of age or older; or
D) for Medicare cost sharing expenses (Part A
and B premiums, deductibles, coinsurance and copayments) made on behalf of
persons described in 42
U.S.C. 1396a(a)(10)(E), when
a request for payment of those expenses was received by the Department prior to
January 1, 2010. Requests for payment of Medicare cost sharing expenses made
after January 1, 2010 are exempt from estate
recovery.
c)
The claim shall apply to assistance provided to or on behalf of a recipient on
or after the following dates:
Assistance Program |
Effective Date |
||
1) |
AABD (Aged) (AABD(A)) |
1) |
1963 |
2) |
AABD (Blind) and (Disabled) (AABD(B) and (D)) |
2) |
November 1963 |
3) |
MANG (Aged), (Blind), and (Disabled) (MANG(A),(B), and (D)) |
3) |
January 1, 1966 |
d) The
Department shall not enforce a claim for medical assistance against any
property, real or personal, of a deceased recipient while one or more of the
following relatives survives: spouse of decedent, child under 21, or child over
21 who is blind or permanently and totally disabled.
e) The Department shall not enforce a claim
for income maintenance assistance against homestead property of a deceased
recipient while the homestead is occupied by one or more of the surviving
relatives previously specified.
f)
The Department shall not enforce a claim against the estate of a decedent to
the extent assets were disregarded because the person was covered under a
qualified long term care policy as provided under 89 Ill. Adm. Code
120.382(c).
g) To avoid undue hardship, the Department
will waive its right to recover from a decedent's estate if pursuing recovery
would cause an heir or beneficiary of the estate to become or remain eligible
for a public benefit program, such as SSI, TANF or SNAP. The Department may
limit the scope of its waiver to that portion of the estate that the heir or
beneficiary would receive and pursue recovery against the balance of the
estate, if any. The Department will not waive recovery despite undue hardship
if payment of the claims of other estate creditors that are equal or inferior
in priority to the Department's claim will exhaust the estate and defeat the
purpose of the waiver. The Department will provide written notice to heirs and
beneficiaries known to the Department of the opportunity, time frame and method
to request a waiver of estate recovery based on undue hardship.
h) For decedents dying on or after July 1,
2022, to prevent substantial and unreasonable hardship, the Department shall:
1) Waive any claim against the first
$25,000.00 of an estate;
and
2) Consider the gross assets in
the estate, including, but not limited to, the net value of real estate less
mortgages or liens with priority over the Department's
claims.
i) The Department
may defer or waive enforcement of its claim for income maintenance assistance
if it determines that:
1) The deceased
recipient is survived by a dependent spouse and minor child or children;
or
2) Rehabilitative training for
employment or other means of self-support for the surviving spouse or children
is feasible, and deferment or waiver will facilitate achievement of
self-support status and prevent or reduce the likelihood of return to
dependency on public assistance of the spouse or children.
Notes
Amended at 36 Ill. Reg. 4119, effective March 1, 2012
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