Though the majority of senior citizens will qualify for Medicare coverage, Medicare is not set up to cover custodial care costs. Learn more about New York medicaid look-back in this presentation.

1. What Is the Five – Year Medicaid Look-Back ? www.myestateplan.com 1
“Though the majority of senior citizens will qualify for
Medicare coverage, Medicare is not set up to
cover custodial care costs.”
WHAT IS THE FIVE-YEAR
NEW YORK MEDICAID
LOOK-BACK?
MARK S. EGHRARI
NEW YORK ESTATE PLANNING ATTORNEY

2. What Is the Five – Year Medicaid Look-Back ? www.myestateplan.com 2
When you thinkabout retirement, you probablyenvision the golden years as they
are called. During this period of timeyou enjoy your family members, see the
world, hit the golf course, and enjoy your success.
Thisis all well and good, and you should certainlymakethe most of your active
retirement years. At the sametime, when you are planning ahead for the future,
you should consider the twilight yearsthat will follow.
LONG-TERM CARE
The United StatesDepartment ofHealth and Human Servicestells us that seven
out of every 10 senior citizenswill someday need living assistance. Thisisa telling
statistic, and it is relevant to all of us.

3. What Is the Five – Year Medicaid Look-Back ? www.myestateplan.com 3
You maybe confident about your futurehealth careexpenses becauseyou are
going to be qualified for Medicarecoveragewhenyou reach the ageof 65.
Unfortunately, the Medicareprogramisnot set up to cover long-term carecosts.
These costs areconsiderable, and they can put a dent in the value of your estate.
We practicelaw in the stateof New York. Gen worth Financialtells us that the
medianannualcost for a privateroom in a nursing home in New Yorkis a
whopping $130,670. Themediancost for a semi privateroom is over $124,000
per year.
According toa government survey that wasconducted a couple of years ago, the
averagelength of stay is right around twoyears and threemonths. Somepeople
stay in nursing homes for considerablylonger thanthisaverage.

4. What Is the Five – Year Medicaid Look-Back ? www.myestateplan.com 4
MEDICAID
Medicaid isanother government health insuranceprogram. Thisprogramwill
pay for long-term care, but it is only availableto people who can prove that they
have significant financialneed.
People typicallyengagein a process
called a Medicaidspend down if
they decidethat they want to
qualifyfor Medicaid topayfor
long-term care. This term is
somewhat self-explanatory: When
you spend down, you spend or give
awayassets before you apply for
Medicaid.
When you do apply, you have littleleft in your own name, and you canobtain
eligibility.
At first glance, thiscan sound quitecomforting. Ifand when you need long-term
care, you cangive your childrentheir inheritancesinadvance, and you aregood
to go. On theother hand, if you never need long-term care, you canjust hang on
to your assets untilyou pass away.
Unfortunately, thisis not possible, becausethere is a five-year Medicaid look-
backperiod. If you want to giveaway assets before you applyfor Medicaid, you
must completethe divestituresat least five yearsbefore you submit your
application.

5. What Is the Five – Year Medicaid Look-Back ? www.myestateplan.com 5
Medicaid willevaluateyour financial
transactionsgoing backfiveyears.
Your applicationwillbe denied
initiallyif evaluatorsfind that you have
given awayassets withinthisfive year
timeframe.
You caneventually qualifyfor
Medicaid ifyou did violate the five-
year rule, but it will taketime. Let's say that theaveragecost of nursing home
careis $130,000 per year, and you gave away$260,000shortlybefore you
applied for Medicaid coverage.
Because$260,000 would payfor two years of care, your eligibilityfor Medicaid
coveragewould be delayed by two years.
SUMMARY
Long-term careis very expensive, and most seniorswill eventually need help with
their activitiesof dailyliving. Though the majorityofsenior citizenswill qualify
for Medicarecoverage, Medicareisnot set up to cover custodialcarecosts.
Medicaid isthesolution for many seniors who need help with long-term care
expenses. Thisis a need-based government health insuranceprogram, soyou
cannot qualifyif you have significantfinancialresourcesinyour own name.

6. What Is the Five – Year Medicaid Look-Back ? www.myestateplan.com 6
It is possible to give awayassets beforeyou apply, but you must completethe
divestituresat least five years before you submit your application.
Becauseof this60 month look-back, you must plan ahead in advancein a
measured fashionif you want to be able to qualifyfor Medicaid withoutbeing
penalized.
If you would like to discussMedicaid planning strategieswith a professional, set
up a consultationwith a licensed elder law attorney.
REFERENCES
Medicare
http://www.medicare.gov/
Medicaid
http://www.medicaid.gov/

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About the Author
MarkS. Eghrari
Mark S. Eghrari is an attorney in private practice in Smithtown, New
York. He has been in practice since 1988. Mark S. Eghrari provides
extensive estate and tax planning services to individuals and
businesses. Mr. Eghrari’s primary focus is helping clients avoid
probate, minimize or eliminate Federal and State Estate taxes and
protect their assets from the high cost of nursing care, if they become
ill. Mr. Eghrari’s expertise is in providing unique and innovative
estate planning solutions that create a secure future for his clients and their loved ones. Mr.
Eghrari is a member of the American Bar Association and New York State Bar Association as
well as the National Academy of Elder Law Attorneys and the American Academy of Estate
Planning Attorneys.
Mr. Eghrari completed his undergraduate work at Lafayette College in Easton, Pennsylvania
and received his MBA in banking and finance from Hofstra University on Long Island. He
earned his Juris Doctorate from the Hofstra University School of Law, where he was a member
of the Law Review. While in law school, Mr. Eghrari gained practical experience in the
corporate tax department of Citicorp in New York city.
Mark S. Eghrari and Associates PLLC
www.myestateplan.com
50 Karl Avenue, Suite 202
Smithtown, NY 11787
Phone: (631) 265-0599
Fax: (631) 265-0754