The five year look-back is triggered at application for all Medicaid long-term care benefits including Nursing Home and Home and Community Based Medicaid benefits (HCBS) since HCBS are provided under "waiver" programs subject to the same asset eligibility rules.
For community based Medicaid programs the application is somewhat different than the one for LTC in a NH. NH Medicaid is up to 5 yr look back and require all their income to be a co-pay to the NH except for a small personal needs allowance. Community Medicaid expects them to retain income & assets to pay to continue to live in the community. But just what & how much depends on how your state runs it's programs. What's important to understand that Medicaid is an entitlement limited to persons deemed to be "at need" both medically and financially. If they have income and assets to any degree, they will not qualify for Medicaid either community based or NH.
For NH Medicaid, the "at need" means they are impoverished within whatever your state has as it's monthly income ceiling (seems to be around $ 2,100) and usually 2K in non-exempt assets and are requiring skilled nursing care. But for community based programs, those are a use of Medicaid waiver diversion funding and each waiver program can place it's own determinates on what is needed to qualify.
Since it sounds like you are thinking about some sort of community based program, the current trend is for enrollment in a PACE or PACE-like community center of care program. I'd suggest you contact your local Area of Aging to see what programs are available in your area and then contact each to see which could meet the needs of your parent and what the criteria is.
Now all these vary by state as Medicaid is a joint federal & state program but administered uniquely by each state for criteria. Some states have all sorts of waiver programs while other states just a few. But whatever is done, keep it all accurate and transparent, filing for Medicaid allows for an all-access pass to their finances and everything is just a few keystrokes from being found out.
We had a Medicaid caseworker from the day I first applied. I didn't want to call attention to the look back period so I didn't ask her about it but she was very helpful when it came to any other questions I had. There are also a lot of answers on the Medicaid website.
When I applied for Medicaid on behalf of my dad who needed it to pay for a nursing home I don't think they did a look back and the reason I don't think they did a look back was because months prior I had liquidated his small annuity and put the money in my account to settle most of his bills. When we were in the process of getting approved for Medicaid I was never notified about this annuity. So either Medicaid didn't do a look back on my dad or they didn't care about the annuity (the annuity was more than $5000).
For NH Medicaid, the "at need" means they are impoverished within whatever your state has as it's monthly income ceiling (seems to be around $ 2,100) and usually 2K in non-exempt assets and are requiring skilled nursing care. But for community based programs, those are a use of Medicaid waiver diversion funding and each waiver program can place it's own determinates on what is needed to qualify.
Since it sounds like you are thinking about some sort of community based program, the current trend is for enrollment in a PACE or PACE-like community center of care program. I'd suggest you contact your local Area of Aging to see what programs are available in your area and then contact each to see which could meet the needs of your parent and what the criteria is.
Now all these vary by state as Medicaid is a joint federal & state program but administered uniquely by each state for criteria. Some states have all sorts of waiver programs while other states just a few. But whatever is done, keep it all accurate and transparent, filing for Medicaid allows for an all-access pass to their finances and everything is just a few keystrokes from being found out.
We had a Medicaid caseworker from the day I first applied. I didn't want to call attention to the look back period so I didn't ask her about it but she was very helpful when it came to any other questions I had. There are also a lot of answers on the Medicaid website.