Does Medicaid have to be paid back in Missouri?

Asked by: Immanuel Farrell  |  Last update: January 26, 2026
Score: 4.9/5 (58 votes)

In certain situations, the MO HealthNet Division (MHD) is required to seek repayment of costs for healthcare services after a participant dies. This is called estate recovery. An estate can include assets owned by the participant such as a home, or savings or retirement account, etc.

Will Medicaid make me pay them back?

If you save any of the lump sum payment into the months after you received it, and it pushes your resources above the Medicaid resource limit, you can be held liable to repay Medicaid for services you receive in all the months you are over the resource limit.

What is the look back rule for Medicaid in Missouri?

When applying for Medicaid in Missouri, the state will “look back” to see if any gifts have been made in the past five years. Missouri will not just let you give away your property or your money to qualify for Medicaid.

Does Missouri Medicaid back pay?

Now, Medicaid is available to all Missourians with incomes below 138% of the federal poverty level, or about $18,800 per year for an individual. Those whose applications are approved will be eligible for coverage retroactive to the month they applied, and possibly up to three months before then.

What assets are exempt from Medicaid recovery?

Medicaid Estate Recovery Exemptions

Life insurance proceeds paid directly to a designated named beneficiary. Assets placed in a trust prior to the death of the decedent. Irrevocable funeral reserves used for the funeral costs. Certain trusts for disabled individuals.

How Does Missouri Medicaid Work? Find Out!

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How do I protect my assets from Medicaid look back?

By transferring your assets into an irrevocable trust, you effectively remove them from your ownership, thereby protecting them from Medicaid's asset requirements. However, it's important to note that once assets are transferred to an irrevocable trust, you no longer have control over them.

How to avoid Medicaid estate recovery in Missouri?

The MO HealthNet Division will not seek repayment on a participant's estate if any of the following dependents are still living:
  1. Spouse.
  2. Child under age 21.
  3. Child of the participant of any age who is blind or disabled.

What assets are exempt from Medicaid in Missouri?

There are also many assets that Medicaid considers to be exempt (non-countable). Exemptions include personal belongings, household furnishings, an automobile, irrevocable burial trusts (also called personal funeral trust accounts) up to $9,999, and generally one's primary home.

How often does Medicaid check your income?

Yes, income and assets have to be verified again for Medicaid Redetermination. After initial acceptance into the Medicaid program, redetermination is generally every 12 months. The redetermination process is meant to ensure the senior Medicaid beneficiary still meets the eligibility criteria, such as income and assets.

What is Medicaid clawback?

Medicaid's Look-Back Period Explained

To be eligible for Medicaid, one cannot have assets greater than the limit. Medicaid's Look-Back Period is meant to discourage Medicaid applicants from gifting assets, including selling them under fair market value, to meet Medicaid's asset limit.

How to avoid Medicaid 5 year lookback in Missouri?

The best way to avoid the 5-year lookback period is to not give away assets or transfer them for less than fair market value within 5 years before submitting a Medicaid application.

What happens to assets if you go into a nursing home?

No one “takes” assets from the patient; the nursing home simply requires payment for its services if the patient intends to reside in the nursing home. The notion of assets being seized by the government or a nursing home is only one of several misconceptions about paying for long term care.

What happens if you win money while on Medicaid?

Winning the lottery generally doesn't require you to pay back Medicaid costs. However, it can affect your eligibility for Medicaid, as eligibility often depends on income levels, which vary by state. You might lose your benefits if your lottery winnings push your income above the Medicaid threshold.

Do I have to pay back Medicaid if I sell my house?

Note: California stands apart from the other states. CA eliminated their Medicaid (Medi-Cal) asset limit effective 1/1/24. Medi-Cal applicants and beneficiaries can have unlimited assets and still be eligible for Medi-Cal. They could sell their home and it have no impact on their eligibility.

Can a nursing home take your inheritance?

With the passage of the Omnibus Budget Reconciliation Act, state Medicaid officials have the power to recoup any covered funds from your estate after you pass away. This means that unshielded assets could be lost for future generations unless proper steps are taken beforehand in preparation for nursing home care.

Does Medicaid monitor your bank account?

Medicaid agencies can check your account balances at any financial institutions you use during the month you apply or during a 60-month look-back period.

Do you have to pay back Medicaid if you get a job?

No. Unlike employer-sponsored plans, Medicaid is not tied to your job. You'll still have it even if you lose your job because of COVID-19 or for any other reason. If you find a job, your new financial situation will determine whether you qualify for Medicaid.

Do you have to report all income to Medicaid?

Yes. Some forms of income that are non-taxable or only partially taxable are included in MAGI and affect financial eligibility for premium tax credits and Medicaid.

How to protect assets from Medicaid in MO?

A Medicaid Asset Protection Trust (MAPT) is one option a person may consider to protect their assets from Medicaid and nursing homes or long-term care. A MAPT is an irrevocable trust created during your lifetime.

How much money can you have when you go into a nursing home?

If a senior's income is below that amount, they will qualify for Medicaid to pay the difference between their income and the cost of the nursing home. All of the senior's income must go to pay the nursing home, except for the $60 monthly allowance. The senior can also maintain a savings account of no more than $2000.

How do I check my Medicaid status in Missouri?

Check Your Medicaid Status

1Go to mydss.mo.gov. 2Click on the “check your status” button at the top.

How far back can Medicaid recoup payments?

There are also two state exceptions when it comes to the Look-Back Period – California and New York. There is no Look-Back Period for HCBS Waivers in California, and it's 30 months (2.5 years) for Nursing Home Medicaid, although that will be phased out by July 2026, leaving California with no Look-Back Period.

What happens if you inherit a house while on Medicaid?

California stands apart from the other states. In CA, Medicaid (Medi-Cal) recipients can gift inheritance, which is considered “income”, the month in which it is received. Furthermore, Medi-Cal recipients have no asset limit, and therefore, can have unlimited assets and still be eligible for long-term care benefits.

How do I shelter my assets from Medicaid?

Strategies for Medicaid Planning. Asset Protection through Irrevocable Trusts: Irrevocable trusts, such as Medicaid Asset Protection Trusts (MAPTs) and Special Needs Trusts (SNTs), are invaluable tools for shielding assets from Medicaid eligibility calculations and planning for long-term care expenses.