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Medicaid Lookback Rules for Washington State

Suppose that your elderly mother in Seattle needs nursing home care. Her income and resources are limited, so she applies for Medicaid. The eligibility worker tells your mother that she is ineligible for long-term care Medicaid services for 26 months. The reason? She had given away $175,000 to a friend four years ago. This transfer took place within the "lookback" period--a certain number of months before the month of application.

  1. Transfer of Resources and Lookback Periods

    • Federal law states that certain gifts or transfers made to qualify for Medicaid are subject to penalties.

      According to the Department of Social and Health Services in Washington State, under state and federal law, the eligibility worker must review any transfer of resources that took place 60 months before the date you apply for Medicaid. If resources were transferred within that time frame and you did not receive fair market value for them, you may not be eligible to receive long-term care Medicaid services for a period of time.

    When to Apply Transfer Rules

    • Waiting for therapy

      According to the Washington State Department of Social and Health Services Eligibility A-Z Manual, transfer rules apply to eligibility for all institutional services in all medical facilities with the exception of hospice care centers; hospital stays of 30 days or more; waiver services with the exception of services provided under PACE; and SSI recipients receiving any of the services listed above. (See Resources)

      Transfer rules apply to income and resources transferred by the client or the client's spouse; a person with legal authority to act for the client; or a person acting at the direction or request of the client.

    Lookback Periods for Transfers Made Before May 1, 2006

    • The date of transfer affects the length of the lookback period

      If the transfers were made on or after August 11, 1993, and before May 1, 2006, the lookback period is 36 months. If the transfers were made before August 11, 1993, the lookback period is 30 months.

    Transfers That Do Not Require a Penalty Period

    • There are many conditions under which transfers do not require a penalty period. Please refer to WAC 388-513-1363, 388-513-1364 and 388-513-1365 for the particular conditions. (See Resources)

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