Updated August 27, 2026. Quick answer: Idaho’s rule states the arithmetic and prints no number. Under IDAPA 16.03.05 the period of restricted coverage is the number of months computed by dividing the net uncompensated value of the transferred asset by the statewide average cost of nursing facility services to private patients. Idaho also does something most states do not: the penalty is restricted Medicaid coverage, not a loss of Medicaid – except for waiver and personal-care recipients, for whom the rule says the penalty is ineligibility.
What Idaho publishes
| What the state lists | Figure |
|---|---|
| What the rule divides by | the statewide average cost of nursing facility services to private patients |
| When that cost is measured | at the time of the participant’s most recent request for Medicaid |
| The section that states it | 834 |
| What the penalty is | restricted Medicaid coverage |
| What restricted coverage stops | Medicaid will not participate in the cost of nursing facility services |
| The penalty for waiver and personal-care recipients instead | ineligibility |
| Look-back | 60 months |
| What the look-back is counted from | the application date or the transfer date, whichever is LATER |
| Multiple transfers | one penalty period must expire before the next begins |
| Written notice before the penalty is imposed | at least 10 days |
| Current dollar figure published in the rule | not found – see below |
How the penalty period is calculated
- Section 834 of IDAPA 16.03.05 states the division in one sentence: the period of restricted coverage is the number of months computed by dividing the net uncompensated value of the transferred asset by the statewide average cost of nursing facility services to private patients.
- The rate is pinned to the person, not to the transfer. The same section says the cost “is computed for the time of the participant’s most recent request for Medicaid”, so a later application can be measured against a later – usually higher – divisor.
- Idaho’s penalty is narrower than most. Section 832 defines restricted coverage as meaning “Medicaid will not participate in the cost of nursing facility services or in a level of care in a medical institution equal to nursing facility services” – the rest of the person’s Medicaid continues. For someone receiving personal care services or HCBS waiver services, though, the same section says the penalty is ineligibility.
- The look-back is sixty months, and section 833 counts it from an unusual point: “the date of the application for long-term care or HCBS services or the date of the transfer, whichever is later in time”. The same section says the penalty applies to transfers made during a period preceding OR FOLLOWING a request for long-term care services.
- Transfers are accumulated, not taken one at a time: section 835 says the value of all asset transfers made during the look-back period is added together for the purpose of calculating the penalty.
- Where separate penalty periods are computed, section 836 requires them to run consecutively – one penalty period must expire before the next begins.
- The penalty keeps running whether or not the person is still in long-term care, and it ends early only if the assets are recovered or fair market value is received. When a penalty period ends after the first day of a month, eligibility begins the day after it ends rather than the following month.
- If a transfer is discovered after the penalty has already been served, section 835 says a new penalty period begins the month following timely notice of closure of benefits, and section 832 requires at least ten days’ written notice before a penalty is imposed.
Once you have the figure above, the Medicaid penalty period calculator does the arithmetic. This page is the Idaho rate record; the calculator is the class parent.
What this page does not settle
- This page carries no dollar figure because Idaho’s rule carries none, and that was checked across the whole rule rather than in section 834 alone. IDAPA 16.03.05 extracts to 264,261 characters containing 74 dollar amounts, and the phrase “statewide average” appears exactly once in the entire document – in the divisor sentence itself, with no amount attached. “Private pay” appears nowhere.
- The figure exists; the Department publishes it outside the rule. Because section 834 ties the divisor to the date of the most recent request for Medicaid, the operative number is whichever statewide average the Department was applying on that date, and this page does not guess at it from commercial sources.
- Restricted coverage and ineligibility are different penalties in Idaho and the rule applies them to different people. A reader in a nursing facility and a reader on the HCBS waiver are reading two different outcomes from the same paragraph.
- The look-back’s “whichever is later in time” wording is genuinely unusual and this page reports it as written rather than smoothing it into the familiar version. Anyone relying on it for a specific file should read section 833 directly.
- The rule text retrieved here is stamped 7-1-24 throughout. Idaho reissues IDAPA chapters on its own schedule, so a later amendment would not appear in the copy this page was built from.
Eligibility is decided by the state agency on the whole file, not by this one number. Nothing here is legal advice, and no one should transfer, retitle or give away property on the strength of a worksheet.
Sources
Each source above was retrieved and read against the state text on August 27, 2026. Every figure on this page was checked against those bytes.
A transfer penalty is a separate test from the income standard that decides eligibility in the first place. For what Idaho uses as that standard, and the state document it comes from, see Medicaid nursing home income limit in Idaho ($3,002/Month).
Related: Idaho’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
Related: Idaho’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.