One of the most frequently asked questions I get as an elder law attorney pertains to the Medicaid five-year look-back. There are many types of Medicaid programs, and I am referring only to Kentucky's Medicaid program for long-term nursing home coverage. While there are several eligibility requirements, the five-year look-back may particularly concern individuals facing nursing home admission who have been gifting or were sold something for less than fair market value.

When a Medicaid application is made, the Medicaid caseworker reviews any prior transfers of resources made by the applicant during the look-back period. This lookback period begins on a date that is sixty months (or five years) from the date of the Medicaid application (907 KAR 20:030 Section 1(3) (2021).

During the application process, the Medicaid caseworker will request verification of any resources that were transferred by the applicant for less than fair market value and were made during the look-back period (MS 2050 (2021). If it is determined that the applicant (or an applicant's spouse) has transferred resources for less than fair market value, the caseworker will impose a period of ineligibility, which is often referred to as a penalty period. Id.

That said, the five-year look-back rule has several exceptions, and sometimes it can even be used in an applicant's favor. To discuss the look-back and other Medicaid eligibility requirements, please contact Darpel Elder Law today for a consultation.