Florida Medicaid Planning Attorneys

We Help You Restructure Assets & Income to Qualify for Medicaid Long-Term Care & Nursing Home Assistance

Why Medicaid Planning Matters

With proper Medicaid planning, families can maximize the assets and income available to improve their loved one’s quality of care. This may include setting aside funds for upgraded nursing home rooms, personal care, or other comforts Medicaid doesn’t cover. Additionally, planning allows remaining assets to be preserved and passed on to family members, ensuring financial security for future generations. By understanding Medicaid’s healthcare services and how to meet eligibility requirements, families can secure high-quality care without depleting their resources. 

What Healthcare Services Are Covered by Medicaid in Florida?

Florida Medicaid provides a wide range of healthcare services to meet the needs of individuals and families, including seniors requiring long-term care. Covered services include doctor visits, hospital stays, prescription medications, preventive care, and essential treatments. For those needing long-term care, Medicaid also covers nursing home care, in-home health services, personal care assistance, and specialized therapies. These benefits provide critical support for families managing the high costs of aging, chronic illnesses, and long-term care needs.

Myths and Misunderstandings About Medicaid for Long-Term Care

One common myth is that Medicaid assistance is only available to people with very low income and no assets. In reality, you don’t have to be considered low-income to qualify. With proper planning strategies, such as restructuring assets, utilizing Medicaid trusts, or spending down on exempt resources, individuals can meet Medicaid eligibility requirements without losing everything they’ve worked hard to save. Another widespread misconception is that Medicaid planning must be done five years in advance. While Medicaid does have a five-year look-back period to review financial transactions, effective crisis planning strategies can still be implemented to secure benefits even when long-term care is needed immediately.

These misunderstandings can cause unnecessary stress for families. The truth is that more than 60% of nursing home residents rely on Medicaid to pay for their care—a percentage that continues to rise as nursing home costs in Florida now exceed $10,000 per month on average. With proper Medicaid planning, families can maximize the assets and income available to improve their loved one’s quality of care while ensuring the remainder of their assets can be passed on to family members at the time of their death. Working with an experienced Orlando will and trust attorney can help you navigate these rules, protect your financial resources, and secure the care your loved one needs.

Florida Medicaid Eligibility Information

Florida Medicaid eligibility is determined through a collaborative process managed by key state agencies. The Agency for Health Care Administration (AHCA) oversees the program, ensuring access to vital healthcare services for eligible individuals. Financial eligibility is assessed by the Department of Children and Families (DCF), which reviews applicants’ income and assets to ensure they meet Medicaid’s requirements. Medical eligibility is determined by the Department of Elder Affairs (DOEA), which evaluates whether applicants require long-term care based on their ability to perform essential activities of daily living, such as eating, bathing, and mobility. 

This coordinated approach ensures that applicants meet both the financial and medical criteria necessary to qualify for Medicaid benefits. Proper planning and guidance can help families navigate this process effectively, preserving their resources while securing the care their loved ones need.

Physical Eligibility

Applicants must demonstrate a need for long-term care services to qualify for Medicaid. This typically involves requiring assistance with at least two of the following activities of daily living (ADLs):

• Eating
• Bathing
• Dressing
• Transferring (e.g., moving from bed to chair)
• Using the bathroom
• Walking

In addition, the applicant must have a medical condition that requires round-the-clock care or skilled nursing services. Supporting documentation, such as physician statements and care assessments, is critical to proving medical necessity.

Financial Eligibility

To qualify for Medicaid in Florida, applicants must meet strict income and asset limits established by the state. These financial requirements ensure eligibility for long-term care assistance while allowing families to protect certain assets with proper planning. The limits are reviewed and adjusted annually to reflect economic changes.

Income Requirements

Income includes all regular sources of money, such as:

• Social Security payments
• Pension payments
• Wages or salaries
• Other income sources

For 2024, the monthly income limit for an individual is $2,829. If an applicant’s income exceeds this limit, they may still qualify by establishing a Qualified Income Trust (QIT), which redirects surplus income into a trust to meet Medicaid eligibility requirements.

Asset Requirements

Assets, also referred to as resources, include:

• Real estate (other than a primary residence or rental real estate)
• Bank account funds
• Retirement accounts like 401(k)s or IRAs that are not making regular distributions
• Stocks, bonds, and other investments

To meet Medicaid’s requirements, an applicant’s countable assets must not exceed $2,000. Certain resources are considered exempt, including:

• Primary Residence: Homestead property is exempt as long as the applicant lives there, intends to return, or a spouse resides in the home (with equity up to $713,000).
• One Vehicle: Any car or truck is exempt, regardless of value.
• Household Furnishings and Personal Belongings: Furniture, clothing, and everyday household items are excluded.
• Retirement Accounts in Payout Status: If your 401(k) or IRA is making regular distributions, it is treated as an income-producing asset rather than a countable asset.
• Income-Producing Property: Rental properties or businesses that generate income may be exempt, provided they are actively producing revenue.
• Prepaid Funeral Plans: Non-revocable prepaid funeral contracts are exempt and can help reduce countable assets.

Countable Assets and Income That May Hurt Eligibility

Certain assets and income are considered “countable” and will be included when determining Medicaid eligibility:

• Investment Accounts: Stocks, bonds, and mutual funds, regardless of value, are countable.
• Bank Accounts: Checking, savings, and CDs.
• Real Estate (Non-Homestead): Property other than your primary residence, like vacation homes, that don’t produce income.
• Retirement Accounts (401k, IRA): If these accounts are not in payout status (not making regular distributions you), they are treated as countable assets.
• Cash Savings: Money held in any form outside exempt categories.

Certain assets can have a significant impact on Medicaid eligibility if not properly managed. For example, a large investment account worth $1 million would count against Medicaid eligibility as a liquid asset. However, an IRA worth $1 million in payout status is exempt because it’s treated as income, not a countable resource. By converting countable assets into exempt ones, such as paying off a mortgage or purchasing a prepaid funeral plan, families can meet Medicaid requirements without losing their savings.

Medicaid Crisis Planning/Emergency Medicaid Planning

Medicaid Crisis Planning, also known as Emergency Medicaid Planning, provides immediate assistance for individuals who suddenly require long-term care but have not yet planned for Medicaid eligibility. This situation often arises when a loved one is unexpectedly admitted to a nursing home or requires urgent in-home care. While they may meet the physical eligibility requirements due to their sudden medical need, they may not qualify financially due to excess income or countable assets.

Crisis planning helps families address these financial hurdles quickly to secure Medicaid benefits without unnecessary delays. An attorney can help families implement solutions to achieve eligibility and protect their financial future from being depleted by long-term care costs.

Documents Required to Apply for Florida Medicaid Benefits

Applying for Florida Medicaid benefits requires detailed documentation to verify eligibility. Gathering the necessary paperwork in advance can streamline the process and help avoid delays or denials. Below is a list of essential documents typically needed for a Medicaid application:

• Proof of Identity: Birth certificate, driver’s license, or state-issued ID.
• Proof of U.S. Citizenship or Residency: Passport, naturalization certificate, or permanent resident card.
• Income Verification: Pay stubs, Social Security statements, or pension income records.
• Asset Documentation: Bank statements, investment account summaries, property deeds, and vehicle registrations.
• Medical Records: Physician reports and care assessments demonstrating medical necessity for long-term care.
• Insurance Information: Copies of health, life, and long-term care insurance policies.

Because each case is unique, additional documents may be required based on individual circumstances. Consulting with an Orlando estate planning attorney can ensure your application includes all the necessary paperwork and complies with Florida’s Medicaid regulations.

Hire a Florida Medicaid Attorney to Assist You

Our experienced Florida Medicaid attorneys specialize in helping individuals and families navigate the complexities of Medicaid planning. We understand Florida’s Medicaid laws and regulations, and we work closely with clients to develop tailored strategies that protect assets while securing vital long-term care benefits.

Whether you need assistance with Medicaid applications, crisis planning, or establishing trusts, our dedicated team is here to guide you. We are committed to ensuring compliance with state rules, avoiding expensive mistakes, and providing peace of mind during a challenging time. Trust our knowledgeable Orlando trust administration attorneys to protect your financial future and secure the care you deserve. Call or submit a request through our website to request a meet-and-greet.