Starting on April 1, 2022, a long delayed “look-back” rule will come into effect In New York, affecting anyone who applies for long-term healthcare benefits through Medicaid. Anyone who is potentially affected by this change may find themselves with substantial penalties to their Medicaid benefits, or may even be denied benefits entirely. For some New Yorkers, that could mean the difference between being able to afford critical medical care, and being stuck with a substantial medical bill.
What Are Medicaid Long-Term Community Healthcare Benefits?
Among the many benefits that Medicaid provides are community-based “long-term services and supports” (LTSS). This includes programs to assist with at-home care for people with long-term health needs, as well as payments for people caring for elderly or disabled loved ones. These sorts of benefits are crucial for addressing the healthcare needs of elderly and disabled people who otherwise could not afford the costs of long-term health problems.
What is the “Look-Back” Period?
The look-back period is a measure that affects whether someone is considered eligible for LTSS in New York. Normally, when someone is assessed for Medicaid eligibility, they examine their annual income and total assets to determine if they fall below a certain maximum. With the look-back rule put into place, Medicaid will not only look at your current assets, but also any assets you previously owned within the past thirty (30) months. It should be noted that a similar rule has already been in place for those seeking help with nursing home payments, which has a 60-month look-back period.
Why Does This Matter?
In order to prepare for applying for Medicaid LTSS benefits, many people will transfer their property out of their possession, either to family members or to a so-called “Medicaid trust.” With the look-back rule in place, that property will still be counted for a full two-and-a-half years after it is transferred out of their possession. These additional assets, when factored into Medicaid’s calculations, could push someone above the level where they would be eligible for those benefits. This could lead to Medicaid penalizing their benefits, or denying them access to those benefits entirely, causing them to be stuck paying for all medical expenses without LTSS benefits.
What Should You Do?
The best way to potentially avoid these penalties is to begin the process of Medicaid planning as soon as possible. The sooner you begin planning, the more likely you will be prepared for when you need to apply for Medicaid LTSS benefits. The best way to make sure everything is done correctly is to speak to a lawyer with experience handling Medicaid planning and other estate planning issues, who can guide you through the process.
The estate planning attorneys at David J. Lorber & Associates, PLLC will work with you to determine whether a guardianship might be necessary for your loved one, and help you to ensure your loved one receives the assistance they need. For comprehensive estate and elder law services in New York, call David J. Lorber & Associates, PLLC at (631) 750-0900 or contact us online to schedule a free consultation at our Setauket office.
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