No — as of 2026 New York's 30-month lookback does not yet restrict home care for dementia patients. The state passed the rule but has not put it into force, so eligible applicants can still qualify without a transfer penalty.
The lookback means a review of gifts and unpaid asset transfers in the 30 months before applying. Community Medicaid pays for long-term care at home rather than in a nursing facility. When active, the rule will include dementia patients with no special waiver.
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Official resources:
- Read the official guidance from Nyassembly — Use this primary source to verify the official guidance.
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Table of Contents
- What did the 2020 law change?
- Is the rule in force now?
- Which home-care services would face review?
- Does dementia change the financial test?
- What happens after a transfer, and what should families do?
What did the 2020 law change?
New York's April 2020 budget law created a 30-month transfer review for Community Medicaid home care. Before that change, Community-based long-term care had no lookback. The N.Y.
Department of Health described the plan in its MRT II lookback proposal. The change was aimed at people who need ongoing care while living at home. It did not change income or disability rules by itself. It added a financial history test to home-care applications.
Is the rule in force now?
No. Implementation was delayed from Jan. 1, 2021 to no earlier than March 31, 2024 and then into 2025.
According to Alatsas Law Firm's 2026 review, the state had set no confirmed start date as of 2026. That delay creates the current opening for families. Eligible applicants can still transfer assets and qualify for immediate home care without a lookback penalty. Families should still save transfer records and plan as if 30-month review could begin as early as late 2026.
Which home-care services would face review?
When implemented, the rule will affect non-institutionalized applicants for Community Medicaid long-term services used to age at home. These are services that support daily life outside a nursing facility.
A dementia diagnosis does not remove these services from review. If the person lives at home and seeks Community Medicaid, the listed services fall in the same group.
- personal care at home
- Managed Long-Term Care
- CDPAP family-caregiver services
- home health services
- adult day care
Does dementia change the financial test?
Dementia does not waive financial review. It lowers only the functional test for Community Medicaid. Most applicants generally must need help with more than two Activities of Daily Living, which are basic self-care tasks.
People with Alzheimer's or dementia qualify with supervision for more than one such task, as explained in the Families.care Medicaid guide. Nursing-home Medicaid stays separate and stricter on history. New York reviews asset transfers over 60 months before a nursing-facility application. The planned home-care period is 30 months, half that length.
What happens after a transfer, and what should families do?
A violation would cause a period of home-care ineligibility. The period is calculated as total uncompensated transfers divided by the regional monthly care rate, according to Medicaid Planning Assistance. A bipartisan repeal bill, S4786/A1907, would remove the home-care lookback while keeping 60-month review for nursing facilities.
Introduced Feb. 12, 2025, it advanced to third reading in 2025 but did not pass. Families facing choices now should take three practical steps.
- keep dated records of gifts, transfers, account changes, and care bills
- seek Medicaid planning advice before large transfers
- apply promptly if home care is needed, rather than waiting for the rule to start
