Quick Answer: How Many Years Does Medicaid Look Back?

five years

What is the 5 year look back rule for Medicaid?

The general rule is that if a senior applies for Medicaid, is deemed eligible but is found to have gifted assets within the five-year look-back period, then they will be disqualified from receiving benefits for a certain number of months. This is referred to as the Medicaid penalty period.

Can Medicaid Take Back gifted money?

Under federal Medicaid law, if you transfer certain assets within five years before applying for Medicaid, you will be ineligible for a period of time (called a transfer penalty), depending on how much money you transferred. Even small transfers can affect eligibility.

How many years can a nursing home go back and retrieve funds?


The look back period has been extended from three to five years. This means that the government has the right to examine all financial transactions a person has made within the past five years.

What does the 5 year look back mean?

The Medicaid case worker will review all transactions for the prior five years to determine whether any assets (money, stocks, property, etc…) were given to any individual or entity for less than fair-market value (also called a “gift”). This review by the Medicaid case worker is referred to as the “look back period.”

Does Medicaid check bank accounts?

Although Medicaid is a federal program, the income and asset limits are set by each state, so you should check with your state’s agency when you’re ready to apply. Assets are defined as money held in a savings or checking account, plus any investment or retirement accounts.

Does Medicaid look at your taxes?

MAGI is the basis for determining Medicaid income eligibility for most children, pregnant women, parents, and adults. The MAGI-based methodology considers taxable income and tax filing relationships to determine financial eligibility for Medicaid.

How much money can be gifted after Medicaid?

(For 2014 you can give up to $14,000 to any individual without paying gift tax.) That’s great – but beware the look back period. When you apply for Medicaid, any gifts or transfers of assets made within five years (60 months) of the date of application are subject to penalties.

How much money can be gifted before Medicaid?

The $10,000 annual “limit” on gifts to one person (now $14,000 in 2016) is a rule of tax law and has no relation to Medicaid law.

Does gifting affect Medicaid?

The annual tax-free gift exclusion is an IRS regulation only, and does not relate to Medicaid eligibility rules. Gifting assets, in any amount, will create an eligibility problem should the individual enter a long-term care facility and need to qualify for Medicaid benefits.

Are family members responsible for nursing home bills?

Nursing homes are prohibited from requiring third parties to guarantee payment of nursing home bills, but many try to get family members to voluntarily agree to pay the bills. Many contracts have a murky provision asking the family member to sign as “responsible party.”

What assets are exempt from Medicaid?

Exempt assets include one’s primary home, given the individual applying for Medicaid, or their spouse, lives in it. Some states allow “intent” to return home to qualify the home as an exempt asset. There is also a home equity value limit for exemption purposes.

Is power of attorney responsible for nursing home bills?

While you are not personally responsible for expenses that exceed a principal’s ability to pay, it is within your authority to bind the principal to financial obligations. You have the power to approve certain expenses, including nursing home bills, which effectively obligate the principal to pay the bill.