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What is a lookback period?

On Behalf of | Jan 15, 2021 | Medicaid

As you and your spouse age, you may find that one or both of you needs additional care. You or your spouse may need care either at home or in a nursing care facility. But how are you going to afford that? Nursing home care can cost more than $10,000 a month in Pennsylvania.

You may want to know how to qualify for Medicaid, so you don’t have to use all your assets to pay for additional care. However, you know that you’ll need to show you have limited resources, But what if you decide to give your children your home or some of your assets to qualify? That’s when Medicaid’s lookback period applies.

Pennsylvania’s lookback period

In Pennsylvania, those applying for Medicaid are subject to a five-year lookback period. That means any large assets you gifted to someone in the last five years before applying impact you or your spouse’s Medicaid eligibility. You will face a penalty of not qualifying for Medicaid for a certain period of time, based on the value of the assets you gave away.

For example, you gave your daughter $35,000 for a down payment on a home two years ago. Your penalty will be based on $35,000 and the average monthly cost of nursing home care in Pennsylvania: $10,733 a month. Because of the lookback period penalty, you won’t be eligible for Medicaid for 3.25 months (the penalty equals $35,000 divided by $10,733).

Every state except California has a five-year lookback period when qualifying for Medicaid.

Seeking help to manage your assets and qualify for Medicaid

If you know you or your spouse may need more care in the coming years, you should consult with an elder law attorney. An attorney can help you manage your assets to help you qualify for Medicaid. You want to do all you can to prevent your hard-earned money from all going toward you or your spouse’s increased care needs.