The Medicaid Look Back Period: What is it and Why Should I Care?

Have you heard the term “Medicaid 5-year look back period” and wondered how it could impact you and your loved ones? We receive many calls from potential clients who ask about the Medicaid look back period and worry they may have missed their opportunity to protect their assets and qualify for Medicaid. Luckily, there is often a solution to protect assets even if long-term care will be needed within a 5-year period. What does the “5-year look back period” mean?

Medicaid transfers

When someone applies for Georgia Medicaid, they must disclose and provide proof of any transfers made within 5 years of the date of application.  If the potential Medicaid recipient has made a transfer, they may be penalized resulting in a period of ineligibility during which the applicant won’t receive payment toward nursing home facility charges or community-based services. With the cost of care continuously rising this can be a frightening concept often resulting in thousands of dollars. We talk to many well-meaning families who now suffer the consequences of decisions made several years ago.

If you or your loved one has transferred funds or property within the past 5 years our Hurley Elder Care Law attorneys can review the impact on your Medicaid eligibility. If the transfer has a negative impact, we can discuss ways you may be able to reduce or eliminate the potential penalty period.

Wait. Are you saying that we can’t spend our own money?

If a Medicaid applicant has used their own funds to pay for care or living expenses, then this is not an issue. The Division of Family and Children Services (DFCS) caseworker closely examines bank statements when processing a Medicaid application. Do not hide anything! An applicant’s authorized representative should be prepared to explain large transfers or withdrawals that occurred within a five-year period of the application.

Good News! There are some potential transfer exemptions including:

• A spouse;
  • A child who is under age 21 or who is blind or disabled;
  • A sibling who has an ownership interest in the house; or
  • A “caretaker child,” who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant’s institutionalization and who during that period provided care that allowed the applicant to avoid a nursing home stay.

This isn’t an all-inclusive list and there are nuances to these exemptions. It is imperative that you seek the guidance of a Certified Elder Law Attorney (CELA) prior to making any transfers.

If you worry about long-term care needs and expenses and want to uncover options available to protect your assets, call our office at 404-843-0121 to schedule a consultation.