Medicaid Look-Back Period & Transfer Penalty Calculator

Medicaid looks back 60 months (5 years) for gifts or under-market transfers before a nursing home application — except in California, where Medi-Cal's long-term care look-back is 30 months. A penalty is measured in months: the uncompensated amount divided by your state's average private pay rate for nursing facility care. Estimate it here with your state's official rate.

How the look-back works

The look-back window is the 60 months before the month the person applies for long-term care Medicaid. Every state uses this window for nursing home coverage except California, whose Medi-Cal long-term care look-back is 30 months.

Any transfer for less than fair market value within that window — cash gifts, property sold below value, assets moved into certain trusts — is reviewed.

Penalty months are calculated as the uncompensated transfer amount divided by the state's average private pay rate (the same rate states use when calculating transfer-of-assets penalties).

A penalty delays Medicaid coverage — it does not erase it. The penalty period must be served before Medicaid starts paying, and private pay may be required in the meantime.

Transfers that may be exempt (verify with your state)

• ·Transfers to a spouse, or to a blind or disabled child.
• ·A transfer of the home to a child who lived with and cared for the parent for at least two years while the care helped keep the parent at home.
• ·A transfer of the home to a sibling who already held an ownership interest and lived there for at least one year.
• ·Funds placed into a qualified trust for a disabled beneficiary under state rules.
• ·Small gifts that are clearly below the state's materiality threshold for penalties.

Exemptions are fact-specific and interpreted by state agencies. A denial based on an assumed exemption is the most common costly mistake — confirm each exemption with the state or a licensed elder-law attorney.

The 60-month window and the penalty divisor are defined in federal law: 42 U.S.C. §1396p(c)(1)(B)(i) (look-back) and §1396p(c)(1)(E)(i) (penalty = uncompensated value ÷ average private pay rate).