The Medicaid lookback period is a rule you must understand if you think you may need to qualify for Medicaid coverage to pay for costly services like nursing home care or other types of long-term care. There is a possibility that you could be disqualified from getting Medicaid coverage that you rely on if you engage in certain financial transactions during the lookback period. Understanding how long this period is, and what happens during the lookback period, can help you to do everything possible to get Medicaid benefits when you need to.
Zimmer Law Firm can explain the Medicaid lookback period to you and can help you to determine what steps, if any, you should be taking new to try to qualify for Medicaid coverage as soon as you need to get nursing home care or long-term care paid for. To find out more about how our legal team can assist you, give us a call today.
What is the Medicaid Lookback Period and How Long Does it Last?
Many people apply for Medicaid coverage when they get very sick or seriously hurt and they need nursing home care. Medicaid is a means-tested program, so it is supposed to provide coverage for nursing homes and other services only to people with very limited incomes and with few resources.
Medicaid does not want you to discover that nursing home care is needed and immediately give away your property to friends or family so that you can impoverish yourself and get Medicaid. Instead, Medicaid wants you to spend your own money and even sell some of your assets in order to pay for the high costs of nursing home care or long-term care services.Once you’ve impoverished yourself and have very few resources left (except for assets that Medicaid doesn’t count in determining eligibility), only then will Medicaid begin to cover you.
Medicaid doesn’t just look at transfers made within the few days or weeks prior to the illness or injury that has necessitated your application for benefits. Medicaid looks back for a period of five years from the time you apply for benefits to ensure you didn’t intentionally give away valuable assets, or sell those assets for less than fair market value, solely to game the system and get coverage for care.
This five-year period is called the five year lookback rule. A standard formula is used to determine the period of disqualification that is imposed for asset transfers during the five years before trying to get Medicaid. The formula involves adding up the value of assets that were given away and dividing this number by average monthly nursing home costs in your area. This number equals the number of months of disqualification.
Because of this five-year lookback rule, it is important to talk with an experienced attorney about asset protection long before you need nursing home care. You need to do this even if you have Medicare and/or private insurance coverage. The reason it is so important is because most insurers, including Medicare, pay only for skilled medical services in a nursing home and pay only for a very brief time.
Most people who have to go into a nursing home don’t need skilled medical services. They need custodial care, or routine help with everyday daily tasks like bathing or eating. Needing help with everyday tasks is also a common reason why people need long-term care at home if they don’t go into a nursing home. If you don’t make plans in advance to get Medicaid to cover this kind of care, you’ll have to pay the exorbitant costs out of your own pocket until you’ve spent down your assets enough to qualify for Medicaid.
Getting Help from A Cincinnati Medicaid Planning Lawyer
Zimmer Law Firm can provide you with the help that you need to make a Medicaid plan that protects as much of your wealth as possible. If you need care within the five-year Medicaid lookback period, our legal team can still help you to try to make effective use of legal tools to try to get covered as quickly as possible while minimizing the loss of assets.
If you have time still before you need nursing home care and it is possible you may be able to plan ahead, give us a call right away so we guide you in making a comprehensive Medicaid plan that will hopefully help you to protect your assets long before the five-year period that Medicaid reviews when you apply for coverage.
To find out more about how our Cincinnati Medicaid planning lawyers will assist you with with your plans, give us a call at 513.721.1513 today.