How does Medicaid look at monetary gifts made to children?

A fellow caregiver asked...

Three years ago, my mother lived in Philadelphia. She sold her house and since she had no other savings account funds, the money from the sale of her house became her primary financial asset. Mother then moved in with her daughter elsewhere in Pennsylvania and became diagnosed with stage two dementia. Mother insists on paying a small monthly amount to her daughter. In December 2008, Mother gifted each of her six children with money from the house sale funds, leaving a balance in her account. My question is, if Mother, in 2009, needed to go into an assisted living center or nursing home, how would Medicaid look at the gifts Mother made to her children in 2008?

Expert Answer

If your mother qualifies for Medicaid coverage of residence in a nursing home, Medicaid pays the entire cost (and in some states, for a Medicaid-participating assisted living facility). But to qualify for Medicaid nursing home coverage, she has to have very low income and assets. In examining her assets, Medicaid will consider the gifts she made in 2008 under the following "look-back" rule. For any assets given away (or transferred for less than full value) after February 8, 2006, Medicaid will look back 60 months from the date of the Medicaid application. So, if your mother applies for Medicaid at any time within 60 months after the 2008 date of the gifts, she will be ineligible for Medicaid coverage for a period of time that begins to run when she applies for Medicaid.

How long will the period of ineligibility be? The exact period of ineligibility will be calculated by taking the value of the gifted assets and dividing them by the average monthly nursing facility cost in the state where your mother lives. For example, if she gave away $60,000 total, and the average monthly nursing home cost in her state is $3,000, she would be denied Medicaid coverage for 20 months [$60,000 ÷ $3,000 = 20 months].

For further explanation of these rules, take a look at the web page Elder Law Answers.