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Gifts before Medicaid application can impact eligibility

Are gifts included in the five-year Medicaid eligibility look-back period? If my father makes a gift to his heirs, but needs to be admitted to a nursing home and his money is depleted after several years, are the heirs responsible for returning that gift to Medicaid? Are birthday gifts under $100 and monthly donations to his church also subject to the five-year look back?

Any assets your father transfers to others in the five-year period before applying for Medicaid -- including gifts -- delay his eligibility for Medicaid nursing home benefits.

The Medicaid application form asks you to explain all asset transfers in excess of $2,000 made during the previous five years. "Medicaid can also ask for an explanation of smaller amounts if it wants to," says Sharon Kovacs Gruer, a Great Neck elder law attorney. All gifts are presumed to have been made in order to qualify for Medicaid. To dispute that presumption, your father would have to show a long-standing pattern of gifts made while he was perfectly healthy and had no reason to anticipate a need for long-term care.

Medicaid has no claim on gifts made during the five years before application -- but the gifts temporarily disqualify the applicant for benefits.

How long your father would be uncovered depends on how much he gave away. Medicaid divides the value of transferred assets by the average monthly cost of a nursing home. "The monthly rate used for Long Island is $12,390," says Gruer. If your father transferred $120,390 to others -- his children, his church, an irrevocable trust -- he'd be ineligible for Medicaid for 10 months. In the meantime, who would pay for his nursing home care?

THE BOTTOM LINE Gifts made within five years of applying for Medicaid nursing home benefits delay the applicant's eligibility.


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