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What Is Medicaid Payback?

  • Writer: Purple
    Purple
  • Aug 21
  • 2 min read

If you’re managing an ABLE account—or planning to open one—you’ve probably heard about something called Medicaid payback. But what is it, and when does it apply?


In this article, we’ll explain:

  1. What Medicaid payback means

  2. When states can claim ABLE account funds

  3. Who is affected

  4. What expenses are covered

  5. How to protect your savings

  6. How Purple supports long-term planning



1. Medicaid Payback, Explained


Medicaid payback refers to the government’s ability to recover the cost of Medicaid services from a person’s estate after they pass away.


If someone received Medicaid benefits during their lifetime, the state may try to recover those costs by claiming assets from their estate—including funds remaining in an ABLE account.


This is also known as estate recovery.



2. Does Medicaid Payback Apply to ABLE Accounts?


Yes—but with some conditions.


If the beneficiary of an ABLE account received Medicaid after the ABLE account was opened, the state may file a claim against the remaining funds in that account when the person dies.


Funds may only be claimed after:

  • Funeral and burial expenses are paid

  • Any outstanding bills are resolved

  • Other qualifying final expenses are covered


So not all funds go directly to the state—but anything left may be at risk.



3. Who Is Affected by Medicaid Payback?


Medicaid payback only applies after the death of the ABLE account holder.


It typically affects:

  • Adults with disabilities who received Medicaid services

  • ABLE account holders who did not spend down their balance

  • Families or caregivers hoping to pass unused ABLE funds to heirs


Importantly, not all states enforce Medicaid payback. Some have chosen to waive or limit recovery for ABLE accounts. Policies vary by state, so it’s worth checking with your state Medicaid office.



4. What Services Are States Reimbursed For?


If the state does pursue estate recovery, it’s usually limited to:

  • Medicaid services received after the ABLE account was created

  • Services like doctor visits, home care, or long-term care

  • Costs paid by the state that weren’t covered by Medicare or private insurance


The state cannot claim more than what was actually spent on care. And they can’t claim funds for services received before the ABLE account was opened.



5. How to Protect ABLE Account Funds


Here are a few steps you can take:

  • Use ABLE funds regularly for qualified disability expenses, instead of letting the balance grow unused

  • Pay final expenses quickly after the beneficiary’s death (before the state files a claim)

  • Know your state’s policy on Medicaid payback for ABLE accounts

  • Pair your ABLE account with a Special Needs Trust, especially if you’re receiving large gifts or inheritances

  • Talk with an estate planning expert familiar with disability law


Even if payback applies, you can often minimize the amount that’s claimed through smart planning and spending.



6. How Purple Helps with Long-Term Planning


At Purple, we believe financial tools should work for people with disabilities—not against them.


We’re building technology that helps:

  • Track your ABLE account contributions and spending

  • Separate funds for daily use, savings, or backpay

  • Store estate documents securely

  • Educate families on Medicaid payback and state-by-state rules

  • Plan for both short-term needs and long-term legacy


Because protecting your benefits shouldn’t come with fear or confusion.


 
 

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