New Mexico Medicaid Look-Back Period

Last updated: August 21, 2026 Jurisdiction: New Mexico

New Mexico applies a five-year transfer review

New Mexico’s Institutional Care Medicaid rule applies a 60-month look-back to transfers made on or after February 8, 2006. The rule says the look-back starts when the person applies for Institutional Care Medicaid and is in an institution; trust-payment transfers that are treated as disposed assets also use a 60-month look-back (HCA 8.281.500 NMAC institutional-care rule).

The review is not a tax calculation. HCA calls the result of a disqualifying transfer “restricted coverage,” meaning that a person can face a limitation on the Medicaid coverage otherwise sought for long-term care. The rule directs HCA to identify transfers for less than fair market value during the applicable period and apply the state’s transfer provisions (HCA 8.281.500 NMAC institutional-care rule).

The published 2026 penalty divisor

HCA’s 2026 ABD Medicaid sheet lists the average cost of a nursing facility at $9,209 per month. The Institutional Care rule directs the agency to divide the total uncompensated value of transferred resources by the current average monthly private-patient nursing-facility cost to determine months and partial months of restricted coverage (HCA 2026 ABD Medicaid programs sheet; HCA 8.281.500 NMAC institutional-care rule).

Using the published 2026 figure, the mathematical starting point is the uncompensated transfer value divided by $9,209. That is only a starting point: whether a transaction is exempt, whether value was received, the transfer date, and the date of application all require the actual records and current HCA policy.

Gifts, home interests, and trusts need separate analysis

A transfer should not be judged solely by its label. A family gift, adding a person to a deed, selling property below value, funding a trust, or giving up an interest in a home can each create different valuation and exception questions under the transfer rules. The official rule’s focus is whether resources were transferred for less than fair market value during the applicable review period (HCA 8.281.500 NMAC institutional-care rule).

New Mexico also has a separate hardship process for a transfer penalty. HCA states that an applicant or recipient subject to a less-than-fair-market-value transfer penalty may seek a waiver under its undue-hardship criteria, but hardship is a factual and procedural request, not an automatic exception (HCA 8.281.500 NMAC institutional-care rule).

2026 transfer divisor: $9,209 per month. Confirm the transfer date, the current HCA divisor, and the availability of an exception before relying on a penalty estimate (HCA 2026 ABD Medicaid programs sheet).

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New Mexico Medicaid Look-Back Period

New Mexico applies a five-year transfer review

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