Practice Areas

Medicaid & Long-Term Care Planning

Elder Law Associates PA advises clients regarding how to obtain public benefits, including Medicaid. The firm utilizes various legal techniques and legal instruments which 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 develops personalized plans 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 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 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 which 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. 

Caution should be taken and a full analysis should be done by an elder law attorney before any transfers are made. We provide Medicaid Planning services to clients throughout Florida. For more information or to request a consultation with one of our experienced elder law attorneys, contact us today. 

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