Medicare-Medicaid Pay-Down of Assets
State law and regulations impose income and asset limits on persons applying for Medicaid.
The income limit for the institutional Medicaid program and certain home and community-based waiver programs is determined by the Department of Medical Assistance Services and is set at 300% of the SSI individual payment limit. For 2025, the Medicaid income limit for individuals eligible is $2,901 per month.
The asset limit is $2,000 for individuals or $4,000 for married couples.
The look-back date is the date that is 60 months before the first date the individual is both (a) an institutionalized individual and (b) has applied for Medicaid. The look-back date is the earliest date on which a penalty for transferring assets for less than fair market value can be imposed. The length of the penalty period is based on the value of the uncompensated transfer of assets and the average cost of nursing facility care in Virginia. The period is calculated by taking the uncompensated value of the assets transferred on or after the look-back date, divided by the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid. The remainder is divided by the daily rate (the monthly rate divided by 31).