Medicaid Planning

We know it is imperative that your loved ones receive the best care and quality of life. Unfortunately, sometimes a loved one’s level of care is so significant, they are not able to receive sufficient care at home. We can help you through the hurdles of establishing a good care plan while also preserving what they have worked for their whole lives.

In Florida, the average cost of nursing home care is between $8,000 to $10,000 monthly, and assisted living facility charges can range anywhere from $5,000 to $7,000 monthly. At that rate, the annual costs for care are anywhere between $60,000 to $120,000 per year. With average stays at approximately 3 years, this could dwindle a retirement savings in no time. By meeting with an experienced attorney and preparing ahead of time, Medicaid Planning could be the best investment you could ever make just in terms of saving your assets and your return on your investment. With just the cost of ONE month of care, you could have these long-term care costs completely paid for – for life.

There are several different Medicaid long-term care programs available. These programs have slightly different eligibility requirements and benefits. The whole process is complex – eligibility requirements obligate you to meet certain income and asset levels. Further complicating eligibility are the facts that the criteria vary with marital status and that Florida offers multiple pathways towards eligibility.

Medicaid services in Florida is a Medicaid Managed Care Program.  There are three programs available to assist seniors or disabled persons who need long-term care services. 

Florida’s Medicaid Long Term Care Program (ICP) is a program for those who need nursing home care. It is an entitlement program which means the government guarantees benefits if you meet all the eligibility requirements.  There is no waiting list.  Eligibility is based on specific income and assets requirements.  The applicant must be a resident of Florida and a US Citizen or have proper immigration status.  The applicant must be 65 years or older or disabled and the applicant must meet certain medical requirements for the level of care requested.

Home and Community Based Services Program.  This Program provides long-term care at home, adult day care, adult foster care homes and assisted living facilities.  This is not an entitlement Program, therefore if you meet all the eligibility criteria you may be placed on a waiting list for services.  Unfortunately, waiting lists for this Program are often the case.

Regular Medicaid for Seniors and Disabled.  This is an entitlement program, meaning all persons who are eligible will receive services. Benefits are provided at home or adult day care.

Eligibility for Florida’s Medicaid Programs and Options for Qualifying When Over Limits

When determining eligibility for Medicaid, income that an applicant receives is counted.  Medicaid is very strict about “gifting” assets to meet eligibility guidelines.  Medicaid divides assets into two categories:  Exempt and Available.  Exempt assets are specifically designated under the rules and ownership of an exempt asset by the applicant and will not result in a denial of benefits.  Examples of exempt assets are a residential home (allowable amount dependent on marital status and whether Florida homestead property), one vehicle, irrevocable burial trust, household furnishings, clothing, jewelry, etc.  If an asset is not listed as an exempt asset, it needs to be liquidated and applied toward the cost of long-term care. Countable assets include cash, stocks, bonds, investments, credit union, savings and checking accounts, and real estate in which one does not reside.  It is important to know that the state has a look back period of 5 years with a penalty for people who sell assets below fair market price, transfer assets to others, or give money and property away.

 If your income exceeds Medicaid’s income cap ($2,382 monthly) it does not mean that you will not be able to obtain Medicaid.  There are options available:

1. Medically Needy Pathway Persons: This Program is for persons who are seniors and are applying for regular Medicaid.  If the applicant is over income but has significant medical bills, the access income can be used to pay down the medical bills each month to reach the Medicaid eligibility limit.  Medicaid will provide the benefit for the remainder of the month once that eligibility limit has been reached.  This Program only addresses access income, NOT access assets.  If the applicant’s assets exceed Medicaid limits, the applicant will not be eligible for this Program.
    
2. Spending Down Extra Assets: Medicaid allows applicants to spend down assets by spending excess assets on non-countable assets, such as home modifications, (i.e., addition of wheelchair ramps or stair lifts), prepaying funeral and burial expenses and paying off debt.
    
3. Qualified Income Trusts (QIT): The amount of monthly income in excess of $2,382 can be placed into a Qualified Income Trust (QIT). The trust must be irrevocable, and Florida must be the designated recipient when the beneficiary dies. Only income in excess of $2,382 must be placed in the trust. The trust funds are used to pay the nursing home patient responsibility amount and deposits to the trust must be made monthly. 

The cost of care for aging or disabled loved ones can leave families in financial ruins. In fact, a primary reason people file for bankruptcy is health care costs. Protecting your loved one’s assets is important to ensure they receive the best care possible, and to protect the surviving spouses as well. With our help, we can mitigate the cost of long-term care and help you protect your families' assets.