Texas Medicaid Estate Recovery (MERP): what families should know
If a loved one got certain Medicaid long-term care in Texas after age 55, like nursing home care or some home and community waiver services, the state may file a claim against their estate after they die to recover what Medicaid paid. It never asks for more than it paid. It doesn't ask at all in several cases, such as when there's a surviving spouse or a child under 21, and the family can apply for a hardship waiver.
What is MERP?
Every state must have a Medicaid Estate Recovery Program. Texas started its program on March 1, 2005. It covers certain long-term care services a person received at age 55 or older, for people who first applied for those services on or after that date. The person doesn't have to be getting services when they die. Sources: Texas HHS, your guide to the Medicaid Estate Recovery Program, Texas HHS handbook D-7800, Texas HHS, MERP frequently asked questions.
Which services does it cover?
- Nursing facility care
- Intermediate care facilities for people with an intellectual disability or related conditions
- Medicaid waiver programs, including CLASS, DBMD, HCS, TxHmL and the STAR+PLUS waiver
- Community Attendant Services
- Related hospital and prescription drug services
Primary Home Care isn't affected. Being on an interest list for a waiver program doesn't count as applying. Sources: Texas HHS handbook D-7800, Texas HHS, your guide to the Medicaid Estate Recovery Program.
When does the state file a claim?
After the death, the state's MERP contractor sends a Notice of Intent to File a Claim within 30 days of learning about it. The notice goes to the estate's representative, or to the guardian, power of attorney or family member who acted for the person, if their name and address are known. The claim goes through probate as a Class 7 claim, so funeral costs, legal costs, a home mortgage and the other claims ahead of it are paid first. MERP doesn't put liens on property. Sources: Texas HHS, MERP frequently asked questions, Texas HHS, your guide to the Medicaid Estate Recovery Program, Texas HHS handbook D-7800.
What counts as the estate?
Property that goes through probate: for example a home, a car or cash, including property in another state. Things that pass straight to a named person generally aren't part of it, like a life insurance policy with a named beneficiary, a bank account payable on death, retirement accounts and pensions, and joint accounts. Sources: Texas HHS, MERP frequently asked questions, Texas HHS, your guide to the Medicaid Estate Recovery Program.
When won't the state ask for money?
- There's a surviving spouse.
- There's a child under 21.
- There's a child of any age who is blind or permanently and totally disabled under Social Security rules.
- There's an unmarried adult child who lived full time in the person's home for at least one year before they died.
- The estate is worth $15,000 or less.
- The Medicaid costs are $5,000 or less.
- Selling the property would cost more than it's worth.
Source: Texas HHS, your guide to the Medicaid Estate Recovery Program.
What is a hardship waiver?
Heirs can ask the state to waive the claim when it would cause an undue hardship. The state may consider it a hardship when:
- The property was a family business, farm or ranch for at least 12 months before the death and is the heirs' main source of income.
- Heirs would need government help if the state collected, or could lose that help if it didn't.
- The homestead is worth under $150,000 and an heir's family income is under a limit tied to the federal poverty guidelines.
- The person was a crime victim getting services because of the crime.
- Other circumstances create a hardship.
The application is Form 5006, and it comes with the Notice of Intent. Heirs have to ask for the waiver and send the proof the state requests. Sources: Texas HHS, your guide to the Medicaid Estate Recovery Program, Texas HHS, MERP frequently asked questions.
Do the heirs pay out of their own pocket?
No. Heirs aren't asked to pay from their own money, MERP can't collect more than the estate is worth, and the family doesn't cover any shortfall. If heirs want to keep the home, they can choose to pay the claim with other funds. MERP doesn't offer payment plans. Source: Texas HHS, MERP frequently asked questions.
Who do we call?
Since Sept. 1, 2026, Texas MERP is run by Stellarware Corporation: 800-641-9356, toll free. For complaints that aren't resolved, the HHS Office of the Ombudsman is at 877-787-8999. The state also suggests an attorney of your choice or your local Area Agency on Aging. Source: Texas HHS, your guide to the Medicaid Estate Recovery Program.
Keep it where your family can find it
When the notice arrives, the family has to answer quickly with facts: who the heirs are, who lived in the home, what the property is worth, and which accounts name a beneficiary. Keep the Medicaid letters, the signed estate recovery form (Form 8001) and a list of who's named on each policy and account in one place your family can reach. If there's no will, see what happens if you die without a will in Texas.
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Frequently asked questions
Can the state take my mom's house?
The state can't take property directly. It files a claim in probate, and debts are paid before property is distributed. It doesn't ask at all in some cases, like when there's a surviving spouse or a child under 21, and heirs can apply for a hardship waiver.
Does MERP apply if my parent only had regular Medicaid?
MERP recovers only certain long-term care services received after age 55, like nursing facility care and some waiver programs. Primary Home Care isn't affected.
Do I have to pay the claim from my own money?
No. MERP can't collect more than the estate is worth, and heirs aren't asked to pay from their own money.
Is this legal or financial advice?
No. It's general information from Texas Health and Human Services. For your family's case, talk to an attorney or call the MERP contractor.
Sources
- hhs.texas.gov/regulations/legal-information/your-guide-medicaid-estate-recovery-program
- hhs.texas.gov/medicaid-estate-recovery-program-faqs
- fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/d-7800-medicaid-estate-recovery-program
General information, not legal or financial advice. Rules change; check the official sources above or talk to a licensed professional about your situation.
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