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How Elder Law Can Guide You through Medicaid Eligibility and Qualifying for Florida  Nursing Home Benefits 

At first glance the eligibility requirements for attaining Florida Medicaid benefits for nursing home care may appear fairly uncomplicated. Unfortunately, meeting the necessary requirements regarding coverage for nursing home care can turn out to be quite complex, requiring the assistance of an experienced attorney. If you are attempting to secure Medicaid Nursing Home assistance there are specific income requirements you must meet as well as asset and categorical obligations.

What is Medicaid and How Can It Help Me?

For those individuals who require medical and/or nursing home treatment, Medicaid is a federal and state program which can significantly assist those who can show true need. Once qualified, a person may be eligible for the state of Florida to pay the difference between their monthly income and the monthly nursing home expenses.

Medicaid Eligibility Requirements

If you meet the following requirements, you may be able to receive specific benefits for Florida Medicaid.

  • Should you meet the financial eligibility requirements, be age 65 or older or be blind or disabled, you likely qualify for Medicaid benefits.
  • You must be considered a resident of the state of Florida in order to qualify for benefits.
  • You must need support with three or more of the stated daily living activities in order to be considered for nursing home placement under Medicaid rules. Those activities include independently walking and standing, feeding oneself, getting dressed without assistance, bathing oneself and performing basic toilet and hygiene functions for oneself.

Income and Asset Limits for Medicaid Eligibility

Keep the following information in mind when determining whether or not you or a loved one qualifies for Medicaid assistance:

  • If you possess substantial assets, you may be able to make transfers or gifts in order to decrease your countable assets however you will then be subject to a 36-month look-back period prior to applying for Medicaid benefits.
  • You may need to speak with your attorney regarding repairs to any of your non-countable assets in order to protect that asset.
  • Purchasing an immediate annuity may allow you to convert certain assets to income.

Remember that every circumstance is different, and should be discussed in detail with a qualified attorney as the advice and recommendations may vary considerably from case to case.

Challenges in Attaining Medicaid Benefits

Many people find it extremely challenging to meet the specific limitations set on income and property or possessions under Medicaid law. The income of the person applying for Medicaid Nursing Home benefits may not surpass $2,022 per month. When considering assets, the assets considered non-exempt may not exceed a value of $2,000. The spouse of a married applicant who resides in the same community is allowed assets up to the amount of $109,560.

Exempt Medicaid Assets

  • So long as your home possesses an equitable value (fair market value less debt encumbrances) of less than a half million dollars, it is considered exempt under federal and state law.
  • Regardless of the value, you are allowed to have one wedding ring and one engagement ring which are considered exempt items.
  • Regardless of the age or value, you are allowed to have vehicle for your regular transportation needs.
  • Items such as rental property which produce a regular income are considered income rather than assets.
  • If your life insurance policy’s cash surrender value is less than $2,500, it will be considered exempt.
  • A plot for burial for yourself and your immediate family as well as any burial plan with a value up to $2,500 or an irrevocable burial plan in any amount is considered an exempt asset.
  • You are allowed to have personal and household items which have an equity value of $2,000 total.  Generally speaking, unless you own antiques, art or collector’s items which have significant value, your home’s furnishings and personal items are considered to be worth $2,000 or less

Strategies for Medicaid Qualification

Unfortunately, many people desperately require Medicaid coverage in order to meet the considerable expenses of nursing home care, but will not immediately meet the asset and income test. These cases benefit the most from the services of a highly knowledgeable attorney who can develop strategies to allow qualification.  These strategies may include the following:

  1. Qualified Income Trust—Should your monthly income exceed the cutoff of $2,022, an irrevocable qualified trust, also known as a Miller Trust should be considered. Once such a trust is created and the benefits for Medicaid are approved, your income will be deposited into this trust monthly and distributed as follows:
  • A personal needs allowance in the amount of $35 is retained by the applicant.
  • For married applicants whose spouse’s income is below the stated Monthly Maintenance Income Allowance, the difference between the spouse’s income and the MMIA will be paid to the community spouse.
  • Some health insurance premiums may qualify under the Qualified Income Trust rules.
  • The remainder of the applicant’s income is paid to the nursing home or other facility which provides care and is known as the patient’s responsibility.

The most crucial issue surrounding a Qualified Income Trust is management of the trust, meaning the income received monthly must be properly managed each month. Qualified Income Trusts are generally managed by an attorney who understands the importance of the monthly management. Creation and Implementation of the trust document must be in place in the same month application is being made for nursing home Medicaid eligibility.

  1. Service Contracts—One popular method of satisfying the asset eligibility test for Medicaid is through a personal service contract. This is most often necessary when the applicant’s assets exceed the allowable amount of $2,000. A service contract allows assets to be effectively transferred to a trusted family member or friend in exchange for services not provided by the nursing home or other facility. Such services could include personal shopping, weekly visitation, personal groom

 

Let us help you determine the best Medicaid Planning strategy that will work for your particular situation. We offer a FREE initial consultation that will answer many of the additional questions not covered here on our web site. Call us in Jacksonville at (904) 900-2750 or toll free anywhere in Florida at 1-866-306-3550, or you can fill in and submit the form below.

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