Medicaid look-back period by state

California's transition

California's maximum is 30 months, but the months reviewed depend on when the application is filed. Transfers made from January 1, 2024 through December 31, 2025 are excluded. For applications from July 1, 2026, the review starts with January 2026 and grows month by month; the full 30-month window returns for applications on or after July 1, 2028.

Use the California calculator for the exact dates.

Is it five years or six?

Five. The federal look-back is 60 months, counted back from what the statute calls the look-back date — for a nursing-home applicant, the first date as of which the individual both is an institutionalized individual and has applied for medical assistance. Not the day of the gift, and not the application alone: both conditions, and the later of the two. Some pages say "six years." That is not the rule in any state, and it has never been: the window was 36 months for most transfers before the Deficit Reduction Act of 2005 raised it to 60. If a source tells you six, it is wrong, and the rest of what it says deserves the same suspicion.

What does Medicaid actually review?

The look-back is a rule about transfers of assets — anything of value given away, sold for less than it was worth, or moved out of your name. The statute defines assets broadly: The term "assets", with respect to an individual, includes all income and resources of the individual and of the individual's spouse, including any income or resources which the individual or such individual's spouse is entitled to but does not receive because of action by the individual, the spouse, or someone acting for them.

• Resources — savings, property, investments. Every transfer inside the window may be reviewed. This is what the divisor is applied to.
• Income. Two different questions, and it is easy to conflate them. Your ordinary income is tested for eligibility at the time of application — the look-back does not reach back through it. But transferring or redirecting income is a transfer of assets under the definition above: waiving a pension, assigning a benefit to someone else, or declining income you are entitled to so it goes to a relative all fall inside the window like a gift of cash.
• Bank statements are the evidence, not the rule. States ask for statements in order to see the transfers. A transfer found in any month of the window counts, whatever paperwork surfaced it.

Whether a transfer found in the window is penalized is the next question, with its own exemptions. Which gifts do not count against you.

Home-care and community Medicaid: a narrower rule

Everything above is about nursing-home Medicaid. Outside a nursing home the federal rule is narrower, and the two halves are easy to confuse.

• Home- and community-based waiver services — the programs a state runs under a federal §1915(c) or (d) waiver to keep people out of institutions — carry the federal transfer rule in every state, no option. The statute lists them in the same branch as nursing-facility care: services with respect to an institutionalized individual include Home or community-based services furnished under a waiver granted under subsection (c) or (d) of section 1396n. A waiver recipient is, for this rule, an institutionalized individual.
• State-plan community services — home health, personal care, consumer-directed assistance and similar programs paid for directly under a state's Medicaid plan — are the other branch, and there the rule applies only at the option of a State, a noninstitutionalized individual. A state that has not taken the option has no look-back for those services. New York had not, and its 30-month rule is New York taking the option.

New York's 30-month rule, and why it matters that it is still not in force. New York enacted a 30-month look-back for community-based long-term care on April 2, 2020. The state's own proposal reads: New York is seeking approval to impose a lookback period of 30 months for non-institutionalized individuals seeking coverage of CBLTC services. The statute made the rule effective October 1, 2020, and the state intended to implement this Amendment effective January 1, 2021.

It has not happened. Implementation was blocked by federal pandemic maintenance-of-effort rules, and the state's document names March 31, 2024 as the earliest date it would seek to begin. As of February 2, 2026, New York Health Access — a legal-aid tracker, not the state — reports the 30-month community look-back still not implemented: federal approval of both a State Plan Amendment and a waiver amendment is required first, and neither had been granted. A repeal bill (A1907 / S4786) is also pending in the legislature. A rule that has been law for six years and enforced for none of them is exactly the kind of fact that needs a date beside it — so this section carries one.