Subsection 144-101-VII-5.03 - ELIGIBILITY Following the death of a Member, the Department shall assert a claim against the estate of that Member or the Member's beneficiary for MaineCare benefits that the Member received when:
A. The Member owned undisclosed property or other assets during the period when MaineCare benefits were paid for the Member and disclosure of the property or assets at the time benefits were being paid would have rendered the Member ineligible to receive the benefits; or B. The Member was fifty-five (55) years of age or older when the Member received MaineCare benefits; or C. The Member received or was entitled to receive benefits for nursing facility services, long-term care services, or other institutional care services under a long-term-care insurance policy and MaineCare paid for those services on behalf of the Member. This paragraph shall not apply in the case of an individual who was entitled to receive benefits under an insurance policy meeting the requirement of the Long-term Care Insurance Partnership Program described in Section 5.02-10 to the extent that payments are made under that policy. Effective November 24, 2021, the Department's claim is limited to the amount paid by MaineCare for all nursing facility services, home and community-based services, and related hospital and prescription drug services paid on behalf of the Member.
C.M.R. 10, 144, ch. 101, ch. VII, 144-101-VII-5, subsec. 144-101-VII-5.03