What is the look back period for Medicaid?

Pursuant to the applicable provisions of the Federal Deficit Reduction Act of 2005 (DRA 2005), the look back period for Medicaid is five years (60 months). That federal statute requires that any uncompensated transfer that occurred during the relevant look back period will cause a penalty period with regard to the receipt of Medicaid benefits.

The penalty period is the amount of the uncompensated transfer ( say gifts of $68,000)divided by the state's reimbursement rate (Maryland is $6,800). The result is ten (10) months that will constitute the penalty period. The penalty period begins in the month in which the person applying for Medicaid would have been approved to receive Medicaid nursing home benefits if the uncompensated transfer had not occurred.

Accordingly, for 10 months after the applicant otherwise qualifies for Medicaid nursing home benefits, the applicant cannot receive Medicaid benefits, and the nursing home cost would be required to paid by someone other than Medicaid.

There are options available other than making uncompensated transfers of assets to your children that will allow you to remain eligible for Medicaid nursing home benefits. I encourage or advise you, to seek an elder care attorney, to help you on those options, and who can help you determine the most beneficial course of action for you and your family.