The Three Most Confused Medicaid Terms
The three most confused terms in Medicaid planning are the look back date, the look back period and the penalty period. If you go to any beauty shop or coffee shop and ask the people what would happen if they transfer assets, the common answer will be that they are ineligible for Medicaid for sixty months. Medicaid practitioners know sixty months is merely the period of time Medicaid can look back at the financial records of a Medicaid applicant, a.k.a. the “look back period.” The period of the look back (sixty months) has no impact on qualifications. The look back period begins on the look back date. The look back date is the date a Medicaid applicant resides in a care facility and applies for benefits. It is critical that a practitioner understands this distinction. If a client resides in a nursing home and you apply for medical before continuing the client’s eligibility, you can disqualify a client from medical and create a penalty period that is far greater than sixty months. This occurs when there is a large uncompensated transfer within the look back period.
Once Medicaid looks back at the financial records from the look back period it examines whether any uncompensated transfers occurred. An uncompensated transfer is the transfer of assets made by an applicant to someone else with no compensation in return. Gifts are typically the most common uncompensated transfer. If there is an uncompensated transfer, Medicaid will deem the applicant ineligible for a certain number of months based upon two factors: the amount of money transferred and the monthly divisor in the region where the applicant lives. Each state must publish, at least annually, the average cost of one month’s private pay nursing home cost for the region. If the average monthly private cost of a nursing home was $5,000 and the uncompensated transfer was $100,000, the applicable penalty for the transfer is 20 months. So the 60‑month look back period has nothing to do with how long an applicant may be ineligible, it’s merely a period of time Medicaid can look back at financial records to determine if an uncompensated transfer occurred, and if so, then calculate the penalty period based on the amount of the uncompensated transfer and the regional divisor.
It’s that simple.
David J. Zumpano, Esq, CPA, Co-founder Lawyers With Purpose, Founder of MPS, Founder and Senior Partner of Estate Planning Law CenterPosted by dzumpano | 0 comments