How Does the Medicaid Look-Back Rule Affect Medicaid Eligibility?

Medicaid written near a laptop and stethoscope. - Asset Protection & Elder Law of Georgia

Eligibility for Medicaid coverage for long-term care costs requires a complicated analysis of a senior’s assets and income. One asset rule that causes a lot of confusion is the Medicaid look-back period. While the rule itself is complex to apply in some situations, the basic concept is relatively easy to explain.

What Is the Medicaid Look-Back Period?

Medicaid uses an asset and income means-based test to determine eligibility for coverage of long-term care costs for seniors over age 65. In conducting the asset analysis, Medicaid rules take into account certain asset transfers made within a specific period preceding the Medicaid application date. That period is the “look-back” period.

In Georgia (and in most other states), the look-back period is 60 months. Only certain types of transfers within that five-year period pose potential problems.

If, within the five-year look-back period, the Medicaid applicant (or spouse, in some cases) transfers property without receiving full fair market value in return, the transfer may violate the look-back rule. A violation of the rule results in a period of ineligibility for Medicaid for the applicant. The length of the ineligibility period is based on the value of the transferred asset.

The look-back rule prevents applicants from satisfying Medicaid asset limitations by giving away assets (such as transferring them to family members) immediately before applying for Medicaid. (Transfers made before the five-year period are not subject to review.)

Rules that govern the look-back period vary from state to state. For Georgia residents, rules established by the State of Georgia apply in making the look-back assessment.

Exceptions to the Medicaid Look-Back Rule

Some transfers within the look-back period do not constitute a violation. In addition, even if an applicant made a transfer that violates the rule, it may still be possible for the applicant to become eligible for Medicaid.

The exceptions and remedies for a transfer that may violate the look-back rule are extremely complex. For an applicant who is trying to evaluate potential look-back issues in connection with Medicaid eligibility, the best strategy is to consult with a knowledgeable Medicaid planning professional.

A Medicaid planner can help with much more than look-back issues. Even if you think you are over the asset limitation, there may be ways to spend down excess assets without violating the look-back period.

Talk With a Georgia Elder Law Attorney About the Medicaid Look-Back Period

In our Cartersville elder law practice at Asset Protection & Elder Law of Georgia, Medicaid planning is an essential part of our services for many clients. If you have questions about the Medicaid look-back rules or other questions about Medicaid eligibility in Georgia, we can answer your questions and help you make the right decisions.

We provide legal services to clients throughout the communities northwest of Atlanta, including in Bartow County, Cobb County, Cherokee County, Gordon County, Floyd County and Paulding County. Call us at (770) 382-0984 or contact us through our online form.