Medicaid is a government-funded program that helps low-income seniors with limited assets afford health care including long-term care. In addition to meeting some medical requirements, applicants must also adhere by stringent financial eligibility requirements both before applying for this benefit and after qualification.
What is Medicaid?
Medicaid, a common government-funded program in the United States, is a federal and state program that offers health care coverage to individuals who qualify. Each state operates its Medicaid program and have different eligibility requirements.
While states have guidelines on how they operate their Medicaid, they are still obliged to abide by the federal government rules. Aside from providing the rules which the states must follow, the federal government also provides at least half of the funding for the Medicaid requirements.
According to Federal Regulations, states create and operate their Medicaid to best serve their residents who are eligible. States may also decide to offer more services than the federal government requires and may also offer coverage to larger groups of individuals. Medicaid offers health care coverage for individuals who qualify based on income and the value of their assets.
Who is Medicaid for?
The Medicaid program is designed for specific groups of people. These people include:
- Pregnant women with inadequate income
- Children of low-income families
- Children in foster care
- Individuals plagued with all sorts of disabilities
- Seniors with low income
- Parents or caregivers with inadequate income
States may decide to expand eligibility to other groups of individuals, such as individuals with low income who may or may not have children.
Eligibility for Medicaid
A lot of seniors with inadequate resources find out that their countable assets and/ or income surpasses their state’s Medicaid limits. To ensure that they meet the financial requirement so they are eligible for this program, they must carefully reduce or spend down excess funds on things such as medical expenses, home renovations, a prepaid funeral plan, etc. Gifting (giving away money or assets for less than fair market value) cannot be among an applicant’s spend-down technique as far as Medicaid is concerned.
To stop seniors from simply giving their entire assets to family and friends and then depend on Medicaid to settle their long-term care, the Centers for Medicaid and Medicaid Services (CMS) created a system for scrutinizing applicant’s financial background.
Medicaid look-back period
Medicaid only analysis applicants’ past finance details within a specific period of time. Each state’s Medicaid programs uses diverse eligibility rules. However, most states observe all the financial transactions of an individual going back five years (60 months) from the date of their qualifying application for long-term care In California, this window is just 30 months.). This is commonly known as the Medicaid look-back period.
It doesn’t matter how many gift a Medicaid applicant initiated during the lookback period or whom they offered the gifts to. If money or assets were transferred to another individual during the five years prior a senior’s application date, then they will incur a penalty period of Medicaid ineligibility.
What is the look back penalty period in Brooklyn?
The rule of thumb is that If a senior who applies for Medicaid is considered otherwise eligible but is discovered to have gifted assets within the five-year look-back period, then the individual will be disqualified from receiving benefits for a specific number of months. This is commonly known as the Medicaid penalty period.
For instance, if you write a check to your adult daughter for $15,000 and apply for Medicaid long-term care within five years of the date written on the check, then Medicaid will delay paying for your nursing home care expenses since you could have used that money to settle it yourself. Worthy to note is that the clock for the penalty period starts on the date a senior applies for Medicaid benefits, not the date on which they gifted the money.
With that said, what is the look back penalty period in Brooklyn?
The look back penalty period in Brooklyn can be calculated by dividing the amount gifted by the regional rate. For instance if you made a transfer of $10,000 to your adult son, the penalty period will be $100,000 divided by $13, 037 (the regional rate of Brooklyn). So your penalty will be 7.6 months.
Need an Elder Law Attorney?
Contact us if you need to know more about the look back penalty period or if you need the help of a Medicaid attorney.
