Maine Medicaid Look-Back Calculator

Maine's look-back and penalty divisor

Maine divides counted transfers by $13,339 per month (2026 MaineCare Eligibility Guidelines (OFI, rev. 6/23/26), effective June 1, 2026) and looks back 60 months.

• When the penalty is less than a full month, the amount is added to the cost of care in the first month one is due. (10-144 CMR ch. 332, Part 15, Sec. 1.8(I)(C))
• The private rate is set from nursing facility cost reports and redetermined each year effective June 1. (10-144 CMR ch. 332, Chart 4.3 (Rule #302, eff. June 1, 2023))
• Whole months are counted first, and the leftover partial month is turned into a dollar amount added to the cost of care. (10-144 CMR ch. 332, Part 15, Sec. 1.8(I)(C))
• The penalty applies to nursing facility services and to home and community-based waiver services. (10-144 CMR ch. 332, Part 15, Sec. 1.8(I)(C))

Less certain: The June 1, 2026 start date for the Maine figure is inferred from the annual June 1 rule; the guidelines do not print it.

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.