Montana Medicaid Look-Back Period

Montana’s published penalty rate

DPHHS calculates the penalty by dividing the uncompensated value of transferred assets by the average daily cost of nursing-home care at the later of the application or transfer. Its current located penalty policy lists $306.27 per day and $9,315.71 per month for July 1, 2024 and ongoing; that is the latest state-published rate located for this page, not a promise that it will remain unchanged for a future application (DPHHS CMA 404-2 penalty-period policy).

The resulting penalty is measured in days when Medicaid will not pay for institutional or waiver services. DPHHS says the period begins only after the transfer or application, whichever is later, the person is otherwise eligible, and the person is institutionalized or meets HCBS waiver criteria; it then runs continuously (DPHHS CMA 404-2).

Home, trust, and joint-title changes can be transfers

Montana’s policy says assets include resources or retained income owned by, available to, or beneficially entitled to the client or spouse. It expressly says the client’s excluded home remains subject to the transfer rules, so an exemption while owned does not automatically make a later deed free of transfer consequences (DPHHS CMA 404-1).

The policy gives a direct title-warning example: adding a daughter to a home title limits the owner’s ability to sell or dispose of the home and is treated as an asset transfer. It likewise says reducing ownership or control in joint tenancy, tenancy in common, joint ownership, or a similar arrangement can be a transfer (DPHHS CMA 404-1 joint-asset guidance).

Some home transfers are identified as exempt, including transfers to a spouse, a child under 21, a permanently blind or disabled adult child, a qualifying caregiver child, and a qualifying sibling with equity and one year of residence. Each exception has stated conditions, including care and physician documentation for the caregiver-child rule (DPHHS CMA 404-1 home-transfer exceptions).

Keep records before relying on a family arrangement

A fair-market-value sale, care agreement, trust transaction, life estate, or title change needs evidence of timing, value, consideration, and authority. DPHHS permits adjustment when transferred property or equivalent value is returned, but says returned value may again count as a resource when eligibility is re-evaluated (DPHHS CMA 404-2 returned-assets policy).

A Medicaid transfer penalty and estate recovery are different issues. Montana’s recovery materials also reach specified non-probate property after death, so a family should have an elder-law attorney review both consequences before an irreversible transfer.