Medicaid is a system for people who qualify as poor at application time but they do not always have to have been poor. Over the last 35 years the government has gone from allowing last minute transfers of everything necessary to qualify to scrutinizing the last 60 months worth of gifts and transfers. Presumptions of gifting, fair compensation, and contemporaneous exchange rules all make review of 5 years worth of finances a necessary consideration in almost every Medicaid case.