Medicare and Medicaid After a Loved One Dies

Health insurance is one of the most immediate practical concerns after a death — particularly for surviving spouses and dependents who were covered through the deceased's plan. This guide explains what happens to Medicare and Medicaid after a death, and what steps survivors need to take.

Medicare After a Death

Reporting the death to Medicare

When a Medicare beneficiary dies, coverage ends. If the Social Security Administration (SSA) is notified of the death (which funeral homes often do automatically), Medicare is typically updated automatically. To be safe, call 1-800-MEDICARE (1-800-633-4227) to report the death directly.

Stopping Medicare payments

If the deceased was paying Medicare premiums (typically for Part B and/or Medicare Advantage), payments should stop once the death is reported. Medicare will often issue a refund for any premiums paid after the date of death.

Coverage for surviving spouses on Medicare Advantage

If the surviving spouse had their own Medicare coverage (Parts A and B), Medicare Advantage, or supplement plan, their coverage continues independently — it is not linked to the deceased's coverage.

Surviving dependents who were on the deceased's Medicare Advantage plan

Medicare Advantage plans are individual plans — there is no "family plan" under Medicare. Surviving dependents under age 65 are not eligible for Medicare unless they are disabled. They will need to find their own coverage (through employer insurance, COBRA, or the ACA marketplace).

Medicaid After a Death

Reporting the death

Contact your state Medicaid office to report the death. Medicaid coverage and any associated payments stop at death.

Medicaid Estate Recovery Program (MERP)

This is one of the most surprising and impactful aspects of Medicaid for estates: many states are required by federal law to seek reimbursement from the deceased's estate for Medicaid long-term care costs (nursing home care, home and community-based services, hospital and drug costs paid by Medicaid for those receiving long-term care services).

What this means practically:

• If your loved one received Medicaid-funded nursing home care, the state may file a claim against their estate for the cost of that care
• This can significantly reduce what heirs receive from the estate
• Estate recovery applies after the death of the surviving spouse and when no dependent children remain
• Some states only recover from the probate estate; others pursue expanded estate recovery (including trust assets and jointly-held property in some cases)

If you are the executor of an estate where the deceased received Medicaid long-term care services, contact your state Medicaid office or consult an estate attorney early — Medicaid's claim has priority in estate administration.

Health Insurance for Surviving Dependents

If the deceased was the primary insured on a family health insurance plan, surviving dependents need to find alternative coverage. Options include:

• COBRA — if the coverage was through an employer, surviving dependents can continue the coverage through COBRA for up to 36 months. They must elect within 60 days of losing coverage. Cost: 102% of the full premium, which can be expensive but provides continuity. See our article on COBRA after a spouse dies for more.
• ACA Marketplace — loss of health coverage is a qualifying life event that allows enrollment outside open enrollment periods. Visit healthcare.gov within 60 days of losing coverage.
• Employer-sponsored coverage — if the surviving spouse is employed, their employer's open enrollment may allow them to enroll in their own plan. Loss of coverage is a qualifying event for mid-year enrollment changes.
• Medicaid or CHIP — for those with low income or children, Medicaid and CHIP may provide coverage. Apply at healthcare.gov or your state's Medicaid agency.
• CHAMPVA — if the deceased was a qualifying veteran, surviving spouses and dependents may qualify for VA healthcare coverage. See our article on VA benefits for surviving family.

For the full overview of survivor benefits, see our complete guide to survivor benefits after a death.