Gifts and the Five-Year Look-Back for Long-Term Care
Elias wants to give each of them a large sum now, while he can see them use it.
Picture a couple named Elias, 74, and Tamar, 72. They have two grown children. Elias wants to give each of them a large sum now, while he can see them use it.
"Why wait?" he said.
Tamar was thinking about her sister, who moved into a nursing home last year. "What if one of us needs that kind of care?" she asked.
Elias had not thought about the two together. They decided to find out how the rules treat a gift when care comes later.
What they found is a rule about timing. When someone applies for Medicaid to help pay for long-term care, the state looks back at what the person gave away. For transfers made on or after 8 February 2006, the federal law sets that window at 60 months, or five years. A letter from the Centers for Medicare and Medicaid Services in July 2006 explained it to the states.
Utah is one example. Its state manual describes the same 60-month window. It also says Medicaid does not pay for long-term care during a penalty period that follows a gift.
| Question | What the sources say |
|---|---|
| How far back does the state look? | 60 months for transfers on or after 8 February 2006 |
| What is the penalty? | A period when Medicaid does not pay for long-term care |
| When does the penalty start? | At the later of the month of the gift or the time the person is otherwise eligible and in a care facility |
| How long is the penalty? | It varies by state; an elder law attorney could say how it is figured |
Why does this matter to a family? Medicaid is the main payer for over 60% of nursing home residents in the United States, according to the Kaiser Family Foundation in 2025. Many families meet this rule without having planned to.
So a gift made today could be counted if care is needed within five years. A gift made ten years before an application is outside the window.
Tamar put it plainly. "So the question is how likely it is that one of us needs care in the next five years."
"Nobody can tell us that," Elias said.
"No. But we can ask someone who knows our state."
You could…
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Write down the date and amount of every large gift, so the record is easy to find.
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Ask an elder law attorney in your state how the look-back works there, since Medicaid rules vary by state.
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Tell your children what you are considering, so the timing is something you decide together.
What did you learn when you asked about your state's rule? Share it here. Someone reading may be standing where Elias and Tamar were.
Figures are estimates for planning, based on public data. Sources: Centers for Medicare and Medicaid Services, State Medicaid Director letter, 27 July 2006; Utah Department of Health and Human Services, Policy 575 (Transfer of Assets); Kaiser Family Foundation, 5 Key Facts About Nursing Facilities and Medicaid, May 2025.
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