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NY Medicaid’s 2.5 Year (30 mo) Look-Back For Community Medicaid

Medicaid is a program that provides medical care coverage for low income individuals, children, pregnant women, seniors and the disabled. In addition, Medicaid also provides coverage for the elderly population residing in nursing homes and assisted living facilities as well as community based home care medical services. The Medicaid home care services program includes private duty nursing services, personal care services and assisted living services.

While Medicaid has always been a resource based program, there was previously no look-back period for people who transferred their assets and applied for home care services the following month. With the new changes coming into effect on October 1, 2020, that will no longer be the case. Now, transfers made from a Medicaid applicant’s assets for less than fair market value, will be subject to a 30 month look-back period. This new 2.5 year look back is being implemented in effort to cut costs to New York’s Medicaid program.

Just as with institutional (i.e. nursing home) Medicaid benefit applicants, where a 60 month look-back period is imposed, if any such transfers are made that do not qualify under an exemption (such as to a spouse), the applicant will be subject to a period of ineligibility for benefits. The exact numbers to calculate the ineligibility period are not yet available as of the time of writing this article, but assuming it follows institutional Medicaid eligibility penalty periods, an applicant will likely be ineligible for a period of one month for every $13,000 that they gave away.

The newly imposed look-back is a significant departure from the way New York State has run its home care Medicaid program in the past. These are now all services which should be planned for even though it may not be possible to precisely anticipate when you may have a need for them. If you have not recently consulted with a New York elder law attorney, now is a great time to check back in with trusted counsel to make sure that you are taking the appropriate steps to secure your own Medicaid eligibility as planning for your future care needs has become increasingly important.

Fortunately, the there will still be exempt transfers which will continue to apply to home-care applicants, even if they are made within the 30 month look-back period. For example, you may transfer excess resources to your spouse, to a disabled child, and applicants under age 65 may make transfers to a qualifying first party supplemental needs trust and become eligible for Medicaid home-care services the following month. Additionally, if steps have been taken far enough in advance, with the help of your elder law counsel, you may still be able to protect your important assets and preserve your Medicaid eligibility without taking advantage of one of the exempt transfer rules.

The Law Offices of Roman Aminov is an award winning Medicaid law firm in NYC. Call us now at 347-766-2685 to discuss your options and prepare for your future needs.

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