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What actually happens if my dad gave a gift within the look-back period? I've read it makes him ineligible for Medicaid to pay for assisted living. But what does that mean? My wife and I take care of my dad who suffers with dementia. Our car broke down and my dad said he would pay for 1/3 of a new car, even though it is in my wife's and my name. Since we drive him everywhere, i.e. doctor, grocery shopping, out to eat four times per week, the bank, to his coin collection shops, etc, he wanted to help select the car so we bought one that he could easily get in and out of. He said it was only fair he paid 1/3 since the car is used so much for him. Anyway, he pitched in $10,000. I'm guessing this would be considered a gift since his name is not on the title. So what does this actually mean as far as the look-back period? If he needs assisted living before the 5 years is up, does that mean they won't take him? What if he doesn't have enough assets to self-pay? Will they just not take him? What is the deal with that? He currently still lives in his own home and my wife and I, or sometimes our daughter, go to his house 4 or 5 times a week just to get him out and also to clean, etc. We also have a care giver that comes to his once a week and she also takes him out to eat and shopping. But we have become increasing worried that the time is coming where he won't be safe living alone. We really appreciate him helping pay for the new car, but would not be able to pay it back if he needs more help in the next 5 years. Can someone please explain what really happens if a gift has been given within the last 5 years of entering an assisted living?

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If a NH costs for example 10 K per month and Medicaid generally pays for example 5K per month for NH reimbursement then the penalty may end up being a loss of 2 months before becoming eligible. This is just a brief example because I do not know of the exact dollar amount to the penalty. You have maybe 2 options...1) realze that you have to take care of him for an extra few months on your own. You may consider doing the look back period a little bit earlier. 2) if a crisis occurs and a rehab from Medicade becomes long term, then you may have to pay for a month or take him home for a month and deal with full time caregiving. 
By the way, AL is considered as private pay around 6 to 8K. You might want to become educated now about what limited support is available. Keep your fingers crossed if he can continue living with you for the 5 year period.
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Igloo is correct. If you need to set some money aside to cover this potential penalty, enter into a care agreement with Dad now so that some of the care you are providing now is compensated. Best to consult with an elder care attorney, which is an acceptable way for Dad to spend his money
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Please try to Meet with an elder law atty to discuss options as to how to lessen the penalty due to the 10k gifting should dad apply for Medicaid before Spring, 2023.

My take on Aging in America is that unless the elder is generationally wealthy, if they live long enough they will run out of $ and family will run out of ability to care for or help with the elders increasing needs and they will apply for Medicaid. Meeting with an atty just helps start dad & his family in dealing with this with the least fallout.

Medicaid doesn’t expect your dad to have family do for him for free but there needs to be in place a legally correct document as for personal care services in order for Medicaid not to run it through a transfer penalty inquiry. Dad could do a personal care agreement that for example you & your wife provide 10 hrs a week of oversight of his finances, transportation, maintenance of his yard. Dad pays you for legit services & all as per the agreement and ok by Medicaid. Set the $ aside just in case the 10k from dad before any agreement happened does get a transfer penalty.

Transfer penalty are state specific as your states Medicaid daily room&board reimbursement rate is the key to the penalty. Like TX is about $171 a day R&B, so 10 K means a penalty of 58 days. That means 58 days of private pay to the facility to get past penalty. Penalties are by # of days.
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There is a spend-down part to being eligible for Medicaid but the applicant's $ must be SPENT on their care-only. The $10,000 may very well be considered a gift. Find an attorney that specializes in Elder Care Law in your area. They should be well versed in the Medicaid laws in your state and a great help in navigating thru Medicaid.
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