Medi-Cal FAQ: What Is A Look Back Period Of Ineligibility?

Hi there. Bridget Mackay here. I’m an estate planning attorney and elder law attorney in Petaluma, California and I’m addressing some frequently asked questions about Long-term Medi-Cal and applying for it. You can find these frequently asked questions and answers to them on my website at www.bridgetmackaylaw.com.

Today, I’m addressing the third question which is, “What is a lookback period of ineligibility?” Medi-Cal employs several formulas to determine if an applicant has transferred highly valued assets for less than their actual value or if they’ve made large gifts, hoping to become impoverished or hoping to bring themselves down to the applicant level of assets in order to qualify for their benefits. Medi-Cal will look back to any of the gifts you’ve made prior to applying and make sure that hasn’t happened. In California, our lookback period is 30 months. In every other state in the union, it’s 60 months.

Here’s how it works. Grandma gifts her $100,000 CD to a son, hoping to reduce her assets to $2,000 in order to qualify for Long-term Medi-Cal. She applies for Long-term Medi-Cal four months later. In the application, she is asked if she has transferred or gifted any assets over the $500 in the last 30 months which is our lookback period and she reports the $100,000 gift four months earlier to her son. Medi-Cal will deny her application because this gift was made in the 30 months prior to her application. Therefore, they think that she moved assets in order to qualify. Further, using that formula, they have a formula they use which I will discuss in another question subsequent to this, it would bar her from applying for Medi-Cal again for nearly a year.

Again, my advice throughout going into a Medi-Cal or looking for Long-term Medi-Cal benefits, you should always consult an experienced attorney in this area.

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