How does the Medicaid lookback period work in New York?

Medicaid is a government insurance program that helps those unable to afford necessary medical care. Strict limitations on who can qualify for Medicaid help limit the overall costs for this important medical safety net. Limiting who can qualify for benefits and also pursuing repayment for benefits can help manage the cost of providing financial support for those unable to pay for their own health care.

Every applicant is subject to state scrutiny when they need benefits. When the state reviews a Medicaid benefit application, they don’t just look at the individual’s current bank account balance and income. They also go over that individual’s financial records to look for recent transfers.

Gifts to your loved ones or transfers into a trust could potentially trigger a penalty that affects the benefits you receive. How does this lookback period work in New York?

The state has delayed the implementation of the lookback period 

Lawmakers in New York made changes to Medicaid rules that specifically apply to those seeking long-term, community-based care coverage. However, federal rules about Medicaid restrictions have forced the state to delay the rollout of the lookback period rules.

The plan has always been to start with a smaller lookback period and then increase it a little at a time. Eventually, the lookback period in New York will go back 30 months, although it will likely only be 18 months when the state first adopts this policy. Currently, it looks like this rule will start to take effect beginning on April 1, 2022, although the state has already pushed that date back before. It is possible that it may be July 1, 2022, or later before the rule actually takes effect. 

What happens if you have a transfer during the lookback period?

Any major gifts or transfers in the months before you apply could affect your right to coverage. If the state identifies an inappropriate transfer in the months leading up to someone’s Medicaid application, that transfer will likely trigger a penalty.

Planning ahead by making transfers and setting up a trust multiple years before you need to apply for benefits can help you avoid that penalty. Learning more about the Medicaid planning process can help you protect yourself as you get older.