Applying for long-term Medicaid for your elderly parent in Florida can help make senior care far more affordable. Thousands of Floridians use it so they can help fund nursing home care, assisted living services, or in-home care. But sadly, the Medicaid application process is far from easy for many people.
To be eligible, your parents will need to meet various personal and financial criteria. As an elder law attorney, I work with families day in and day out who might seem like they are not eligible on paper, but with the help of a few legal tools, are able to attain eligibility in no time.
What Is Florida Medicaid?
Florida Medicaid is a state and Federal partnership that provides health coverage for Florida residents with low incomes. If an applicant is eligible, they can benefit from financial support to pay for their long-term care.
What Is Florida Medicaid Eligibility?
Anyone over the age of 65 or is disabled is eligible, so long as they meet the other requirements.
As of 2022 in Florida, elderly Medicaid applicants must fit the following criteria:
- A U.S. citizen or qualified alien;
- A resident in Florida;
- Have a gross monthly income of no more than $2,523 (2022);
- Countable assets allowed for a non-married applicant: No more than $2,000.
- Assets allowed for a Community Spouse (the spouse who is not in long-term care) of a married applicant: No more than $137,400 in assets.
- You cannot give away money or assets within 5 years of a Medicaid application. (However, charitable families or gifting may be still possible after specific measures are taken through careful estate planning).
How to Apply for Florida Medicaid?
Applicants already below the income and asset levels often turn to nurse homes for application advice. Social workers can also help. If your parent is still at home, then you can call the local Aging Resource Center to be placed on the long-term care wait list. There is no Medicaid nursing home waitlist, but assisted living and in-home Medicaid support involve a long waiting period.
If your parent’s assets or income are above the limits, then the best way to apply is through a reputable Florida elder law attorney. Their knowledge and legal expertise will enable your parents to protect their assets, gain eligibility for Medicaid, and give them the peace of mind knowing everything is being done legally and efficiently.
Understanding Medicaid Income Requirements
Gross monthly income cannot exceed $2,523.
Note that gross income is not the same as taxable income. Gross income includes the money your parents later pay to Social Security taxes, Medicare Part B premiums, and employee portions of health insurance premiums.
The income of the spouse who stays at home, (called the “community spouse“) is not included in the applicant’s income eligibility. So, for example, if your Mother earns the minimum age, she can still qualify for Medicaid even if your Father earns $1 million a year.
The community spouse’s gross income is also permitted to divert some of the Medicaid applicant’s income for their own financial needs, if their gross income is below a certain level. We call this ‘Spousal Diversion.’ It will require substantiation to do so, but our Florida elder law attorneys can assist you with understanding the process and maximizing the diversion.
What If My Parent’s Income Is Too High?
If your parent’s income exceeds that limit, then there are things that can still be done to ensure eligibility. For example, a Qualified Income Trust (QIT) can be created to make the applicant’s income eligible. This type of trust, also known as a Miller Trust, will allow the excess amount of income to be paid out directly to the nursing home from the trust. Any funds left over in the QIT after the Medicaid recipient passes away will be reimbursed to the State of Florida up to the amount of benefits the recipient received. With careful planning, the excess income should not accumulate in the trust over the life of the Medicaid recipient.
Understanding Medicaid Assets Requirements
In 2022, Medicaid applicants can only have a certain amount of ‘countable assets‘ to be eligible for long-term Medicaid.
Countable assets include:
- Credit Union
- Checking Accounts
- Real Estate (not including the applicant’s residence or the value of one income producing property).
For a home to be excluded, your parents must live in it or intend to return to it. A single person’s home equity interest must be no greater than $636,000. If an applicant is married, the value of the home is excluded no matter how much it’s worth.
Jointly held bank accounts are also countable assets and are not divided among the owners.
Assets that are not considered ‘countable’ include:
- A car of unlimited value
- A second car, if it’s not a collectible car is over seven years old;
- Funeral plots;
- Irrevocable prepaid burial policies;
- Life insurance with less than $2,500 in face value.
- A real estate property that is rented out to tenants.
2022 Asset Requirements for Florida Medicaid:
The following are the long-term Medicaid limits for total countable asset value:
- Single applicants: $2,000
- Married with one spouse applying: $2,000 for applicant & $137,400 for non-applicant
- Married with both spouses applying: $3,000
What If My Parent’s Assets Are Over the Limit?
If your parent’s assets are over these limits, you should contact an elder law attorney for legal advice. Even if it looks like your parents do not qualify because their assets are over the limit, there are legal tools available to still get them qualified, and by the same token, have their assets protected from potential creditors.
The most common option is to spend down the assets until you reach the necessary limit. Examples of spending down include making home modifications (such as adding medical equipment), prepaying end-of-life expenses, or paying off debt.
Assets cannot be gifted or sold under fair market value, as doing so can result in a penalty period of Medicaid ineligibility. Given the 5-year look-back period, this is why it’s always wise to plan for long-term Medicaid care far in advance. It’s very easy to make a small error when spending down, which can rule your parents out of Medicaid, so it’s advised that you consult a Florida elder law attorney first.
Other techniques include establishing trusts and care agreements that are specifically tailored for long-term care situations. These are preferable to spending down assets because it allows an applicant to qualify for Medicaid all the while creating a safety net should the applicant have other financial obligations or goals that they would like to save for.
Should We Apply for Medicaid?
Whether it’s optimal for your parents to apply for Medicaid depends on various factors, such as their age, health, assets and income.
Now is a wise time to consult a Florida elder law to ensure you’re prepared for the complexities of long-term care services, asset protection and the Florida Medicaid application.
Hire an Elder Law Attorney in Riverview
If your parent needs assistance applying for Medicaid or has any questions, our Florida Medicaid planning lawyers can help. We advise that you consult with as soon as possible, to avoid making any costly mistakes and to put you and your loved ones at ease. We regularly receive calls from adult children in similar positions to you, and welcome you for a free consultation today.
Battaglia, Ross, Dicus & McQuaid, P.A. is U.S. News and World Reports Tier 1 law firm in Florida, specializing in Estate Planning & Probate since 1958. With award-winning, experienced estate planning attorneys, they can help you plan for the future today.