Look Back and Penalty Periods

The Look Back period and the Penalty Period are two different time periods.

The Look Back is simply how far back Medicaid can examine your records to see what you have done with your money.

The penalty period is how long you are ineligible for Medicaid if they see that you have made gifts of your money within the look back period.

The Look Back Period:

• A 60 month look back for all transfers

The Penalty Period:

If a transfers appears in the look back period, divide the amount transferred by the average regional rate for a nursing home in that region. The regional rate currently in Northeastern New York is $13,235.

The transfer begins the month a person is institutionalized and otherwise eligible for Medicaid. (Has exhausted funds below the Medicaid resource allowance)

Gifts made will create a period of ineligibility unless the transfer is exempt (see page 5) or we can prove the transfer was done for a purpose other than to qualify for Medicaid!