Question 1

What is the Medicaid Estate Recovery Program, and will the state take my parents' house in Cary after they pass away?

Accepted Answer

North Carolina's Medicaid Estate Recovery Program (MERP) allows the state to seek reimbursement from a deceased Medicaid recipient's probate estate for nursing facility, home- and community-based waiver, and related hospital/prescription costs paid on their behalf, generally for recipients who were 55 or older when they received the covered services. Recovery only happens after death and is deferred while a surviving spouse is alive, with additional protections for a minor or disabled child and for cases of undue hardship, and the primary residence may be exempt while a qualifying survivor lives there.

Question 2

If my mother qualifies for Special Assistance in an adult care home in Garner, does she automatically get Medicaid too?

Accepted Answer

Yes — residents approved for State/County Special Assistance are automatically eligible for Medicaid, which then covers medical costs and can cover Medicaid State Plan Personal Care Services (PCS) delivered within the licensed adult care home, layered on top of the SA-funded room-and-board payment. SA itself, however, remains a separate state/county cash program, not part of Medicaid.

Question 3

How do Medicaid Personal Care Services (PCS) work for a resident in a licensed adult care home near North Hills?

Accepted Answer

Medicaid State Plan Personal Care Services can pay for hands-on personal care — help with bathing, dressing, toileting, transferring, and similar activities of daily living — provided to a Medicaid-eligible resident within a licensed adult care home, but PCS does not cover the room-and-board portion of the facility's cost, which is typically covered separately by State/County Special Assistance for eligible residents. PCS hours are individually assessed based on the resident's documented need.

Question 4

Where do I start the paperwork for long-term-care Medicaid if my parents live in Orange County?

Accepted Answer

Apply for long-term-care (aged/blind/disabled) Medicaid through the Orange County Department of Social Services, which handles the financial and categorical eligibility determination; for CAP/DA specifically, also contact the CAP/DA case management entity serving Orange County. The NC Medicaid Contact Center, 888-245-0179, can help direct families to the right local office and answer general eligibility questions.

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