Florida Medicaid planning is a critical issue for the aging population in Florida. Planning for long-term medical care costs is not as simple as it may sound due to the exponentially rising cost of long-term medical care for seniors. At an average cost range of at least $5,000 per month, life savings can be wiped out in a relatively short period of time.

What is Medicaid Planning?

• Medicaid Pre-Planning prepares for long-term care. It applies to a nursing home, assisted living facility, or special home health care services. Pre-planning is essential to prevent financial devastation.

• Crisis Medicaid Planning is when an individual enters a nursing home within a short period of time. Or they are already in a nursing facility and needs to qualify for Medicaid immediately.

In Florida, three categories are utilized for Medicaid eligibility:

• Institutional or Nursing Home Medicaid
• Home and Community-Based Services (HCBS)
• Regular Medicaid

Institutional or Nursing Home Medicaid is available to all those who are eligible and in need of nursing home care.

Home and Community-Based Services (HCBS) support long-term care services that are provided in the home, at assisted living residences that have a managed care system, adult foster care, or adult day care homes. This Florida program utilizes one agency that takes care of all these types of long-term care needs. 

In the past, Florida offered “HCBS Medicaid waivers” but those are no longer available. Like those waivers, this managed care program limits the number of participants to space that is available to them and, therefore, there could be a long waiting list for these services.

Regular Medicaid in Florida is described as for the “Aged and Disabled (MEDS-AD)” and is available to all those who are eligible for the services. With this program, benefits are either provided in a home or adult daycare setting. 

Why Is Medicaid Planning Important?

Medicaid planning usually involves considering the welfare of both senior partners. One spouse may be attempting to qualify for Medicaid so that the cost of long-term nursing care is paid, and the other partner may still be healthy and prefers independent living at home. Here are some facts about Medicaid eligibility that may be helpful:

1. First, the rules and regulations for Medicaid eligibility vary from state to state. Just because one senior may be ineligible for Medicaid does not mean the other will also be ineligible.
2. Every Medicaid application has to have solid documentation as to why the senior needs Medicaid and has proof that his assets are less than $2000 if single and $3,000 if married.

The eligibility rules for Medicaid can be complex and confusing, and that is why a lawyer is often called upon to help. All seniors who apply for Medicaid benefits to cover the costs of a nursing home are required to complete the Medicaid Long Term application, in addition to the Medicaid application. 

This form will require the senior to disclose all income and assets, and what has been given away over the past five years. For example, if a senior wants to become eligible for Medicaid, he or she simply cannot transfer all the assets to children or a relative. Medicaid does a thorough background check to ensure that no transfers have been made in the past five years.

Florida Medicaid planning requires time and effort. If you are considering applying for Medicaid long-term care benefits and want to make sure things are done the right way, consult with a knowledgeable Florida Medicaid attorney. A lawyer who knows the “ins and outs” of the Medicaid rules in Florida can be an immense help. Contact our office to schedule a Medicaid Planning consultation.