Estate Recovery

What is TennCare (Medicaid) Estate Recovery?

Estate Recovery is the way TennCare collects money from the estates of people who passed away and received TennCare long-term services and supports, such as nursing home care or home and community based services. If TennCare pays for nursing facility and other long term care services, TennCare is required by federal law to recoup these payments after the death of the recipient.   This is referred to as “estate recovery.”

Estate recovery is using the value of property you leave behind when you die to pay TennCare back for care you received while you were living. Your “estate” is the property, belongings, money, and other assets that you own at the moment immediately preceding death. Estate recovery only occurs after your death, and your family is not personally responsible for the debt. 

Whose estate has to pay TennCare (Medicaid) back for their care?

TennCare must pursue estate recovery after the death of individuals who are age 55 or older and for whom TennCare paid for services in a nursing facility, ICF/IID, or home or community based setting.

How do I find out if the estate owes money to TennCare (Medicaid)?

After you die, the law says that your estate must be used first to pay the debts you owe, and then the remainder may be distributed to your heirs.

Your debts include any amount you must pay TennCare for care you received while you were living. The probate court cannot close your estate until your lawyer or executor of your estate gets a Release from TennCare. A Release says your estate does not owe TennCare any money.

To find out if the estate owes money to TennCare, you must complete and submit a Request for Release Form.  The form may be downloaded at: http://www.tn.gov/assets/entities/tenncare/attachments/releaseform.pdf. You may also request the form by mailing a letter to Bureau of TennCare, Estate Recovery Unit, 310 Great Circle Road, Nashville, TN 37243 or a faxing a letter to (615) 413-1941.

Follow all of the instructions on the Request for Release Form and transmit it to TennCare as directed on the form.  You must include all of the information and additional documentation that is requested in the Request for Release Form.

If the estate does not owe TennCare money, TennCare will send you a release.   If the estate owes money to TennCare, TennCare will send you an itemized statement of the amounts due.

What if you received an itemized statement from TennCare? TennCare will file a claim against the estate. The claim will state the amount the estate must pay TennCare for care you received. The estate must pay TennCare before TennCare will provide a Release.

How do I ask for a release from TennCare?
  1. Obtain a Request for Release Form by:
    1. Downloading the form online at http://www.tn.gov/assets/entities/tenncare/attachments/releaseform.pdf; or
    2. Faxing a letter to (615) 413-1941; or
    3. Sending a letter to:
      Bureau of TennCare
      Estate Recovery Unit
      310 Great Circle Road
      Nashville, TN 37243
  2. Submit the completed Request for Release Form along with any additional documentation requested in the form to TennCare.  Follow the instructions in the form for how to submit the form to TennCare.​
  3. Complete the Request for Release Form according to the instructions in the form.
How much will the estate have to pay TennCare?

TennCare is a managed care program. This means that TennCare contracts with health plans to provide the services enrollees need. This includes health and mental health services and some long-term services and supports (like care in a nursing home or some kinds of home care).

TennCare pays the health plan a monthly payment for care they are contracted to provide. The payment is based on the kinds of services enrollees are expected to receive from the health plan. It takes into account things like age, disability, and if someone receives long-term services and supports. Part of that payment may be for long-term care services, which is the kind of care that must be paid back to TennCare.

The payment made by TennCare to your health plan is the same each month, no matter what services you actually receive that month. It can also vary depending on which health plan you have and the part of the state you live in.

What are the reasons that TennCare may delay or “defer” estate recovery?

In some situations, estate recovery is delayed or “deferred,” which  means that it is not pursued until a later date.  TennCare defers estate recovery for  an individual’s estate when:

  • The individual is survived by a spouse; or
  • The individual is survived by a child under the age of 21; or
  • The individual is survived by a son or daughter who is blind or disabled.

TennCare will not seek recovery from the estate until the spouse dies, until the child under 21 turns age 21, or until the son or daughter who is blind or disabled dies. For this deferral to take place, a Request for Release must be submitted to TennCare, and TennCare must file a Release in Probate Court.

Are there any exceptions that apply to estate recovery?

TennCare will not recover from an estate when the estate shows that it meets the criteria for an “undue hardship” exception.  The “undue hardship” is defined by Tennessee as existing in the following three circumstances:

  1. The property of the estate is the sole income-producing asset of the survivors, such as a family farm or other family business. 
  2. A sibling of the deceased individual meets the following criteria:
    1. He or she was lawfully residing in the individual’s home at least 1 year immediately before the individual’s admission to the medical institution;
    2. He or she provided care to such individual for that 1 year, which permitted the individual to reside in the home rather than in an institution; and
    3. He or she has lawfully resided in such home on a continuous basis since the date of the individual’s admission to the medical institution.
  3. A son or daughter of the individual meets the following criteria:
    1. He or she was lawfully residing in the individual’s home for at least 2 years immediately before the individual’s admission to the medical institution;
    2. He or she provided care to such individual for those 2 years, which permitted the individual to reside at home rather than in an institution; and
    3. He or she has lawfully resided in such home on a continuous basis since the date of the individual’s admission to the medical institution.

Note: For purposes of #2 and #3 above, the undue hardship shall be considered to no longer exist when sibling, son, or daughter of the deceased individual, as applicable, no longer resides in such home.

For any of these undue hardship exceptions to take place, a Request for Release must be submitted to TennCare.  TennCare will then determine whether the estate is eligible for the undue hardship exception and, if so, TennCare will file a Release in Probate Court.

Where do I obtain more information?
  • You can call TennCare for free at 866-389-8444.
  • OR, you can fax TennCare at (615) 413-1941.
  • OR, you can mail TennCare at:
    Bureau of TennCare
    Estate Recovery Unit
    310 Great Circle Road
    Nashville, TN 37243