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
Illinois probate law. 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 USC
1396 a(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 in behalf of a recipient on or after the following dates:
Assistance Program |
Effective Date |
||
1) |
AABD (Aged) |
1) |
1963 |
(AABD(A)) |
|||
2) |
AABD (Blind) |
2) |
November 1963 |
and (Disabled) |
|||
(AABD(B) and (D)) |
|||
3) |
MANG (Aged), |
3) |
January 1, 1966 |
(Blind), and (Disabled) |
|||
(MANG(A),(B), and (D)) |
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 Section
120.382(c)
of this Part.
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
Food Stamps. 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) 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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