The District of Columbia Department of Health Care Finance (DHCF) is required by federal and local laws to recover certain costs paid by DC Medicaid.
This page provides easy‑to‑understand information about two types of DC Medicaid recovery processes and what they mean for beneficiaries, families, and representatives.
DC Medicaid Estate Recovery
DC Medicaid Estate Recovery applies when a DC Medicaid beneficiary age 55 or older passes away. DHCF may request repayment from the person’s estate for certain services paid for by DC Medicaid.
Key points:
- An estate includes the property a beneficiary owned that does not automatically transfer to someone else.
- DHCF may place a lien on the estate unless an exemption applies.
- Exemptions include situations where a surviving spouse or certain children live in the home.
- Families may request an exemption or an undue hardship waiver if recovery would cause financial difficulty.
Casualty / Trauma Recovery
Casualty or trauma recovery applies when a DC Medicaid beneficiary is injured due to another person or party and receives, or may receive, a settlement or payment related to that injury. DHCF has the legal right to seek reimbursement from the liable party for DC Medicaid services provided.
Examples of cases:
- Assaults
- Accidents
- Malpractice
- Class‑action lawsuits
- Workers' compensation claims
Key points:
- Attorneys, insurance companies, and beneficiaries must notify DHCF when a related legal claim or settlement is being pursued.
- All DC Medicaid recipients and their attorneys must reimburse DC Medicaid after receiving a settlement.
Access the Fact Sheets
Use the links below to view or download detailed guidance: