Preserving & Protecting Your Family’s Assets & Legacy

Medicaid look-back can be reduced to 57 months

by | Jul 12, 2023 | Medicaid Planning |

Medicaid provides coverage for long-term nursing home care, but applicants must adhere to strict asset transfer rules. One such rule is the 60-month look-back period for Chronic Care (Nursing Home) Medicaid (see What is the 5 Year Look-Back for Medicaid?). However, in certain circumstances, Medicaid applicants can use a retroactive payment period to reduce the wait time for Medicaid coverage from 60 to 57 months after a transfer.

For example, a client who transferred their house to an Irrevocable Medicaid Asset Protection Trust for Medicaid planning on September 15, 2018, triggering a transfer of assets, may be eligible for this reduction. If the client is admitted to a nursing home on May 1, 2023, and the transfer will be beyond Medicaid’s 60-month lookback period on October 1, 2023, an experienced attorney may advise the client to pay for care privately until Medicaid will “pick up” the costs instead of undoing the original transfer.  Instead of waiting five months for Medicaid to pay, this can be reduced to two months.

For new Medicaid applications, the client must provide banking for the 60 months prior to the date of application, not the date of institutionalization. Using the retroactive payment period of three months, the application would be filed on October 1, 2023, requesting a “pick-up date” of July 1, 2023 (three months prior to the month of application). The applicant would only have to wait 57 months from the date of the transfer of the house for Medicaid to start paying the costs, saving them three months of private-pay costs, which can be upwards of $50,000 (see Chronic Care Medicaid Pays Retroactively).

It’s important to note that strategies like these are best handled by an experienced elder law and estate planning attorney. Additionally, this strategy does not work for conversion applications, as statements must be provided back to the date of institutionalization in those cases.


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