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Andrew Curtis, Esq.
Stephen D. Wolfe, CSA
Bryan M. Plonsky, CSA
Jonathan J. Williams, MBA
Marilyn Temple, BS
Carol Goldberg, BSW, CLA
Common mistakes made when trying to qualify for nursing home benefits
1. Transferring assets out of the applicant's name without taking understanding the transfer rules and penalties.
2. Establishing the wrong types of Trusts
3. Improper planning with the homestead - in an attempt to preserve the home from Medicaid claims or liens
4. Giving away assets thinking this will help qualify for Medicaid
5. Confusing the transfer penalty and the look back period.
Medicaid Laws and Rules
Medicaid laws and rules are constantly changing. Do not rely on outdated information or people with limited knowledge and understanding of Florida Medicaid Law.
Even if spending down is part of the plan to obtain Medicaid, a knowledgeable attorney is able to counsel clients in a manner that is advantageous to the Medicaid applicant and to the family.
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Florida Medicaid Planning
Medicaid Pre-Planning prepares for long-term care, whether in a nursing home, assisted living facility, or special home health care services. Pre-planning is essential to prevent financial devastation to most families.
Crisis Medicaid Planning is when an individual will be entering a nursing home within a short period of time or is already in a nursing facility and needs to quality for Medicaid immediately. This is a crucial time to speak with an lawyer at Trusts Creators, Inc. who specializes in Florida Medicaid Law.
There are certain criteria for Medicaid eligibility that fall into three basic categories.
Eligibility
The Florida Medicaid Institutional Care Program (ICP nursing home benefits) looks at three criteria test to determine eligibility, which are medical necessity, income, and assets.
Medical Necessity Test
The first criteria to qualify for nursing home Medicaid benefits is medical necessity. This criteria also includes, age, citizenship, and residency requirement. To obtain nursing home Medicaid benefits, a person must be at least 65 years of age, disabled, or blind, and and have the medical necessity to be in a nursing home.
For someone medically qualified for nursing home care but who is still at home, Florida also has certain pilot programs such as the Diversion Program and the Alzheimer's Initiative, which provide certain specific services.
This test is referred to as a "CARES" Assessment. If the person medically qualifies, the Agency will then look at the individual's income and asset levels.
Income Test
Florida is an Income Cap state which means there is an income limit for Medicaid eligibility. This includes income receive from Social Security, pensions, IRAs and all other forms of income. In many cases, one can use a particular trust called a Qualified Income Trust (also known as a Miller Trust) to legally solve the problem of too much income. Income for Medicaid purposes is gross income. This means that all deductions are added back into the income before one can determine the total amount.
Asset Test
To be Medicaid eligible, a nursing home resident must have less than $2,000 of countable assets. However, the community spouse is entitled to keep much more. A married couple's assets are all considered together. It does not matter if all the assets are held jointly or separately in each spouse's name.
Some assets may be exempt, such as a home and its contents, a vehicle, prepaid funerals and cemetery lots, and certain types of trusts. However, it is important to evaluate each asset carefully before one can know if the asset is countable or exempt.
Examples of countable assets are cash in the bank, cash, stocks, annuities, bonds, land, minerals, non homestead property, notes receivable, boats, and certain extra vehicles. The amount of Countable assets change each year. |
