Iowa Medicaid Look-Back Period

Quick answer: Iowa Medicaid reviews transfers for less than fair market value made in the 60 months before an application. For nursing facility cases, the 2026-27 penalty divisor is $9,838.96 a month.

Iowa reviews the 60 months — five years — before a Medicaid application (and, in some cases, after it) for any resource or countable-income transfer made for less than fair market value. That review window applies to transfers occurring on or after February 8, 2006, and it's spelled out consistently in both the LTSS overview and the state's Medicaid resources manual.

This isn't the same thing as a gift-tax rule, even though the two get confused. Iowa HHS calculates a penalty against LTSS payment based on the uncompensated equity value of whatever was transferred, and the analysis looks closely at who made the transfer, exactly when, to whom, and for what value was received in return. There are exceptions built into the policy and separate treatment rules for different circumstances, so a family shouldn't assume every transfer to a relative gets treated the same way — the specifics matter.

For nursing-facility cases specifically, the state's 2026-27 penalty divisor — the figure used to calculate how many months of ineligibility a given transfer amount produces — is $9,838.96 per month.