Long-Term Care

Elder Law Associates PA advises clients regarding how to obtain public benefits, including Medicaid. Our law firm applies various legal techniques and legal instruments that protect and preserve assets. We advise our clients regarding the most appropriate long-term living arrangements for their particular situation and assist with facility placement.

Our firm is best known for our extraordinary personalized service. Elder Law Associates PA will develop a tailor-made plan for clients and their families as loved ones age, including the best use and management of personal and financial resources to meet their long-term objectives, exploring all home-based care options as a first priority when appropriate and easing transitions in the event a facility placement is required.

Medicaid Planning

The Medicaid Institutional Care Program (ICP) is a state/federal program that pays most nursing home costs for people who meet three eligibility requirements including aged or disabled need, medical need, and financial need. In Florida, eligibility for Medicaid is determined by the Department of Children and Families, Office of Economic Self Sufficiency, and is administered by the Agency for Health Care Administration.

In determining the financial need of a Medicaid applicant, Florida’s financial criteria is based on the “income cap” and the “asset test.”

There are certain assets that are exempt from consideration and can be kept when applying for Medicaid. These include:

  • Personal residence ($572,000 maximum)
  • Automobile
  • Whole life insurance with a cash surrender value of less than $2,500
  • Prepaid funeral plans
  • Household furnishings

Planning ahead by consulting with an elder law and special needs attorney early will help preserve assets should placement in a skilled nursing facility become necessary. However, even when advance planning has not been done, an elder law and special needs attorney can still help preserve assets and avoid very costly mistakes.

In Florida, in order to be eligible for Medicaid, the Institutional Care Program, an individual must be determined to be medically needy by the Department of Children and Families (DCF) and must be residing in a Medicaid qualifying nursing home or an Assisted Living Facility (ALF) that participates in the Medicaid Waiver Program.

Additionally, an individual who is applying for Medicaid must have an income of less than $2,313 per month as of July 1, 2019, ($2,250 per month was the standard between July 1, 2018-Jun 30, 2019,) and assets of less than $2,000. If the individual has a spouse who is not currently living in a nursing home, the so-called “community” spouse’s maximum income allowance is $3,161. If the other spouse is also living in a nursing home, the other spouse is only permitted to have an income of $2,250 per month.

A married couple living in a nursing home is only permitted to have $3,000 in assets. If an individual is living in a nursing home and has a spouse living in the community (not living in a nursing home), the individual residing in the nursing home is allowed to have $2,000 in assets and the spouse living in the community is permitted to have $126,420 in assets. One residence, one automobile, personal property, household furnishings, pre-need funeral and burial arrangements and a burial account of $2,500 are all exempt assets and are excluded from the asset limitations.

Under the Deficit Reduction Act of 2005 (DRA), if an individual transfers assets during the five years prior to applying for Medicaid, an ineligibility period may be assessed wherein Medicaid benefits will be denied. Post-DRA, the ineligibility period may not commence until the individual would be otherwise eligible for Medicaid as specified by the criteria above. Caution should be taken and a full analysis should be done by an elder law and special needs attorney before any transfers are made.

We provide Medicaid Planning services to clients throughout Florida, and particularly in the following cities/municipalities and surrounding communities in South Florida.

Long-Term Care Insurance

Elder Law Associates PA advises and assists clients in planning for and purchasing long-term care insurance, a vital asset preservation tool. Long-term care insurance can reduce the financial risk of long-term disability and provide financial security for loved ones.

We have established relationships with some of South Florida’s most widely known insurance agents and companies and are able to pass along this resource to the benefit of our clients.

Medicaid Applications

The attorneys and Medicaid Specialists at Elder Law Associates PA are knowledgeable and experienced in filing and gaining approval of all types of Medicaid applications. We attend the interview on our clients’ behalf, maintain excellent working relationships with case workers, perform all follow-up work and keep abreast of agency and statutory modifications and rule-making.

We are integrally involved in the Elder Law Section of the Florida Bar and the Academy of Florida Elder Law Attorneys and thus participate in the implementation of new laws, like the DRA. We are constantly interpreting the program and policy manuals that contain nuanced information about the application process. Furthermore, we work together with area facilities to achieve results for both our clients and the facilities.

Home & Community-Based Medicaid Waiver Services

Many Florida residents are unaware that Medicaid also covers assisted living facilities (ALF) and even home care. Through a variety of programs that are administered through the Department of Elder Affairs, the Department of Children and Families and the Area Agency on Aging, residents may qualify for Medicaid funding even though they remain at home or in an ALF, and in many cases, need not enter a skilled nursing facility. Elder Law Associates PA represents the best interests of our clients who most often would prefer to remain at home with assistance or in the more social environment of an ALF. Therefore, we are well-versed in these programs and discuss them as an integral part of our planning process.

For more information, contact us or schedule a convenient consultation with one of our elder law attorneys today.