A medicaid hardship waiver letter is a written request that asks your state to give up, reduce, or delay its claim against a loved one’s estate after they die. Medicaid estate recovery lets states bill the estate for long-term care costs it paid. However, federal law requires every state to waive that claim when collecting would cause undue hardship. Your letter is how you ask. For example, it explains who lives in the home, what income the family has, and why losing the property would push someone onto public assistance.
When and Why You Need a Medicaid Hardship Waiver Letter
Estate recovery usually starts with a letter. Typically it is called a Notice of Intent to File a Claim, or a notice of claim. It lists a dollar amount the state paid for nursing home care, home and community-based services, or related costs. That notice is not the end of the story. In most cases it also starts a clock.
A hardship waiver is the relief valve Congress built into the program. Federal law at 42 U.S.C. § 1396p requires states to recover from certain estates. It also requires each state to define undue hardship and to waive recovery when it applies. States write their own tests, so the details differ a lot.
You may need a medicaid hardship waiver letter if the estate’s main asset is the family home and an adult child still lives there. The same is true if the property is a working farm or small business that supports someone. Another common ground is simple: without the inheritance, a survivor would qualify for public assistance. As a result, the state collects a little and creates a new welfare case. Most states will look hard at that.
What to Include (and What to Get Right)
Keep the letter short and factual. Six parts do the job. First, identify the case: the decedent’s full name, date of death, Social Security or Medicaid number, county, and the state’s claim number. Second, say plainly what you want. Third, name the exact rule. Fourth, tell the facts. Fifth, list your proof. Sixth, sign and date it.
Naming the rule matters more than most families expect. Texas hardship grounds live in 1 Tex. Admin. Code § 373.209. Ohio’s are in Ohio Admin. Code 5160:1-2-07. Indiana’s are in 405 IAC 2-8-2. Quoting your state’s language shows the reviewer exactly which box you fit.
Deadlines and tests vary sharply. These are the current published figures:
| State | Deadline to request | Key hardship test | State’s decision window |
|---|---|---|---|
| New Jersey | 20 days from the DMAHS notice | Written waiver or compromise request with supporting evidence | Not fixed by rule |
| Ohio | 30 days from the date the Attorney General mailed the notice | Estate is the survivor’s sole income-producing asset, or survivor would need public assistance | 60 calendar days |
| Texas | 60 days from the Notice of Intent to File a Claim | Home valued under $100,000 and heir income under 300% of the federal poverty level; or farm/business supplying 50% or more of an heir’s livelihood | 40 days after a complete request |
| California | 60 days from the date on the claim letter | Substantial hardship criteria on Form DHCS 6195 | Not fixed by rule |
| Indiana | 90 calendar days after the personal representative receives notice | Recovery would make an estate beneficiary eligible for public assistance | Claim suspended while hardship continues |
Two limits apply almost everywhere. Losing an expected inheritance is not, by itself, a hardship. Neither is a hardship you created by sheltering assets to dodge recovery.
Sample Template You Can Adapt
Below is a plain-English starting point. Swap in your state’s agency name, statute, and facts before you send it.
Sample template — adapt to your state and your situation. This is an informational sample, not legal advice.
[Your Full Name]
[Street Address]
[City, State ZIP]
[Phone] | [Email]
[Date]
[State Medicaid Estate Recovery Unit]
[Mailing Address from your notice]
RE: Request for Undue Hardship Waiver
Decedent: [Decedent Full Name]
Date of Death: [Date]
Medicaid / Case Number: [Number]
Estate Recovery Claim Number: [Number]
Notice Date: [Date on the notice]
County: [County], [State]
To the Estate Recovery Unit:
I am the [surviving child / spouse / personal representative / heir] of [Decedent Full Name]. I received your notice of claim dated [Date] seeking [$ amount]. I am requesting a full waiver of that claim, or in the alternative a partial waiver or a deferral, based on undue hardship under [exact statute or rule section, e.g. 1 Tex. Admin. Code § 373.209].
1. The hardship. [Two to four sentences of plain facts. Example: I have lived at [property address] since [year]. It is my only home. My gross monthly income is [$ amount] from [source]. If the state collects against this property, I would have to sell it and would then apply for [SNAP / SSI / Medicaid / housing assistance].]
2. The property. The estate’s main asset is [describe: home / farm / small business] at [address], with an assessed value of [$ amount] per the [County] [year] tax statement. [If applicable: This property provides [percentage]% of my household’s livelihood.]
3. Household and income. My household includes [names, ages, relationship]. Total household income is [$ amount] per [month/year], which is [percentage]% of the federal poverty level for a household of [number].
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4. Documents enclosed. [List: most recent federal tax return; two months of pay stubs or benefit award letters; county property tax statement; utility bills showing residence; bank statements; death certificate; letters testamentary; any state hardship form.]
I certify that the statements above are true and correct to the best of my knowledge. Please confirm in writing that you received this request. I can be reached at [Phone] or [Email].
Sincerely,
[Signature]
[Your Full Name]
[Your role: heir / personal representative]
Enclosures: [list]
How to Make It Valid in Your State
Most states do not require witnesses or a notary on a medicaid hardship waiver letter. However, several require their own form alongside your letter. California uses Form DHCS 6195. Texas provides a hardship waiver request form with the notice. Send both when a form exists, and treat your letter as the explanation attached to it.
Send it in a trackable way. Certified mail with return receipt, or the agency’s official email address, gives you proof of the date. Keep a full copy of the medicaid hardship waiver letter and every enclosure. In most cases, the agency will also want a copy filed with the probate estate, so the personal representative can show the court why the claim is unresolved.
If the answer is no, ask about appeal rights right away. Texas, for example, has a separate rule granting review of a denial. Deadlines for appeals are usually short, so check with your state’s court or a licensed attorney.
Frequently Asked Questions
Does a medicaid hardship waiver letter stop the claim while it is reviewed?
Often, yes. Many states pause collection while a request is pending, and Indiana suspends its claim as long as the hardship continues. Ask the agency in writing to confirm the pause in your case.
Can I ask for a partial waiver instead of a full one?
Yes. Ohio’s rule lets the director approve a request in full, in part, or for a limited time. Some states also accept a compromise, where the estate pays a reduced amount. Ask for the full waiver first, then name your fallback.
Who can sign the letter?
Typically the affected survivor signs, since the hardship is theirs. The personal representative may also file. Indiana generally limits waivers to immediate family, though other people may qualify for good cause.
Where to get real help, free or low-cost
You do not have to figure this out alone, and you do not need to buy anything to get started. Your state’s probate court usually has a self-help desk, and free legal aid can walk you through the next steps.
- Your state probate (or surrogate’s) court: search “[your state] probate court self-help” for free forms and instructions.
- Free legal aid: lawhelp.org — find free and low-cost legal help in your state.
- Eldercare and benefits help: eldercare.acl.gov — connects families with local support.
Sources & How to Verify
The information on this page is drawn from official government and court sources. Estate, probate, and tax rules change, so always confirm the exact figure with your state’s court, statute, or a licensed attorney.
- IRS — Estate Tax: irs.gov — federal estate-tax rules and exemption
- Find free legal help: lawhelp.org — free and low-cost legal aid in your state
- Cornell Legal Information Institute: law.cornell.edu/wex — plain-English legal definitions
- Your state probate code & court self-help portal: search “[your state] probate code” and “[your state] probate court self-help” for the exact law and forms
Content last reviewed September 2026. If you notice outdated information, please contact us.
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Informational only — not legal or tax advice. Wills Probate Guide is an independent educational resource, not a law firm, tax advisor, or financial planner, and this page does not provide legal or tax advice. Estate, probate, and tax rules vary by state and change over time, so always verify the exact rule with your state’s probate code, your local probate court’s self-help portal, or a licensed attorney. For urgent matters like an active probate or a tax deadline, contact a licensed attorney in your state right away.