What is the Medicaid look-back period, and will it affect you?

Published By | Apr 22, 2022 | Long-Term Care Planning |

If you are looking into setting up long-term care plans, then you need to consider how you’ll access Medicaid. One of the issues that some people run into is having too many assets to qualify for this support, which can mean that they have to spend much of their income on their own nursing home care.

Medicaid has an important period called the Medicaid look-back period that you need to know about. This is a five-year time period that the government will review to see if you moved any significant assets out of your estate. For example, if you need to go into long-term nursing home care in May of 2022 but moved $100,000 by gifting it to your child in May of 2018, you may still have to spend that asset down before you’ll qualify for Medicaid.

The alternative is to wait to file for Medicaid until the lookback period has passed, allowing that money to go untouched completely.

Penalties can happen if you completed transactions within the lookback period. For example, that $100,000 may disqualify you from seeking Medicaid for a period of time. This is problematic for those who have given away assets and who now no longer have access to them.

How does the look-back period differ in New York?

New York is a little different because it does uphold the 60-month look-back period for nursing home care, but it doesn’t use the same look-back period for Community Medicaid. This is the kind of Medicaid that is used for long-term home health care as well as other community-based services.

This could be extremely helpful for someone who technically falls within that 60-month look-back period for traditional Medicaid and who may need nursing home care. If they, like in the example above, need another year before they’ll qualify, then they might opt to get in-home health care instead and try to wait longer before filing for traditional Medicaid.

In 2022, Medicaid will change in New York, starting to phase in a 30-month-look back program. That’s something to look into as you begin planning for your future.