Full Definition

The Texas Medicaid Estate Recovery Program (MERP) is the mechanism by which Texas seeks to recover some of the cost of Medicaid long-term care services from the estates of deceased Medicaid recipients. Federal law requires all states to have a Medicaid estate recovery program.

In Texas, MERP can pursue recovery from the estate of a Medicaid recipient who was 55 or older when they received Medicaid-funded nursing facility or community-based long-term care services. Recovery is sought against probate assets — property that passes through a will or intestacy — including the primary home in many cases.

However, Texas MERP recovery is deferred while a surviving spouse, a minor child, or a disabled/blind child of any age is living in the home. Recovery is pursued from the estate after the death of the recipient and the death or move of any protected surviving household members.

Families can take legal steps to minimize MERP recovery exposure, including proper titling of property, use of life estates, and trust planning — but these strategies must be implemented well in advance of a Medicaid application to comply with the look-back period rules. An elder law attorney is essential for this planning. Understanding MERP is critical for families who expect a parent to spend down to Medicaid while still owning a home.