The Listen to Lawrence Letter: Understanding the Five-Year Lookback

April 19, 2024
April 18, 2024 • Volume 5 Issue 236
The five-year look back lasts five years…read on:


My Mom’s house has been in an irrevocable trust for about one and a half years. She recently was in the hospital for 2 days and then transferred to a rehab facility for 49 days.   Do we have to break the trust first before they can request Medicaid for payment?


Medicare will pay the first 20 days of rehab and then the next 80 days for rehab (with a $204 per day co-pay), provided it is preceded by 3 days in the hospital. Since your mother was only in the hospital for 2 days, then Medicare will not pay for rehab in the nursing home.  Are you sure it was only 2 days?  In any event, if Medicare is not paying, then Mom will have to pay herself unless she is on Medicaid. Considering these facts, she would not be eligible for Medicaid because of the transfer of the house into the trust within the 5-year lookback. Therefore you would have to break the trust and return the house. Medicaid, in turn, can put a lien on the house. However, if Mom returns home the lien will be extinguished.

It’s complicated…I know. But that is why you have us. 😊

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