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What to Know about Medicaid in Florida


Medicaid planning is essentially estate planning for long term care benefits, as Florida is an income cap state. This means that in order to be eligible for Medicaid benefits, the state imposes a hard limit on income, and the amount must not be higher than their limit when filing the application. This differs from non-capped states that allow people to spend down their money to meet the limit for their long-term care.

There may be alternatives to preserving your assets and protecting your legacy without having to lose everything because a family member is in a nursing home. The laws are extremely complex in regard to Medicaid, much like with Veterans benefits, so it’s important to retain a skilled Florida elder law attorney who can assist you through this process.

Available Methods of Paying for Long-Term Medical Care 

There are several methods you can use to pay for long-term medical care in Florida. These include:

  • Medicaid
  • Medicare
  • Private long-term-care insurance
  • Veteran’s benefits

It’s important to understand the differences between Medicare and Medicaid. Medicare is for people who are aged 65 and older who have paid into the system throughout their younger working years. Medicare may also cover some younger individuals who have disabilities or those who require a kidney transplant or dialysis.

Medicaid was enacted in 1965 to help address the growing problem of senior citizens who can’t pay for their medical care. It is a need-based system, and although it’s a federal program, it is state administered and therefore rules can vary by state.

Medicaid Eligibility Requirements

There are such strict requirements for Medicaid because it’s a need-based program. The income levels may change, but currently, a household size of one must have a pre-tax annual household income of $16,040 or less, while a family of three must be below $27,159.

To be eligible for Medicaid in Florida, you must be either a United States citizen, U.S. national, legal alien, or a permanent resident, and a resident of Florida. You must need insurance/health care assistance, and your financial situation must be categorized as either very low income or low income. In addition, you must be 65 years of age or older, or a parent, pregnant, or a relative caretaker of a dependent child under 19 years old, or have a disability or have a disabled family member in your household.

Protecting Your Assets

If you are concerned about protecting your assets for your family members and do not have long-term care insurance benefits, you may be interested in an irrevocable trust that can be deemed unavailable if you ultimately need to apply for Medicaid.

When you file for Medicaid, there is a five-year lookback period, which means any assets you gifted or transferred could result in hefty penalties, including a denial of Medicaid benefits. This is why it’s important to start planning early, especially if you want to ensure your family receives the majority of your estate.

In a crisis situation where someone has already been admitted to a nursing home and they have too many assets, there may still be options to gain eligibility. This is why it’s important to speak with an attorney who is very familiar with the Florida Medicaid program. Contact Schwartz | White at 561-391-9943 and let one of our knowledgeable attorneys help you and your family navigate the complex Medicaid process.



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