Starting March 31, 2024, New York State will join California in imposing a 30-month Medicaid lookback for community-based long-term care (CBLTC) services. When you apply for Medicaid to cover these services, the state will review your financial records for the past 30 months to see if you qualify. This significant change will impact many New Yorkers, so it’s important to understand how it affects you if you plan to apply for Medicaid to cover CBLTC services.
Below, we discuss the Medicaid lookback period, what CBLTC services are covered, and how the new lookback period will work. We’ll also explain how the Law Office of Andrew M. Lamkin, P.C., can help you plan for your community long-term care.
What Is Medicaid?
Medicaid is a health insurance program funded by the government and designed to provide healthcare coverage to individuals with limited financial resources. It is funded jointly by the federal government and states. Medicaid provides coverage for many healthcare services, including long-term care.
In New York, Medicaid pays for nursing home care, non-medical services, and support to help frail seniors live at home or in the community. Non-medical services include personal care, home health care, and adult day health care.
What Is the Medicaid Lookback?
The Medicaid lookback is a period of time when Medicaid reviews your financial records to see if you have given away assets to qualify for Medicaid. If you have given away assets during the lookback period, you may be ineligible for Medicaid for some time, depending on the value of the assets you gave away.
The lookback is in place to prevent people from giving away their assets to meet Medicaid’s asset limit. This limit is the amount of money and property an applicant can have and still qualify for Medicaid.
The current lookback period reflects the federal lookback period of 60 months. With this change, the Medicaid lookback period in New York will be 30 months for community-based long-term care services. This means that Medicaid will review all your financial transactions for the 30 months—two-and-a-half years—before your application date.
What Types of Assets Are Subject to the Lookback Period?
The Medicaid lookback period applies to all types of assets, including cash, investments, real estate, and personal property. However, there are some exceptions to the lookback period. These exceptions include:
- Transfers to a spouse or minor child. This means you can give your spouse or minor children assets without paying a penalty.
- Transfers to a qualified disability trust. A qualified disability trust is a special type of trust that can be used to protect the assets of a person with a disability.
- Transfers to pay for medical expenses. You can transfer assets to pay for your, your spouse’s, or your minor children’s medical expenses without paying a penalty.
- Transfers to certain types of trusts, such as pooled trusts. A pooled trust is a special type of trust that combines the assets of multiple people with disabilities.
- Transfers made more than 30 months before you applied for Medicaid. This means that you can give away assets more than 30 months before applying for Medicaid without paying a penalty.
It is important to note that the exceptions to the Medicaid lookback period can be complex. If you are considering making any transfers of assets, it is essential to consult with an attorney experienced in Medicaid planning.
What Are Community-Based Long-Term Care Services?
Community-based long-term care services (CBLTC services) help people with disabilities and older adults live independently in their homes and communities. These services can include:
- Personal care services involving help with activities of daily living (ADLs), such as bathing, dressing, and using the toilet;
- Home health care services such as skilled nursing care, physical therapy, and other medical services in the home;
- Adult day health care, including supervision and activities for adults who need care during the day;
- Assisted living services, including housing, meals, and personal care services in a residential setting; and
- Consumer-directed personal assistance services that allow you to choose and manage your own caregivers.
New York State’s new Medicaid lookback period for CBLTC services applies to those not living in a nursing home or other institution.
How Will the New Medicaid Lookback Period Work?
If you transfer assets during the 30-month lookback period, you may have to pay a penalty before qualifying for Medicaid. The penalty amount will depend on the value of the assets you transferred and how many months before your application date you transferred them.
Here are some examples of how the new Medicaid lookback period could affect you:
- If you give your child a gift of $10,000 in 2023 and then apply for Medicaid in 2024, you will have to pay a penalty of $500 per month for 20 months, or a total of $10,000.
- If you sell your house for $200,000 in 2023 and then apply for Medicaid in 2024, you will have to pay a penalty of $1,000 per month for 20 months, or a total of $20,000.
- If you transfer $50,000 to a Medicaid trust in 2023 and then apply for Medicaid in 2024, you will not have to pay a penalty.
In general, the more money you transfer and the closer to your application date you transfer it, the higher your penalty will be.
What to Do If You’re Thinking About Applying for Medicaid
If you’re considering applying for Medicaid, it’s important to talk to an attorney focusing on Medicaid planning. A lawyer can help you understand the new lookback period and how it will affect you. They can also help you protect your assets and qualify for Medicaid.
With the new 30-month Medicaid lookback period for community-based long-term care services approaching, staying informed is essential. This change presents challenges and opportunities for people planning their long-term care needs.
The implementation of the lookback period has been delayed several times in the past, so it could be delayed again. However, it’s always best to be prepared, so it’s a good idea to start planning now.
How We Can Help You Plan for Long-Term Care
We have comprehensive knowledge of New York’s Medicaid laws at the Law Office of Andrew M. Lamkin, P.C. We can help you create a plan to protect your assets and income for your family, both now and in the future.
We focus exclusively on New York estate planning, estate administration, supplemental needs planning, residential real estate transactions, and elder law. This allows us to provide you and your family with a comprehensive approach to estate planning and asset protection.
When you work with us, you can expect:
- A personalized consultation—we will carefully listen to your concerns and goals and create a plan tailored to your needs;
- Clear explanations—we will explain the asset protection concepts we use in plain language so you understand precisely how they work to achieve your goals;
- Personal attention—we will personally work on every aspect of your case, from start to finish; and
- Collaboration—we will work with your other advisors, such as your accountant and financial planner, to create a complete estate plan.