Let’s say your grandma needs to move into a nursing home, and she’s applying for MassHealth (that’s what we call Medicaid in Massachusetts). MassHealth helps pay for long-term care, but before they say “yes,” they check your grandma’s money moves from the past five years. Why? To make sure she didn’t give away money or property just to qualify for help.
This check-up is called the “5-Year Look-Back” period—and it’s a big deal. Here's what you need to know:
What Exactly is MassHealth “Looking Back” At?
MassHealth looks at all transfers over $1,000 your grandma made during the five years before she applied. They want to know:
- What was given away (money, house, car, etc.)
- When it was given
- Who received it
- How much it was worth
- Whether your grandma got fair value back (did she sell it or just give it away?)
What Happens If She Gave Something Away for Free?
If your grandma gave away money or stuff and didn’t get full value back, that’s called a disqualifying transfer.
Example: She gave her house to your uncle for free or sold it way under market value. That could trigger a penalty period.
- During this penalty time, MassHealth won’t help pay for her nursing home care. That means your family might have to cover the cost out of pocket until the penalty ends.
MassHealth Wants Proof—And Lots of It
To avoid a problem, you need to show the paper trail for every big transfer. This means:
- Bank statements
- Copies of checks
- Sales contracts
- Receipts showing fair market value
- Anything that proves it was a legit deal
Without proof? The application could be denied or delayed.
What Can You Do If There’s a Problem?
If your family runs into a penalty or missing documentation, don’t panic. You have options:
- Talk to an elder law attorney who knows how to fix Medicaid transfer issues.
- Try to get the gift or asset back—returning the money or house can sometimes cancel the penalty.
Final Thoughts
The 5-Year Look-Back isn’t meant to punish—it’s just how MassHealth makes sure the program is fair. But even small mistakes can turn into big problems if you're not prepared.
So remember:
- No hidden gifts
- Keep all your records
- Get legal help if needed
