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Medicaid & gift-giving: a doubled edged sword


By Patrick J. Kelleher, Esq.

Mabel’s children were concerned that Mabel would need long-term nursing-home care in the near future. It was the holidays, and Mabel always got a lot of joy out of generosity. But her children had heard that people in Mabel’s circumstances should not give gifts because it could jeopardize their eligibility for Medicaid benefits.

The concern is real. For Medicaid to cover the huge expense of nursing-home care, Mabel would have to show that she owned nothing more than around $2,000. And she must also show that she had not given away money or assets over the prior five years (2.5 years in California). That Medicaid rule – the “look-back period” or the “transfer penalty” – would charge Mabel dearly for her generosity. Depending on the size and number of the gifts, the penalty could be substantial. I often refer to gift giving as a “double edge sword” when teaching my educational elder law workshops.

Many wrongly think that there is no penalty for gifts of up to around $15,000 annually. That misunderstanding confuses tax law with Medicaid law (and it also misstates tax law, but that’s another subject). The Medicaid rules are entirely different from the tax rules. In the Medicaid context, gifts of any amount that are given during the look-back period can be penalized.

There are exceptions. These include gifts to spouses and siblings under certain circumstances, disabled children, and children who are caregivers and who live at home with the elder for a span of time. But overall, gifts and Medicaid do not go together. The Medicaid rules are complicated and the consequences for mistakes can be very costly. There are a number of options to protect assets and still qualify for benefits, but these options must be weighed with great care. This is why it’s best to consult elder law attorneys who, like our team, are qualified by experience and expertise in Medicaid law.

There is one harmless deception Mabel’s children might consider to keep Mabel happy and still satisfy the Medicaid rules. The children might help Mabel fill out checks for all the gifts she’d like to give, together with a greeting card for each gift. Everybody could thank Mabel, tear up the check later, and tell her what they “bought” with that amount. It may be that that little device would be worth it, so Mabel could enjoy the holidays too.

Contact us now because our caring Elder Law Team is here to help you get started with the process of protecting what you have for the people you love the most!

Next steps: Attend our FREE educational Estate Planning & Elder Law workshop by calling 781-871-7526 or email pat@elderlawcare.com because seating is limited and our Learning Center fills up quickly!


Patrick J. Kelleher

About the Author: Patrick’s mission in life is to help his clients and their families in a meaningful way with Estate Planning, Elder Law, Veterans and Special Needs Planning! For more information visit www.elderlawcare.com or call (781) 871-7526. ∞


Reprinted from the March 2019 edition of the South Shore Senior News.



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