Ask the expert: When plans provide Medicaid ‘look-back’ exemption
My question is about the look-back period for Medicaid eligibility. I have New York State Partnership for Long-Term Care insurance with Medicaid protection. Does this mean if I go to a nursing home, I can immediately sign over my assets to my children, and the nursing home will get my Social Security payments, but Medicaid will pay any additional costs for my care?
The New York State Partnership offers several plans. The answer is yes, if you have a “total asset protection” plan.
Let’s start with the basics. Medicaid is the only government program that pays for long-term care, but it’s only available to poor people. Middle- and upper middle-income people sometimes plan to qualify for Medicaid’s long-term care coverage by transferring their assets to their children. The success of this strategy depends partly on its timing, because giving away assets during the five-year period before applying for Medicaid delays the applicant’s eligibility for its nursing home benefits.
But a New York State Partnership long-term care policy with total asset protection qualifies you for Medicaid as soon as your coverage runs out. Since you’re exempt from the five-year “look-back” period, you can transfer assets to your children at any time, says Sharon Kovacs Gruer, a Great Neck elder law attorney. The exemption doesn’t apply to income, like your Social Security benefit, she adds, or to an asset that’s a stream of income, like a pension.
If you have “dollar for dollar” asset protection, your exemption is for an asset amount equal to the benefits paid by the policy. A two-year policy paying a $294 daily benefit would exempt up to $214,620 of assets from the look back, for example.
THE BOTTOM LINE New York State Partnership long-term care insurance policyholders are exempt from some Medicaid eligibility rules.
WEBSITES WITH MORE INFORMATION nyspltc.org/medicaid and nyspltc.org/expansion.htm