Ohio Medicaid Non-Probate Estate Recovery: TOD Accounts, Joint Assets, and ORC 5162.21
Why Ohio's Recovery Program Reaches Beyond Probate
Most families assume that keeping assets out of probate — through Transfer-on-Death (TOD) designations, joint accounts, or payable-on-death beneficiaries — shields those assets from Medicaid estate recovery. In Ohio, that assumption is wrong.
Under Ohio Revised Code § 5162.21, the Ohio Attorney General's Office (AGO) is authorized to recover Medicaid costs from both probate and non-probate assets of deceased recipients who were 55 or older or permanently institutionalized. Ohio was one of the early states to expand its recovery program beyond the probate estate, and it pursues non-probate assets aggressively.
What Non-Probate Assets Are Subject to Recovery
Transfer-on-Death (TOD) accounts. A bank or brokerage account with a TOD beneficiary designation passes directly to the named beneficiary outside of probate. Ohio can file a claim against the beneficiary for the value received, up to the total Medicaid benefits paid on behalf of the deceased.
Joint bank accounts with survivorship rights. When a Medicaid recipient held a joint account, the surviving joint owner receives the funds automatically. The AGO can pursue the deceased recipient's legal interest in the account under the expanded estate-recovery rules; survivorship does not automatically shield the funds.
Life estates. If the Medicaid recipient retained a life estate in real property (a common planning technique where the parent transfers the remainder interest to children while keeping the right to live there), the value of the life estate at death is recoverable.
Revocable living trusts. Assets held in a revocable trust that the Medicaid recipient controlled during their lifetime are treated as part of the recoverable estate.
Payable-on-death (POD) designations. Similar to TOD accounts, POD designations on bank accounts do not protect the funds from Ohio's expanded recovery.
The Executor Notice Requirement
Under ORC § 2117.061, the person responsible for the estate must notify the Ohio Attorney General's Office (AGO) Medicaid Estate Recovery Unit using probate Form 7.0 within 30 days after the court issues letters testamentary or letters of administration, or after an application for release from administration. The AGO has 90 days from receipt of the notice to file a claim.
Failure to follow the notice process can complicate estate administration, and non-probate transfers are not automatically immune from recovery. Beneficiaries who received assets may still face recovery claims under the expanded estate rules.
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Protections That Delay or Block Recovery
Ohio's recovery program does have limits. The protections do not all work the same way:
- Recovery is deferred while the surviving spouse of the deceased Medicaid recipient is living
- Recovery is permanently waived when a child of the deceased is under 21
- Recovery is permanently waived when a child of the deceased is blind or permanently disabled (as determined by the Social Security Administration)
The surviving-spouse protection defers recovery until the spouse dies; the under-21 and qualifying blind-or-disabled-child protections are permanent waivers. Once the surviving spouse passes, the AGO can pursue its claim against the remaining estate assets, including real property that was protected during the spouse's lifetime.
The family home is the most common asset affected by delayed recovery. If the community spouse continues to live in the home, recovery is postponed. When no protected individual remains, the home becomes subject to the state's lien and recovery action.
What This Means for Planning
The expanded scope of Ohio's estate recovery program undercuts several common informal planning strategies. Simply retitling accounts as TOD or adding a child's name as a joint owner does not protect those assets — it just changes who receives the AGO's recovery demand.
Strategies that can reduce estate recovery exposure include spending down to exempt assets before death (irrevocable prepaid funeral contracts, necessary home repairs, medical equipment), using irrevocable Medicaid asset protection trusts established outside the five-year lookback, and ensuring the caregiver child exception is properly documented for home transfers.
The Ohio Medicaid Long-Term Care & Asset Protection Guide covers the full scope of Ohio's estate recovery program and walks through the specific steps families can take during the spend-down phase to minimize what the state recovers after a parent's death.
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Download the Ohio — Medicaid Long-Term Care Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.