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How will New York’s new Medicaid look back period impact applicants?

On Behalf of | Jul 16, 2020 | Medicaid

Applicants for assistance under the Medicaid program must meet specific asset and income limits in order to qualify. Beginning in October, applicants for community Medicaid benefits will be subject to new regulations under New York law. What do you need to know about this new look-back period?

What is the Medicaid look back period?

Medicaid, a government assistance program that provides support to disabled and elderly people in need of long-term care, generally recognizes two types of long-term care benefits. Institutional long-term care benefits through Medicaid fund care through a nursing home. Community long-term care benefits fund additional care for recipients living in their own home rather than a care facility. Each state has its own guidelines for reviewing applications.

Under New York law, Medicaid applicants looking for institutional care are subject to a look-back period. The government, when reviewing their application, will examine any transactions that applicants and their spouse made for the five years before they applied for assistance. Any gifts or asset transfers made within 60 months of the application could be seen as the applicant voluntarily placing themselves in an impoverished state, and that applicant would temporarily lose eligibility for Medicaid as a result. The period of ineligibility is based on the amount of the gift or transfer.

Previous Medicaid guidelines in New York did not penalize asset transfers made before disabled or elderly person applied for community Medicaid to fund their long-term care costs at home.

New guidelines could put New York Medicaid recipients’ benefits at risk.

Starting October 1, 2020, New York law will apply a new look back period of 30 months to elderly and disabled people applying for community Medicaid. While this period is shorter than the look-back period for institutional Medicaid, any non-exempt transfers made during this time will result in a similar period of ineligibility.

This new look-back period makes it especially important for elderly people to plan their Medicaid asset spend-down carefully. If you or a loved one plans to apply for benefits, it can be important to speak to an experienced attorney to protect both your assets and your eligibility under these new regulations.