What is the Medicaid Look-Back Period in Florida? 


The Medicaid look-back period is one of the key concepts for anyone considering applying for Medicaid for long-term care assistance such as a nursing home. The best way to get set up for Medicaid is to think about your planning journey before needing long term care. But sometimes, circumstances just don’t work out that way. If you’re in a position to plan for the future, working with an elder law attorney can help you structure your assets in ways that protect them.

The Purpose of the Medicaid Look-Back Period

The purpose of the Medicaid look-back period is to see whether a person applying for Medicaid has given away their assets or sold assets below market value to qualify for Medicaid. 

For example, suppose a person gives most of their money to their children for the purpose of qualifying for Medicaid. That type of gifting will be discovered during the look-back period. 

Bank records and other financial asset information will be examined during the look-back period, and this deep dive reveals whether you gave away or sold significant assets. While options for protecting your assets are indeed available, they should be pursued only according to specific guidelines with the guidance of a Certified Elder Law Attorney in order to protect you during the Medicaid look-back period.

When Does the Look Back Period Begin and End?

The Medicaid look-back period begins on the date you apply for Medicaid benefits. The Department of Children and Families (“DCF”) is the organization in charge of looking back at your documents and information. Assets and resources will be examined, along with what you currently own, how much money you have, and other related factors. 

In Florida, the Medicaid look-back timeframe is 60 months (five years) from the date of your Medicaid application. It can affect your eligibility if you’ve sold or given away assets during this time.

What is Included in the Look Back Period?

During the look-back period, DCF will scrutinize any transfer of assets, whether given away or sold. This includes transfers of cash, real property, personal property, and other assets, such as annuities. Essentially, anything that you sold or gave away is subject to review. For example, selling your vehicle to a family member at a deep discount during the look-back period could cause eligibility problems. The same is true if you give money to your grandson or another family member instead of saving it to pay for your long-term care needs.

There are some exceptions, though. For example, some of your assets can be legally transferred to your spouse without harming your eligibility. You can also give assets to a family member who’s a caregiver under certain circumstances. 

It is also important to know that some otherwise penalizing transfers can be properly explained or even reversed.  Working with an elder law professional is essential to ensure you’re handling these things correctly. You don’t want to lose Medicaid eligibility simply because you didn’t understand that there were specific details you needed to follow in transferring some assets.

What Happens if I Miss the Look Back Period?

If you miss the Medicaid look-back period, there are financial penalties. Generally, you’ll be penalized based on the amount of money or other assets given away during the five years before you applied for Medicaid compared to the cost of nursing home care. For example, consider if you need to live in a nursing home, and your care costs $10,000 per month. However, you gave away $60,000 in assets last year. As a result, you may be ineligible for Medicaid for six months. However, after that time has passed, you can receive Medicaid benefits.

That’s why it is crucial to work with an elder law attorney as early as possible to address any asset concerns ahead of time.  Similarly, if you are concerned that you have made a transfer that might jeopardize your eligibility, you should consult an elder law attorney right away to determine how you might move forward in addressing the transfer.

What Does This Mean for Medicaid Recipients?

Medicaid recipients must be clear on the Medicaid look-back period, what exceptions exist, and how an elder law professional can help them. Planning ahead can mean avoiding penalties and getting proper financial help and support if you need a nursing home or other long-term care options. However, not everyone understands the look-back period and its significance, so it’s important to work with an experienced Elder Law attorney.

We can Help

Our experienced team at Family Elder Law will make sure you have the right plan in place to protect your elderly loved ones. Reach out to us today, and let us help you find the right options and create the legal paperwork for your security and peace of mind.

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