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How Does the Medicaid Lookback Period Work?


If you are anticipating that you will need to take advantage of Medicaid’s long-term care insurance program, or if you have an elderly parent or loved one who will soon need long-term care, it is more important than ever to think about asset protection and to learn more about how the Medicaid lookback period works. Indeed, to establish an effective long-term care plan, you may need to consider Medicaid planning, which is currently the only government program that can cover the cost of long-term care for seniors.

Medicaid Coverage in New York

Before you consider the lookback period, you will need to make sure you are otherwise eligible for coverage. There are different ways to qualify for Medicaid, but anyone over the age of 65 can be eligible. However, in order to be eligible, not only must you be over a certain age (or have another qualifying condition), but you also must have limited assets. Medicaid is known as a means-tested program, which ultimately means that it is only for older adults who cannot otherwise afford to pay for their own long-term care.

How much does long-term care cost, and do you really need to learn about Medicaid planning and the Medicaid lookback period? The average cost of nursing home care in the downstate area, including in Westchester County, is approximately $450.00 per day, which comes out to be $164,250.00 annually. For most older adults in Westchester County, that is significantly more money than they are able to afford. As such, Medicaid planning, and learning about the Medicaid lookback period, becomes essential.

What is the Medicaid Lookback Period?

If you want to qualify for Medicaid, as we mentioned above, you must have a limited amount of assets. Currently in 2020, a single person cannot have more than $15,750.00 in non-exempt assets. Accordingly, you may need to “spend down” assets in order to be eligible for coverage. However, Medicaid does not want applicants spending down quickly for the purpose of being eligible for coverage. As such, Medicaid has a lookback period—or the amount of time Medicaid will “look back” at your assets to determine your eligibility.

In New York, if you are applying for long-term care coverage for a nursing home, the lookback period is five years. As such, if you gift any assets or transfer property within the five-year period before you apply for Medicaid, you can face a penalty and the Department of Social Services may investigate your case. The total penalty will be based on the amount of money that was transferred during the lookback period.

Contact an Elder Law Asset Protection Lawyer

If you have questions about the Medicaid lookback period, a Westchester County asset protection attorney can help. Contact Meyer & Spencer, PC today.

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