What is the look-back period in Medicaid?  If you are one of many residents in Pittsburgh confusing Medicaid and Medicare and assuming that paying for long-term care is the same in both programs, reading this post may be beneficial not only to explain the differences between the two but also to understand the impact of the look-back period.

Medicaid is administered by each state to help those in need. The rules for Medicaid vary from state to state. Medicare, on the other hand, is an entitlement program that is funded through payroll withholding.

Paying for long-term care in a Medicaid program begins when an individual’s assets are reduced to the eligibility limits. If someone has savings, it is assumed that they would use those savings to pay for their own care and would, therefore, require assistance only if their funds ran out. This is why many people engage in timely long-term care planning, allowing them to spend their assets on a spouse and children rather than extinguish it on themselves.

One of the ways to ensure that loved ones are cared for is to engage in timely gifting. Medicaid has a five-year look-back period. This means that any gifts given within five years of a Medicaid application can result in penalties for the gift-giver. For example, if a gift has been given in 2016 and a Medicaid application made in 2017, this gift will subject to penalties. Anything outside of a five-year period is not subject to those penalties.

Understanding the implications of saving and spending is essential when it comes to Medicaid planning. An experienced elder law attorney may be able to explain the ever-changing rules of Medicaid to Pittsburgh residents.