Medicaid Estate Recovery in Nevada

By Kim Boyer

Under federal law, state Medicaid programs must recover from the estates of deceased Medicaid beneficiaries. This recoupment is referred to as “Medicaid Estate Recovery.” Usually the greatest asset owned by people facing a long-term care stay is their home. It is their greatest asset not only in terms of monetary value, but in terms of sentimentality.  In 2024, a federal bill was submitted to end Medicaid Estate Recovery, but it did not pass.  

The home is an exempt asset for purposes of qualifying for Medicaid. However, this does not mean that it is exempt from estate recovery. In fact, the home is the asset most frequently sought in Medicaid Estate Recovery.

Under federal law, states cannot “recover” during the lifetime of a surviving spouse.  In Nevada, Medicaid Estate Recovery can place a lien on the home during the lifetime of a surviving spouse and this was upheld in a Nevada Supreme Court case called Nevada Department of Human Resources v. Estate of Ullmer. 

The lower court prohibited the State from placing Medicaid liens against homes of surviving spouses of Medicaid recipients. On appeal, the Nevada Supreme Court ruled that the State may impose a lien, subject to certain limitations, before the surviving spouse’s death upon property in which it has a legitimate interest.

The Court said that the state “will release the lien upon the surviving spouse’s demand for any bona fide transaction, including, but not limited to, selling the property, refinancing the property, and obtaining a reverse mortgage.” However, “the state’s interest is not extinguished when the deceased recipient’s interest in the property is transferred for less than fair market value.”

This means that if the surviving spouse wants to sell the house, refinance or obtain a reverse mortgage, the lien must be lifted. If the house is gifted to someone, the lien will remain. The Court also said that the lien must be limited to the deceased Medicaid recipient’s interest in the home. For example, if the husband and wife own the property as joint tenants, then the state can only lien a one-half interest in the property.

When families come into our office for long-term care planning, this issue frequently arises.  We work with families to put together a comprehensive estate plan.

Disclaimer: Information provided as a service of Kim Boyer, Certified Elder Law Attorney, updated as of 7/22/25. It does not constitute legal advice. For specific questions you should consult a qualified attorney.