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Glossary

The words you'll hear
in every conversation.

Medicaid planning has its own vocabulary. Here are the 15 terms you need to understand before your first call with a Certified Medicaid Planner or elder-law attorney.

Stacked cream and amber washes like pages of an old reference book

What Medicaid planning vocabulary do I need to know?

The 15 terms that come up on every planner call: the 5-year lookback (60-month transfer review), penalty divisor (state cost-of-care), CSRA (community-spouse asset shelter), MMMNA (community-spouse income floor), Snapshot Date (asset-valuation moment), and estate recovery (post-death claim). Learn these once and every conversation gets easier.

5-Year Lookback

A federal Medicaid rule reviewing every asset transfer made in the 60 months preceding a long-term-care Medicaid application. Uncompensated transfers during the window create a penalty period of ineligibility.

Penalty Divisor

State-specific monthly figure approximating private-pay nursing-home cost, used to convert uncompensated transfers during the lookback into months of Medicaid ineligibility.

CSRA (Community Spouse Resource Allowance)

The portion of a married couple's combined non-exempt assets that the non-applicant spouse may retain when the other spouse applies for long-term-care Medicaid.

MMMNA (Minimum Monthly Maintenance Needs Allowance)

The minimum income the non-applicant spouse may retain each month from the couple's combined income.

Snapshot Date

The date of first continuous institutional stay — typically the nursing-home admission date. Medicaid values the couple's assets as of this date to calculate the CSRA.

Spend-Down

Converting countable assets into exempt ones or paying off obligations to reduce the applicant's assets to the eligibility threshold without triggering the lookback penalty.

MAPT (Medicaid Asset Protection Trust)

An irrevocable trust that, if funded 5+ years before a Medicaid application and properly structured, shields assets from the lookback.

Estate Recovery

State Medicaid agencies' authority to recover Medicaid payments from a deceased recipient's estate. Posture varies from minimum-TEFRA-required to aggressive expanded recovery.

QIT / Miller Trust

A Qualified Income Trust used in income-cap states to shield income above the Medicaid cap from counting for eligibility purposes.

Caregiver-Child Exception

Federal safe harbor allowing transfer of a home to an adult child who lived with and provided care that delayed institutionalization for at least 2 years.

Personal Service Contract

A formal written agreement paying a family member at fair-market rates for documented caregiving hours, counted as spend-down when properly structured.

Aid & Attendance

A tiered enhancement to the VA Improved Pension paid monthly to wartime veterans and surviving spouses needing help with activities of daily living.

MAGI

Modified Adjusted Gross Income — the income definition used for most non-LTC Medicaid, ACA subsidies, and some VA programs.

ADL (Activities of Daily Living)

The six core self-care tasks (bathing, dressing, toileting, transferring, continence, eating) used to assess functional eligibility for long-term care.

Managed Long-Term Care

A state Medicaid model in which long-term-care services are delivered through enrolled managed-care plans rather than fee-for-service.

Because the federal Social Security Act and each state's Medicaid manual use specific legal terms. Understanding the vocabulary lets you ask precise questions, follow the reasoning, and spot when a caseworker is applying a rule that doesn't fit your facts.
60 months, exactly. Different from the VA's 3-year lookback (36 months), which applies to Aid & Attendance and the Improved Pension, not Medicaid.
Spend-down is paying down balances — mortgage payoff, medical bills, prepaid funeral. Exempt-asset conversion is trading one form of asset for another — countable cash becomes an exempt home improvement or a new vehicle for the community spouse. Both reduce the applicant-countable base; neither trips the lookback penalty.
About half. Others use a 50%-of-combined-assets rule between the federal floor and ceiling — meaning the community spouse gets half of countable assets, but no less than the floor and no more than the ceiling. Check your state's page for current posture.
Email [email protected] with the term and your state. We add state-specific vocabulary — New York's Community Spouse Pooled Trust, Oregon's OSIPM, Texas's STAR+PLUS — on an ongoing basis.