When helping clients plan for long-term care, one of the most important Medicaid rules to understand is the lookback period. This regulation can have a major impact on your clients’ ability to qualify for benefits, especially when it comes to asset transfers. As a financial advisor, knowing how this rule works helps you guide clients toward compliant strategies that protect their assets and achieve eligibility.

Nate Ziolkowski Medicaid Annuity Sales Manager Krause Agency

What Is the Medicaid Lookback Period?

The Medicaid lookback period is the five years (60 months) prior to a person’s Medicaid application. A caseworker will review the applicant’s financial records during this time to determine whether any assets were sold, transferred, or gifted for less than fair market value.

If such transactions occurred, Medicaid may impose a penalty period of ineligibility, meaning the individual must pay for their care out of pocket until the penalty ends.

Example: If a client gives $100,000 to a child within the five-year lookback period, and the state’s Divestment Penalty Divisor is $10,000, the result is a 10-month penalty before Medicaid coverage begins.

Why Asset Transfers Matter

Many clients assume they can simply transfer or gift assets in order to qualify for Medicaid. However, the Medicaid program prevents this to ensure individuals don’t intentionally reduce their wealth to meet the strict asset limits.

That’s why timing and strategy are essential in Medicaid planning, especially when it comes to the high monthly cost of extended care.

Exceptions to the Rule

Certain transfers are exempt from penalties, including:

• Transfers between spouses
• Transfers to a disabled or blind child
• Transfers to a trust for a disabled individual under age 65
• Transfers of a home to a caregiver child who lived in the home for at least two years and provided care that delayed institutionalization

These exceptions can provide valuable planning opportunities for clients with specific family or care situations.

Asset Protection Strategies for Clients

As an advisor, you can help clients explore tools and strategies that protect assets without violating Medicaid rules. Some of the most effective include:

1. Medicaid Compliant Annuities (MCAs)

Convert excess assets into an income stream for a spouse or applicant. MCAs can help clients meet asset limits, avoid penalties, and expedite Medicaid eligibility.

2. Funeral Expense Trusts (FETs)

Allow clients to prepay funeral and burial costs using an irrevocable trust, reducing countable assets while covering an inevitable expense.

3. Long-Term Care Insurance (LTCI)

Helps clients plan ahead while they’re still relatively young and healthy by purchasing LTCI, thus reducing or even eliminating the need for Medicaid coverage altogether.

4. Early Planning with Irrevocable Trusts

Clients who transfer assets into an irrevocable trust more than five years before applying can protect wealth and secure future assistance without triggering penalties.

Why This Matters for Advisors

Understanding the Medicaid lookback period allows you to position yourself as a trusted advisor in the long-term care space. By explaining the rules clearly and offering compliant planning solutions, you help clients avoid costly mistakes and maintain financial stability as they age.

Ready to help clients navigate Medicaid planning?

At Krause Agency, we specialize in Medicaid Compliant Annuities, funeral expense trusts, long-term care insurance and other solutions that help financial professionals serve clients confidently.

Learn more or schedule a consultation today!