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Introduction to the Medicaid Look-Back

As previous posts on our blog have explained, Georgia residents can qualify for Medicaid, if they meet certain asset and income requirements. The reason is that Medicaid is designed to help those who have a financial need for assistance with their health care costs.

Nevertheless, many people in Atlanta will discover that, despite working and saving all their lives, they are not going to be able both to pay for the cost of a nursing home or other assisted living arrangement and keep their savings. As a result, they may engage in some Medicaid planning, which is a legal process through, which people divest what wealth they have while they are still healthy and able to secure adequate health coverage. Planning of this sort can, among other things, allow Georgia residents to give their wealth to loved ones without having to worry about this money having to be applied to the cost of long-term care.

However, all states have what is called a look-back period that is designed to prevent people who could pay for a nursing home form giving away all of their money right before applying for Medicaid. Each state has slightly different rules in this respect, but the general idea is that regulators will look at all gifts a person made, including gifts to their children, that a person made within 5 or so years before applying for Medicaid.

If the person did make gifts, then he or she will effectively get suspended from receiving Medicaid long-term care benefits for a certain number of months even if they are otherwise eligible. Generally speaking, the number of months a person is ineligible will depend on the size of the gifts and the cost of a nursing home or other facility. During ineligibility, a family will have to make other financial arrangements to pay for nursing home care.

Although this is a general overview, the look-back period and the associated penalties can be complicated. But, they are very important to understand and plan for.

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