What's protected
A Medicare Savings Program (QMB, SLMB or QI; in Oregon, QMB, SMB and SMF) pays Medicare premiums and, for QMB, deductibles and coinsurance. Since a 2008 federal law (MIPPA section 115), states may not recover Medicare cost sharing (premiums, deductibles, coinsurance and copays) paid through a Medicare Savings Program on or after January 1, 2010. Oregon's own rule says the same: "All correctly made payments on or after January 1, 2010 for Medicare cost sharing" are excluded from a claim.
So signing up for a savings program to get your Part B premium paid doesn't put your home at risk through estate recovery.
When estate recovery does apply in Oregon
ODHS says estate recovery applies to people 55 or older who get Medicaid services. Under OAR 461-135-0835, for benefits paid since October 1, 2013, the claim covers Medicaid paid for someone 55 or older during the time the state was paying for:
- Care in a nursing facility,
- Home and community-based care, or
- In-home services through State Plan Personal Care.
The same rule lets Oregon claim amounts it paid the federal government after 2013 toward a recipient's Medicare Part D coverage, for recipients 55 and older. That state payment is made for people with full Medicaid and Medicare; if you have only a savings program, ask ODHS how it applies to you.
Protections for families
- Surviving spouse. ODHS says it generally doesn't make a claim until after the surviving spouse dies, and doesn't require the spouse to sell the home.
- Children. No repayment is sought while there's a surviving child under 21, or a child of any age who is blind or disabled under Social Security's rules.
- Limit. ODHS says it can collect only the lesser of the claim (with interest) or the value of the home.
ODHS staff can't give legal advice. For questions about a specific estate, talk with an attorney or legal aid office. For Medicare Savings Program questions, call ODHS at 1-855-673-2372 or the ONE Customer Service Center at 1-800-699-9075. To review Medicare coverage once a savings program starts, you can request a call from a licensed insurance agent.
Related questions
How do I apply for a Medicare Savings Program?
ONE, by phone or in person.
Does Oregon have an asset limit?
No, since 2016.
How do I qualify for Medicaid long-term care?
Where estate recovery does apply.
Sources
- Oregon Department of Human Services — OAR 461-135-0835, limits on estate claims (effective October 1, 2024)
- Oregon Department of Human Services — Estate recovery
- CMS — State Medicaid Director letter SMD 10-003 (MIPPA changes to estate recovery)
- Oregon Department of Human Services — Long-term care (OPI-M)
More questions in this guide
- Does Oregon have an asset limit for Medicare Savings Programs?
- How do I apply for a Medicare Savings Program in Oregon?
- How do I get Extra Help paying for prescription drugs in Oregon?
- What are the Oregon Medicare Savings Program income limits?
Part of the guide: Medicare Savings Programs in Oregon · All questions
Frequently asked questions
Does Oregon recover QMB, SLMB or QI payments from my estate?
No. Oregon's rule excludes correctly made Medicare cost-sharing payments on or after January 1, 2010, and federal law bars recovering Medicare Savings Program cost sharing paid since then.
Can Oregon make a claim while my spouse is alive?
ODHS says that in most cases it won't make a claim until after a surviving spouse dies. It also won't seek repayment while there's a surviving child under 21 or a child who is blind or disabled.
Does Oregon Project Independence-Medicaid have estate recovery?
No. ODHS says OPI-M has no estate recovery, so nothing has to be paid back later.
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