Outline of the eligibility requirements for Florida Long Term Care Medicaid. Florida Medicaid for nursing home and skilled care has many eligibility requirements. This guide outlines the general requirements for Level of Care, Income, and Assets.
Level of Care Requirement
The applicant must require skilled nursing services, assistance with a sufficient number or activities of daily living (ADLs), or either be a resident or have a move in date, at a Medicaid approved skilled nursing facility.
The income limit is currently $2,250.00. Income must be verified and if over income, but otherwise qualified, a Qualified Income Trust can be used to meet the income eligibility requirement. As a Medicaid recipient, all gross income (less a $105 personal needs allowance) must be paid over each month toward the cost of care as the *patient responsibility*. If there is a community or well spouse, they may be entitled to some of the applicant spouse*s income. Medicaid is then billed for the remaining costs.
The current asset limit is $2,000, which does not include homestead property (equity cap applies), prepaid burial plans, personal property (including a personal vehicle) and certain IRAs (if required minimum distributions are taken). Countable assets include checking and savings accounts, CDs, investment and brokerage accounts, 401Ks, certain annuities, cash value in life insurance policies, and any real, non-homestead property (some assets are subject to additional exclusions or exemptions).
The income of the spouse is not a factor, but there is a spousal asset limit of $123,600. Transfers of assets between spouses are not penalized, however transfers to someone other than a spouse does create a penalty as detailed above.
Medicaid allows for the community spouse to retain some of the institutionalized spouse*s income when necessary. Medicaid allows for a Minimum Monthly Maintenance Needs Allowance of $2,058 per month. This amount can be increased to Maximum Income Allowance of $3,090 in consideration of excess shelter and other expenses. Under special circumstances where these amounts are insufficient to maintain and provide for the community spouse*s quality of life, a petition to the courts for spousal support may be needed.
What to Do
Planning for Medicaid Eligibility can be a complex undertaking. As mentioned above there are techniques that can be used to become eligible within the guidelines of the programs. Many planning options require the assistance of a knowledgeable Elder Law attorney as to avoid penalties or denial of benefits. Should you or a loved one require long term care, seek the guidance of a local Elder Law attorney.
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