“At a minimum, states must recover from assets that pass through probate (which is governed by state law). At a maximum, states may recover any assets of the deceased recipient.” from https://aspe.hhs.gov/basic-report/medicaid-estate-recovery
This particular article is from 2005, but I searched for “Medicad biteback”. It seems to address mainly Medicad nursing home care, but it appears to apply to any Medicad payments.
I have zero assets so recovery isn’t feasible for the state.
Nursing home costs are paid by Medicaid because its expensive and people quickly exhaust their savings to pay for it.
Medicare only pays the first 100 days of post-surgical skilled nursing care. Medicaid pays the cost indefinitely.