Land records · Parcel maps · October 7, 2026
Medicaid Estate Recovery Lien on a House Explained
How a Medicaid estate recovery lien works: states may seek repayment of long-term care costs from a recipient's estate or home, with key exemptions.
Medicaid estate recovery lien refers to the ways a state Medicaid program can recover the cost of long-term care benefits from a recipient’s property. Federal law requires states to seek repayment from the estates of certain Medicaid recipients, generally those who were 55 or older when they received nursing home or other long-term care services, or who were permanently institutionalized. Because a home is often the largest asset left, recovery claims frequently involve real estate, either through a claim against the estate after death or, in some states, through a lien recorded against the home during the recipient’s life. This page is general land-records background, not legal advice.
Two kinds of recovery
| Type | When it happens |
|---|---|
| Estate recovery claim | After the recipient dies, against the estate |
| TEFRA lien | During life, in states that use them, on the home of a permanently institutionalized recipient |
A TEFRA lien, named after the federal law that authorizes it, is recorded in the county land records and must be satisfied before the home is sold or transferred. Not every state uses pre-death liens.
Protections and exemptions
Federal law prevents recovery while certain family members are living or in certain situations: - A surviving spouse is living. - A child under 21 survives. - A child who is blind or permanently disabled survives.
TEFRA liens generally cannot be placed on a home while a spouse, a minor or disabled child, or in some cases a sibling with an ownership interest lives there. States must also have hardship waiver procedures.
What counts as the estate
Federal law requires recovery from the probate estate. Many states have expanded the definition to include assets that pass outside probate, such as jointly owned property, life estates, or property passing by transfer on death deed. Others limit recovery to probate assets. The state’s definition affects whether planning tools like a lady bird deed protect the home.
Effect on heirs
If a Medicaid recipient dies owning a home, the state may file a claim in probate or record a lien. Heirs may need to pay the claim, negotiate, or sell the home to satisfy it. Unresolved claims can cloud title and complicate heirs property situations.
Finding a Medicaid lien
Search the county recorder’s index for liens filed by the state Medicaid agency or human services department. Title searches typically reveal recorded liens. Estate claims may appear in probate court files. See how to find liens on a property.
Planning considerations
Medicaid has look-back rules for transfers made to qualify for benefits, generally five years for long-term care. Transfers during that period can delay eligibility. Planning should be done carefully and early with knowledgeable professionals.
Releasing the lien
When the claim is paid or waived, the state records a release. Title companies require it before insuring a sale.
Bottom line
Medicaid estate recovery lets states seek repayment of long-term care costs from a recipient’s estate, and some states record liens on homes during life. Exemptions protect surviving spouses and certain children, and hardship waivers exist. State definitions of the estate vary. Find county recorders via the Platbookmapper map.
Medicaid estate recovery lien FAQ
Can Medicaid take my parent’s house?
The state may seek recovery from the estate, subject to exemptions.
What is a TEFRA lien?
A lien some states place on the home of a permanently institutionalized Medicaid recipient.
Is a surviving spouse protected?
Yes, recovery is deferred while a spouse is living.
Does a TOD deed avoid Medicaid recovery?
It depends on whether the state counts non-probate assets.
How do I find a Medicaid lien?
Search the county recorder’s index and probate records.