The “Look-Back Period” for a Medical Assistance Application

The Medical Assistance or “Medicaid” applicant must meet several criteria to obtain benefits.

If deemed eligible, Medicaid will partially offset the applicant’s cost of nursing home care. Unlike Social Security which is normally age or disability-based, Medicaid is a means-tested program.

The relevance of this statement is that the State will examine the applicant’s and their spouse’s economic ability to privately pay for nursing home care and also to determine if any gifts were made. Any transfer of assets for less than fair market value is usually considered a “gift” in the Medicaid program.

All Maryland applicants must give the State permission to examine their and their spouses’ assets for 60 months. That five-year time frame is commonly referred to the “look-back period”. The examination includes assets then currently owned and those that were closed during the look-back period.

The purpose of this regulation is to prevent Medicaid applicants from giving away most of their assets to qualify for this program.

The examination is retroactive starting with the month of application. The State “looks back” (examines) the applicant’s assets to determine if the applicant or their spouse, made any gifts. The state imposes an economic penalty when gifts are made during the look-back period. This penalty is that the applicant must privately pay for care for a period of time. Most, but not all such transfers are penalized. There may be other considerations that the State can examine.

The Maryland regulations that control gifting are updated on a regular basis. Our system in Maryland is extremely complex. It is recommended you meet with and experienced Elder Law attorney so a comprehensive plan to preserve assets can be developed.

Richard Abraham, Esquire has almost 30 years of experience providing representation in Medicaid cases. He can be telephoned at 443-901-1333.

Planning ahead is a gift to your loved ones!