Look Back Penalty Period in Buffalo

Look Back Penalty Period in Buffalo

Share This Post:

When a person applies for nursing home Medicaid coverage, one of the crucial issues to observe when drafting the Medicaid paperwork is whether any gifts or transfers by the Medicaid applicant were made during the last five years. Medicaid requires applicants to reveal all financial transactions that were initiated during the last five years before the submission of the Medicaid care application. This five-year period is widely regarded as the “look-back” period in Buffalo and New York State, in general. In Buffalo, the five-year look-back is imposed with regards to institutional Medicaid or nursing home, applications. There exist no look-back timeframe for a community Medicaid application.

Regarding a Medicaid, a sanction is usually meted out to applicants who has made certain transfers (or gifts) within the five-year look back period. Any transfer made during that timeframe might be questioned by the local Department of Social Services (DSS).

The DSS scrutinizes any assets transferred or gifted during the five-year timeframe as if the applicants owned such assets on the date of the Medicaid application. Living expenses like rent, clothing, or items that benefited the applicants wouldn’t be regarded as a gift. If an applicant makes certain assets available to charity, child, or grandchild within the five-year look back period, his or her application may not be acknowledged.

Let us take a look at the look back period penalty for Buffalo

According to recent studies, health care cost for seniors are skyrocketing at a rapid pace. In addition, based on New York State’s office of Health Insurance Program, a year in a nursing home can cost an individual more than $145,000.  In some locations, there are facilities where private pay rates are more than $200,000 annually. According to these stunning figures, it is important that people plan ahead for their long-term care. And what better way to do that than apply for Medicaid. However, applying for Medicaid is one thing and being accepted is another. To enjoy the benefits of this long term care, you need to be eligible. The eligibility requirements of Medicaid can be complicated.

Qualifying for Medicaid in Buffalo.

The eligibility requirements for Medicaid is almost the same in all states In New York. In order to enjoy the benefits of Medicaid, an individual must be over 65 years old or disabled, blind, eligible for public help, or a recipient of Supplemental Security Income. Since it is a means-tested scheme, Medicaid requires that in order to be approved for the benefits, applicants cannot own minimal assets.

In 2017, Medicaid applicants cannot own more than $14,850 in non-exempt assets to be eligible for this healthcare benefit in Buffalo, New York.

What are exempt assets? You may ask. Exempt assets are assets that aren’t countable for Medicaid reasons and they include qualified retirement accounts that are in payout status according to the life expectancy of the Medicaid applicant, including the individual’s home (if the applicant, a spouse, a minor, or a disabled or blind child resides in the home). There exist no other exempt assets and situations that are beyond the coverage of this article.

What is the Look Back Penalty Period in Buffalo?

If the necessary Medicaid agency discovers that a Medicaid applicant has made a gift, it will sanction the individual based on the amount of total gift. The penalty timeframe is a period during which the individual who gifted his or her assets will be ineligible for Medicaid services and will need to make private remittance. The look back period penalty in Buffalo is usually based on the average cost of a nursing home in the county where the applicant resides, as determined by Medicaid. Medicaid updates these rates, which are regarded as regional rates, on a yearly basis.

 For instance, the rate for Buffalo, Manhattan, Staten Island, and Brooklyn is $12, 319. If you are a residence of Buffalo, and you made a gift of $141,000, you will be ineligible for Medicaid for around 11 months ($141,000 divided by $12, 319).

Do you need a Medicaid attorney? Don’t hesitate to call our office. Our Medicaid attorneys have what it takes to assist you regarding any Medicaid issue you are facing.

DISCLAIMER: The information provided in this blog is for informational purposes only and should not be considered legal advice. The content of this blog may not reflect the most current legal developments. No attorney-client relationship is formed by reading this blog or contacting Morgan Legal Group.

Got a Problem? Consult With Us

For Assistance, Please Give us a call or schedule a virtual appointment.