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Medicaid Planning · North Carolina

North Carolina Medicaid look-back rules

Medicaid look-back rules rules for North Carolina.

Published: September 4, 2026. Last checked: September 2, 2026.

Look-back period

60 months from the starting point, which is the earliest date the person is institutionalized or requests CAP or PACE and applies for Medicaid

Source: North Carolina Medicaid Manual MA-2240, Transfer of Assets [state-medicaid-agency] — Revised December 8, 2025 — Change No. 11-25

Transfer-penalty divisor

$396 per day

Source: North Carolina DHHS Change Notice 07-26 [state-medicaid-agency] — Dated June 8, 2026; effective upon receipt

How the state administers the rule

North Carolina reviews all transfers on or after the fixed look-back date; cumulative uncompensated transfers in the period are treated as one transfer and one sanction period. The local agency does not delay initial institutional-services approval solely for the transfer review and must complete the evaluation within three full calendar months.

Source: North Carolina Medicaid Manual MA-2240, Transfer of Assets [state-medicaid-agency] — Revised December 8, 2025 — Change No. 11-25

Sources

Methodology & sources

Checked at least annually and whenever the state publishes a new transfer-penalty divisor or administration rule.

General information, not legal advice.