In New York, Medicaid imposes strict eligibility requirements based on financial circumstances. When you apply for Medicaid coverage, program administrators review significant financial transactions from the last five years, such as gifts, to ensure you did not give away property just to qualify for Medicaid. This review of the five years preceding your application is known as the Medicaid 5-year lookback period. If you are wondering how to avoid the Medicaid 5-year lookback, the key is careful planning in advance. Learn more about our Medicaid Planning services.
At the Law Office of Andrew M. Lamkin, P.C., we help Long Island families protect their assets while still qualifying for necessary care. Our practice focuses on estate planning, estate administration, supplemental needs planning, elder law, and residential real estate. When you work with us, you can expect a personalized review of your family’s situation and hands-on guidance from start to finish. We proudly serve clients across Long Island and New York City, helping families navigate Medicaid planning and asset protection with confidence.
Medicaid in New York
Medicaid provides health coverage to individuals with limited income and resources. It offers long-term care coverage, including services such as nursing homes and home health aides.
To qualify for Medicaid long-term care, you must meet strict financial eligibility rules limiting coverage to those with a monthly income below certain levels and with limited resources.
How Far Back Does Medicaid Look at Income and Assets?
When you apply for long-term care coverage, the state looks at your current financial situation and may look at your past financial activity. Medicaid reviews the applicant’s financial activity from the past five years to prevent people from giving away or hiding wealth just before applying. When does New York look back at income and assets?
Nursing Home vs. Community Care
In New York, the 5-year lookback period’s applicability depends on where the applicant applies to receive care. The lookback period applies to applications for nursing home (institutional) facilities, not applications for community-based long-term care (CBLTC).
In 2020, the New York legislature proposed a 30-month lookback period for CBLTC applications. However, the state has delayed implementation multiple times. The state most recently indicated that it expected implementation in late 2025, which appears unlikely as of October 2025.
Asset Limits
Medicaid divides property into countable and exempt assets. Countable assets are resources that Medicaid considers when determining eligibility. Medicaid excludes exempt assets, such as:
- Furniture,
- Clothing,
- Household items,
- One vehicle, and
- The applicant’s primary home.
As of 2025, an individual applying for nursing home Medicaid in New York may keep up to $32,396 in countable resources, while couples applying together can keep up to $43,781. If only one spouse applies, the non-applicant may retain up to $157,920.
Income
Income includes money you receive regularly, such as:
- Wages,
- Social Security, or
- Pension payments.
Institutional Medicaid does not set strict income limits on applications. Instead, it requires those it covers to apply all income toward their care, except for a $50 monthly allowance.
To qualify for CBLTC, you cannot earn more than $1,800 per month as of 2025. When only one spouse applies, a non-applicant spouse can earn up to $3,948 per month. These figures are updated annually, so they may change.
The Lookback Period Review
During the five-year review, Medicaid examines transactions such as:
- Gifts to children, relatives, or others;
- Property transfers for less than market value;
- Moving assets to accounts with other owners; and
- Forgiving debts without receiving payment.
If Medicaid finds such transfers in those five years, it presumes you made the transfer to qualify for benefits, regardless of the actual reason.
Medicaid excludes some exchanges from this review, such as transfers to a:
- Spouse;
- Disabled child;
- Caretaker adult child who lived in your home for at least two years; and
- Trust for a disabled person under age 65
Even if you make exempt transfers inside the five-year lookback window, Medicaid will not count them against you.
Penalties
If Medicaid locates transfers it considers improper, it applies a penalty period, during which time Medicaid does not cover the costs of long-term care. Until the penalty period ends, you must cover the costs yourself.
In New York, Medicaid calculates the penalty period by dividing the value of the transferred assets by the state’s estimate of the average monthly cost of care, which varies by region.
For example, if you transfer $160,000 within the lookback period, and the state’s regional rate is $16,000 per month, Medicaid would divide the transfer by that rate. In this case, it would equal 10 months of ineligibility, meaning Medicaid would not cover your care for 10 months.
The lookback rule makes timing critical.
How to Avoid the Medicaid 5-Year Lookback
The most important strategic move you can make to avoid the lookback period for Medicaid long-term care coverage is to start planning early. Several strategies can help mitigate the harshness of the 5-year lookback period. You may give gifts, use trusts, spend down planning, or use a combination of strategies.
Using a Medicaid Irrevocable Trust
A common strategy to avoid the Medicaid lookback period is a Medicaid asset protection trust (MAPT). The MAPT must be irrevocable, meaning you cannot undo it or take the property back once you transfer funds into it. Creating and funding a Medicaid irrevocable trust removes the assets held within from counting against you for Medicaid eligibility. Read about our Elder Law services. An experienced attorney can carefully draft the trust to enable you to receive some income generated by trust assets.
Spend-Down Planning
You can also complete spend-down planning to use assets for permissible expenses during the five years, such as:
- Paying off debts,
- Making home repairs or safety modifications,
- Purchasing medical equipment, or
- Prepaying funeral and burial expenses.
Your lawyer can help you coordinate spend-down planning with other asset protection strategies.
Frequently Asked Questions (FAQs)
What Is the meaning of a lookback period?
A lookback period is the time frame during which Medicaid reviews to determine whether a Medicaid applicant transferred assets away for less than fair market value.
How do you determine the lookback period?
The lookback period counts backward from the date you apply for Medicaid coverage.
Does Medicaid always look back 5 years?
No. In New York, the 5-year lookback period applies to long-term care in nursing homes (institutional). Community (home care/CBLTC) Medicaid does not currently have a lookback period, although a 30-month rule has been proposed but not implemented.
Can you hide assets to qualify for Medicaid?
No. Hiding or failing to disclose assets is fraud.
Take the Next Step in Protecting Your Family
Medicaid planning can be confusing, especially with New York’s divided lookback rules. The team at the Law Office of Andrew M. Lamkin, P.C., can guide you through your options and work with you to create a plan that meets your needs.
With nearly two decades of experience in elder law and estate planning, attorney Andrew Lamkin offers compassionate, strategic guidance for families navigating Medicaid eligibility. If you are concerned about how to avoid the Medicaid 5-year lookback or have questions about long-term care planning, contact us today.
Andrew Lamkin is principal in the law firm of Andrew M. Lamkin, P.C., where he focuses his practice in the areas of elder law, estate planning and special needs planning, including Wills and Trusts, Medicaid planning, estate administration and residential real estate transactions. He is admitted to practice law in New York and New Jersey.
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