Virginia Medicaid Look-Back Period

Last updated: August 21, 2026 Jurisdiction: Virginia

Virginia applies a 60-month transfer review

Virginia's long-term-care manual directs workers to obtain information about transfers of income and resources made during the five years before the Medicaid application date. The look-back period is 60 months, measured from 60 months before the first date the person is both an institutionalized individual and a Medicaid applicant. The policy covers facility-based LTSS and community-based care, including HCBS, PACE, and hospice (DMAS Chapter M14).

A transfer for less than fair market value can produce a period when Medicaid will not pay for LTSS. Virginia describes the uncompensated value as the part of fair market value that was not received as compensation, and says that love and affection are not fair-market-value compensation. The penalty does not erase eligibility for other covered Medicaid services if the person otherwise qualifies, but it can interrupt the LTSS payment that the family is counting on (DMAS Chapter M14).

There is no one statewide 2026 divisor

Virginia's current manual does not publish a single statewide 2026 private-pay transfer divisor. Instead, it calculates the penalty by dividing the uncompensated transfer amount by the average monthly private-pay nursing-facility cost for the relevant locality and application date, then uses a daily rate derived by dividing the monthly rate by 31 for a remainder. A family should ask the eligibility worker for the rate that applies to the locality and application date rather than import an old statewide example (DMAS Chapter M14).

The start date has its own rules. If the person was not receiving Medicaid LTSS at the time of transfer, the penalty generally starts on the first day of the month in which the person otherwise would qualify for Medicaid LTSS. If the person was receiving Medicaid LTSS, it generally starts on the first day of the following month, assuming other eligibility requirements are met. Penalties cannot overlap or run concurrently (DMAS transfer-penalty policy).

Transactions should be documented before they are made

Virginia recognizes that a later return of compensation can change the uncompensated amount, and it describes an undue-hardship process where denying LTSS would endanger health or life or deprive the person of necessities. The manual says a request must document that the transferred assets cannot be recovered and that a denial would immediately cause discharge or loss of life-sustaining care or necessities. That is a narrow safety valve, not a planning technique (DMAS Chapter M14).

Virginia penalty formula: uncompensated transfer value divided by the applicable locality's average monthly private-pay nursing-facility cost, plus a possible daily remainder. The current manual confirms the formula but does not set one statewide 2026 divisor (DMAS Chapter M14).

For related crisis-planning concepts, see Crisis Planning / Half-a-Loaf. Before making a gift, changing a deed, funding a trust, or cancelling a contract, obtain Virginia-specific legal advice and the current locality rate.

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Virginia applies a 60-month transfer review

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