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Look Back & Estate Recovery

What is the Medicaid Look Back Period?

Medicaid looks back on any assets you transferred out of your name when applying for assistance.

Any asset that was transferred, sold, or given away within the past 60 months (The Look Back Period) will be reviewed by the county assistance office when you apply for Medicaid. The look back period is determined by the date you apply for Medicaid.

The county assistance office will review any asset transfer to determine if you received fair market value (FMV) at the time of transfer. FMV is the amount that a person can receive for selling an item on the open market. If FMV is not received, a period of ineligibility, (The Penalty Period), will be established. During the penalty period, DHS may not pay for your long term care services. The total of all transferred assets will be used to determine the length of time you are ineligible for Long Term Care Benefits through Medicaid.

What is the Estate Recovery Program?

The estate recovery program enables the Commonwealth to recover from an estate the value of services paid by Medicaid to individuals 55 years of age or older at the time of such benefits. The Commonwealth can recover the amount of Medical Assistance paid for all nursing facility services, home and community-based services, and related hospital and prescription services.

We have noted a basic summary of the Look Back Period and Estate Recovery Programs to make you aware of them. The regulations for these programs are very detailed. Your personal or family situation may not be handled in exactly the same manner as stated above. We recommend that you consult with an attorney versed in elder law matters before making any decisions related to Medicaid Planning.

The Bottom Line: These programs make it clear there is a substantial cost to rely on Medicaid to pay for your long term care expenses.


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