South Carolina Medicaid Look-Back Calculator

South Carolina's look-back and penalty divisor

South Carolina divides counted transfers by $9,758.58 per month (SC DHHS Medicaid Policy and Procedures Manual Section 300 (Chapter 304, Appendix D), effective January 1, 2026) and looks back 60 months.

• In the manual example the months are rounded to two places and the days are rounded down to a whole day. (SCDHHS MPPM Chapter 304 Appendix D (Eff. 01/01/26))
• The rate appears in the appendix of payment rates effective January 1, 2026. (SCDHHS MPPM Chapter 304 Appendix D (Eff. 01/01/26))
• The fractional month is multiplied by 30 days to set the partial-month penalty, rounded down to a whole day. (SCDHHS MPPM Chapter 304 Appendix D (Eff. 01/01/26))
• The look-back applies to nursing home and home and community-based services applications, and a waiver application can start the penalty. (SCDHHS MPPM Chapter 304 Appendix D (Eff. 01/01/26))

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.