Every year Medicaid releases new numbers representing the average cost of a nursing home by region which are used to calculate eligibility after assessing penalty periods for any gifts or transfers that were made. Here are the New York State numbers for 2022:
To provide an example: Let’s assume that three years ago you transferred $120,000 to your children, leaving you with no money. Now, three years later you need a nursing home. Are you eligible for Medicaid? If not, then when? The answer depends slightly upon where you live in the state. Assume you live in Nassau or Suffolk County.
First, we apply the 5-year lookback. Medicaid will say, “Aha, we see that you transferred $120,000 during the five-year lookback…so we will assess a penalty.” The penalty is the number of months in which you will not be eligible for Medicaid. We arrive at that number by dividing the amount transferred by the regional rate from the chart above. In this case, $120,000 divided by $14,012 = 8.56. Therefore, if you applied for Medicaid now, you would not be eligible for Medicaid until your roughly 8-month penalty was over. How would you pay for those 8 months? Just get the money back from your children! 😊
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