Explaining The Medicaid “Look-Back” Period In New York

Medicaid is the cornerstone of long-term care for many in Putnam County, particularly those who need inpatient treatment. While the recent ruthless cuts to the Medicaid program may affect the number of people who can access the program, those who meet its means test and other requirements can rest assured that their care will be paid for. However, New York and most other states institute what is known as a “lookback” period in order to crack down on applicants who may not actually need the assistance in paying for their care.

Medicaid Means Test Often Requires Divestment

Data from the Kaiser Family Foundation (KFF) estimates that just under six million people are enrolled in Medicaid in New York, though it is uncertain how many enroll with the intention of seeking long-term care as opposed to simply looking for help in meeting their medical needs. For those who apply as a means of obtaining long-term inpatient care, many are shocked to know there is a means test one must meet before being approved.

Contrary to so many U.S. programs, though, Medicaid requires that a person have less than a certain monthly income amount, and fewer than a certain amount of assets. The rationale is that if a person has a high enough income, they should be able to pay for their own care (even when this may not be tenable given a person’s or family’s other expenses). There are many ways to “spend down” one’s income and assets in order to meet the qualifications, but there are procedures by which this kind of thing must be done.

The “Lookback” Period Polices Asset Transfers

In order to be eligible to receive Medicaid help in paying for nursing home care, an individual must have a low enough income and a small enough estate. In addition, though, Medicaid authorities will ‘look back’ at an applicant’s financial history for a period of time – in New York, the period is generally 60 months, or five years, from the date of the individual’s application for Medicaid.

This ‘lookback’ period is meant to ensure that a person is truly in a position to need Medicaid assistance. If someone, for example, gives thousands of dollars to their son or daughter as a gift, Medicaid will assume that the person could have paid for a period of medical care with that money. As a result, the program will deny medical care for a certain number of months, but will generally not rescind one’s Medicaid coverage unless the problem becomes particularly egregious.

Contact A Mahopac Medicaid Application Attorney

If you have been planning your estate, or helping your loved ones plan theirs, determining whether a Medicaid application will be necessary is an important step – particularly if you have asset transfers planned. A Mahopac Medicaid application attorney from Meyer & Spencer, PC can help ensure all your questions about the process are answered to your satisfaction. Call our office today to schedule a consultation.

Source:

kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-enrollment-data/