The Medicaid 5-Year Lookback in Ohio, Explained Simply

How it works

1. Your loved one applies for Medicaid nursing home or waiver care.
2. The county reviews bank statements and transfers for the past 60 months.
3. Any gift or below-market transfer is added up.
4. The total is divided by Ohio's average monthly nursing home cost to set a penalty period — months Medicaid won't pay.

Common transfers that cause problems

• Cash gifts to children or grandchildren
• Putting the house in a child's name
• Selling property to family below market value
• Paying a family caregiver without a written agreement

Common exceptions

• Transfers between spouses
• Transfers to a blind or disabled child
• The home transferred to a caregiver child who lived there and provided care for two years before admission
• Certain properly structured trusts

Protections for the spouse at home

Medicaid's spousal impoverishment rules protect a portion of the couple's assets and income for the community spouse. Ohio publishes updated limits each year (see the 2026 Medicaid letter linked below).

What to do

• Start planning 5+ years ahead if possible.
• Keep records and receipts for all large transfers.
• Talk to an elder law attorney before gifting or selling property.

See our Ohio Medicaid eligibility guide and Financial Planning guide, or find an elder law attorney in our directory.