Not as far as we can confirm. As of 9 October 2026, New York’s 30-month Medicaid look-back for home care and other community long-term care has not started. The state passed the law in 2020, but it needs federal approval that CMS still lists as pending, and, as of the latest report we found, the Department of Health had not told local offices how to apply it. The separate 60-month look-back for nursing home Medicaid is in force. That is not a green light to give assets away, and this page explains why.
Is the 30-month Medicaid look-back active for NYC home care?
A look-back asks an applicant to show what happened to their money in the months before applying. If assets were given away or sold for less than they were worth, Medicaid can impose a penalty period with no coverage for the care in question. New York’s 2020 law set up a 30-month version for community care such as home care. Four things have to line up before it starts, and the table shows where each stands.
| What has to happen | Status on 9 October 2026 | Source |
|---|---|---|
| State law authorizing the look-back | Done. Enacted in April 2020 | DOH proposal page |
| CMS approval of the state’s requests | Not done. The CMS demonstration page lists a “Pending Application – CBLTC Amendment Request” dated 03/25/2021 | Medicaid.gov |
| Instructions from DOH to local Medicaid offices, including HRA | Not issued as of the latest update we found, in early 2026. NY Health Access reported none on 29 January 2026 | NY Health Access (NYLAG) |
| A start date | None announced. DOH’s own page still gives March 31, 2024 as the earliest date the state would seek | DOH proposal page |
We also went through the state’s 2026 Medicaid eligibility notices, GIS 26 MA/01 through 26 MA/14, and none of their subjects concerns a community look-back. NY Health Access, the legal-resources program of the New York Legal Assistance Group, said in early 2026 that, given the approvals still outstanding, it seemed unlikely a start could come before later in 2026 or 2027. That is an advocate’s reading, not an official date.
What is the difference between the 60-month and 30-month look-back?
| Nursing home Medicaid | Community Medicaid (home care) | |
|---|---|---|
| Look-back length | 60 months, the federal default | 30 months, planned |
| Status | In force | Not started; awaiting federal approval |
| Services affected | Nursing facility care | Personal care, CDPAP, licensed home care, certified home health agency services, private duty nursing, adult day health care, assisted living program, MLTC enrollment |
| How a penalty is sized | Transfer amount compared with a regional monthly rate. NYC 2026 rate: $15,282 | Planned to use the same method (NY Health Access) |
| Earliest transfers reviewed | Five years before applying | Transfers on or after October 1, 2020 |
The NYC rate comes from GIS 25 MA/14, which sets the 2026 regional rates for nursing facility penalties. As an illustration only, a $76,410 gift would equal five months of penalty at that rate ($76,410 divided by $15,282). The state’s own proposal lists the services above, says the usual exceptions and an undue hardship waiver would apply, and describes a phase-in rather than a full 30-month review on day one.
What would change when the look-back starts?
- More paperwork. Applicants, and their spouses even if the spouse is not applying, would have to produce financial records for the look-back period.
- Gifts can count. Transfers made on or after October 1, 2020 could be reviewed, according to the state’s proposal. Exempt transfers would follow the nursing home exceptions, such as transfers to a spouse or to a disabled child, according to NY Health Access.
- Earlier applications may be protected. The state told CMS that people who apply for community care before the start date would not be subject to the look-back. NY Health Access advises asking for community-based long-term care coverage on the application, so ask HRA or an attorney how to do this.
Can you give away assets now and still qualify for home care?
You should not count on it. The state’s own wording is that its transfer rules for community care are effective October 1, 2020, so a gift made today could be reviewed once the look-back starts. We could not verify from an official source how local offices are treating community transfers in practice right now.
The nursing home rule matters just as much. If a parent needs nursing home care within five years of a gift, the penalty can apply. So giving away a house or savings to “protect” it for home care can backfire if care later moves to a facility.
What should you do now?
- Pause before any large gift or retitling. Talk to a New York elder law attorney first.
- Gather records anyway. Five years of statements covers the nursing home rule and any future community rule.
- Apply when care is needed. Waiting only adds risk if the look-back starts. Our guide to what Medicaid covers for home care explains the application.
- Look at the lawful tools. Spend-down, a pooled income trust and, for married couples, spousal refusal or spousal impoverishment rules address income and spousal assets without giving anything away.
- Check for updates. The DOH proposal page and NY Health Access are the places a start date would show up first.
Looking for the New York home care registry or the M11q form?
Many readers reach this page searching for the NYS Home Care Registry. That is a different thing from the look-back. The state Department of Health says the Home Care Registry provides limited information about individual home health aides and personal care aides who have completed a state-approved training program, and its home care page links to the Home Care Registry lookup. Our guide on how to check the Home Care Registry walks through it.
The HCSP-M11q, titled Medical Request for Home Care, is a different document again. See our M11q guide and the form itself.
Planning ahead without panic: advice from our nurse director
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
Don’t wait for a hospital stay or a fall to start looking at Medicaid and home care programs. It is far easier to arrange safe care before things reach a crisis.
ProLife Home Care is a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. We are not a law firm or a Medicaid office, so we cannot advise on transfers or file your application. We can help you plan the care side. Call (718) 232-2777 or use our contact page.
The look-back status can change at short notice. Everything above was checked against health.ny.gov, medicaid.gov and the NY Health Access legal-resources site on 9 October 2026. This is general information, not legal advice. Talk to an elder law attorney before moving or giving away any asset.
Frequently asked questions
Is the 30-month look-back for NY home care active in 2026?
No, not as far as we can confirm on 9 October 2026. The law passed in 2020, but CMS lists the state’s request as pending and we found no state notice putting it into effect.
What is the difference between the 5-year and 30-month look-back?
The 60-month look-back applies to nursing home Medicaid and is in force. The 30-month look-back is meant for community care such as home care and has not started.
Are gifts made before the look-back starts safe?
Not necessarily. The state’s proposal says transfers on or after October 1, 2020 could be reviewed, and a gift can also trigger the nursing home look-back. Get advice before giving anything away.
If I apply before it starts, will the look-back apply to me?
The state told CMS that people who apply for community long-term care before the start date would not be subject to it. NY Health Access notes that the final policy has not been issued, so confirm with an attorney.
How much is the Medicaid penalty for a transfer in NYC?
For nursing home Medicaid, the 2026 NYC regional rate is $15,282 a month. Divide the amount transferred by that rate to estimate the penalty months.
Where do I check the New York home care registry?
Use the Home Care Registry link on the Department of Health’s home care page. It gives limited information about home health aides and personal care aides who finished a state-approved training program.
