What happens if I refuse to sign the acknowledgement form when I apply for Medicaid covered services?

The MERP Receipt and Acknowledgement Form (Form 8001) is used to explain estate recovery and how it might affect you. §You are asked for a signature to show the state explained MERP to you or your representative. If you don’t sign the form you can still get services. But just because you don’t sign the form does not make your estate exempt from recovery.

What is an estate?

An estate as it relates to estate recovery is the real and personal property of a deceased Medicaid recipient that is subject to probate. Real property may include a home and other real estate. Personal property may include a car, cash and other personal property. A probate estate does not include assets that pass directly to a beneficiary outside of the probate process. Some typical examples of assets that are not usually subject to probate include:

  • insurance policy proceeds;
  • retirement accounts, such as IRAs;
  • pension plans;
  • accounts at financial institutions, such as banks or credit unions, that are paid on death or accounts or joint accounts with right of survivorship;
  • mutual funds; or
  • deferred compensation plans.

Is property that I own in another state exempt from recovery?

Any property you own that is part of your estate, regardless of location, may be subject to estate recovery.

I want to will my home to my children. Can the state still take it?

The state cannot take your property. All claims (debts) against an estate, including MERP claims, must be paid before property can be distributed as stated in a will. The heirs can choose to use other funds to pay the claim if they don’t want to sell the home.

What are the actual incomes which represent 300 percent of the federal poverty level?

2016 Federal Poverty Level — 300% (Effective Date: 1/25/2016)
Number of Persons in
Family or Household
Gross Monthly Income Gross Annual Income
1 $2,970 $35,640
2 $4,005 $48,060
3 $5,040 $60,480
4 $6,075 $72,900
5 $7,110 $85,320
6 $8,145 $97,740
7 $9,183 $110,190
8 $10,223 $122,670
For each additional person, add $1,040 $12,480

How do I apply for an Undue Hardship Waiver?

MERP will include that information with the Notice of Intent to File a Claim. You may also download the application from this website.

What will the heirs to the estate have to pay?

Heirs are not asked to spend their own money to pay the estate claim. The estate assets are expected to be used to pay the debts of the estate.

How will heirs or personal representatives find out if the state will file a claim?

The estate recovery contractor will send a Notice of Intent to File a Claim (NOI) within 30 days of when they receive notice of the death of a Medicaid recipient. The NOI will be mailed to the decedent's estate representative, guardian, power of attorney or family members who have acted on behalf of the recipient, if their name and address are known. The NOI will include information on the program, a list of questions for you to complete and return, and an undue hardship waiver request form.

If I received Medicaid covered services in another state as well as in Texas, which state will file a claim?

Both states may file a claim. The probate court will decide how to divide the estate between the claims.

If I applied for services after March 1, 2005, but terminated these services sometime prior to my death, will MERP still file a claim?

Yes, a Medicaid long-term care recipient does not have to be receiving services at the time of death in order for MERP to file a claim.

Can a family make monthly payments to pay the claim and how long can they take to pay?

MERP does not allow payment plans.

What happens if the family sells the home and there is still a balance due? Who is responsible for paying the rest?

MERP cannot collect more than the value of the estate. Even if there are not enough assets in the estate to pay all or even some of the MERP claim, family members are not required to pay from their own pockets.