California Medicaid Look-Back Calculator

California's look-back and penalty divisor

California divides counted transfers by $14,440 per month (DHCS All County Welfare Directors Letter 26-03 (2026 Statewide Average Private Pay Rate), effective January 1, 2026) and looks back 30 months.

• The 30-month look-back begins with the month before the Medi-Cal application is submitted. (DHCS ACWDL 25-18)
• Transfers made from January 2024 through December 2025 are not reviewed, because Medi-Cal had no asset test in those months. (DHCS ACWDL 25-18)
• For applications from July 1, 2026, only months from January 2026 on are reviewed for transfers. (DHCS ACWDL 25-18)
• From July 1, 2026, the number of months reviewed grows by one each month until the full 30 months is reached. (DHCS ACWDL 25-18)
• The full 30-month review applies to long-term care applications made on or after July 1, 2028. (DHCS ACWDL 25-18)
• A transfer is penalized only if the person was over the asset limit when it was made and the transfer was worth more than the statewide average private pay rate. (DHCS ACWDL 25-18)
• The period of ineligibility cannot be longer than 30 months from the date of the transfer. (DHCS ACWDL 25-18)
• The 2026 rate is used only when the application or institutionalization date is on or after January 1, 2026. (DHCS ACWDL 26-03 (Feb 9, 2026))
• A county cannot impose the period of ineligibility without approval from the DHCS Medi-Cal Eligibility Division. (DHCS ACWDL 25-18)
• Medi-Cal does not impose a partial month, so the period of ineligibility counts whole months only. (DHCS ACWDL 25-18)
• The period of ineligibility applies to nursing facility care and not to community-based Medi-Cal programs. (DHCS ACWDL 25-18)

How the look-back and the penalty work

When someone applies for Medicaid to pay for nursing-home care, the state looks back at gifts and transfers made for less than fair value. Federal law sets the look-back at 60 months before the application for transfers made since February 8, 2006, and California runs its own 30-month rule.

Every counted transfer in the window is added together and divided by the state's penalty divisor, the average monthly cost of private-pay nursing-facility care that the state publishes. The result is the number of months Medicaid will not pay for long-term care. Federal law says a state may not round a partial month down, and states handle the leftover fraction in different ways: as part of a month, as whole days, or as a one-time dollar charge. California, which runs its own rules, does not impose a partial month.

The penalty does not start on the date of the gift. It starts only when the person has applied, would otherwise be eligible, and is receiving long-term care, which is why a gift made years earlier can still delay coverage at the worst moment. California is the exception: under DHCS guidance a Medi-Cal period of ineligibility runs from the month of the transfer.

Transfers federal law does not penalize

Some transfers are exempt under 42 U.S.C. 1396p(c)(2): anything to a spouse or for the spouse's sole benefit; transfers to a blind or disabled child or a trust solely for that child's benefit; a trust solely for a disabled person under 65; and the home, when it goes to a spouse, a child under 21, a blind or disabled child, a sibling with an equity interest who lived there for a year, or a child who lived there for two years and provided care that kept the parent at home.

A penalty can also be avoided if the state accepts that the transfer was for fair value or made only for a reason other than qualifying for Medicaid, if all transferred assets are returned, or if the state grants an undue hardship waiver.