Wisconsin Medicaid Look-Back Calculator

Wisconsin's look-back and penalty divisor

Wisconsin divides counted transfers by $352.06 per day (Wisconsin Medicaid Eligibility Handbook (EBD) 39.4, Elderly, Blind or Disabled Assets and Income Tables, effective January 1, 2026) and looks back 60 months.

• Once started, the penalty runs without interruption even if the person leaves the facility. (MEH 17.3.2)
• A partial repayment does not shorten the penalty. (MEH 17.3.2)
• The rate used is the one in effect when the application is filed. (MEH 17.3.2)
• The penalty is a number of days, and the manual example drops the fraction of a day. (MEH 17.3.2)
• A person cannot enroll in community waiver programs during a divestment penalty. (MEH 17.3.2)

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.