To receive services under Medicaid Long Term Care, candidates must meet all the following criteria:

  • Be legal Florida residents,
  • Be a minimum of 65 years of age OR between 18 and 64 years old and designated as disabled by the Social Security Administration,
  • Need “nursing facility level of care”, and
  • Meet the financial requirements for Florida Medicaid.
An old couple looking at a table as they learn if they qualify for medicaid in Florida

Many families misunderstand exactly what the state means when they use the term “nursing facility level of care.” This does not necessarily mean that the care recipient requires nursing or skilled medical services. Florida uses a standardized in-person exam to understand the degree to which the applicant needs assistance or partial assistance to complete two or more activities of daily living. Examples include bathing, personal hygiene, eating, and mobility. In the case of Alzheimer’s and dementia care patients who do not have any physical limitations, the state also recognizes the need for supervision of individuals who have several memory impairments.

How To Qualify When You Are Over The Limits

Having income and/or assets over Medicaid Long Term Care limit(s) does not mean an applicant cannot still qualify. There are a variety of planning strategies that can be used to help persons who would otherwise be ineligible to become eligible. Some of these strategies are fairly easy to implement, and others, exceedingly complex. 

When persons have income over the limits, Miller Trusts also called a Qualified Income Trust (QIT) can help allow an applicant to qualify. 

When persons have assets over the limits, trusts are an option. Irrevocable Funeral Trusts are pre-paid funeral and burial expense trusts that Medicaid Long Term Care does not count as assets. Another option is annuities that turn countable assets into a stream of income. There are many other options when the applicant has assets exceeding the limit.

Inadequate planning or improperly implementing a Medicaid Long Term Care planning strategy can result in a denial or delay of benefits. Professional Medicaid Long Term Care planners are educated in the planning strategies available in the state of Florida to meet Medicaid’s financial eligibility criteria without jeopardizing Medicaid Long Term Care eligibility. Furthermore, there are additional planning strategies that not only help one meet the financial criteria but can also protect assets from Medicaid Long Term Care’s estate recovery program, preserving them for the family as inheritance as opposed to reverted to the State of Florida. For these reasons, it is highly suggested to consult with a Medicaid Long Term Care planner for assistance in qualifying for benefits when over the income and/or asset limit(s).

Medicaid Long Term Care Planning

Our law firm deals with clients applying for Medicaid and helps them qualify for the benefits.  Medicaid will pay for several benefits, like home nursing, assisted living, and home care. The Medicaid long-term care program has a variety of rules and regulations and the process of applying is seldom, if ever, straightforward with expert advice. Speak to an attorney at the Finity Law Firm before applying for Medicaid in Florida.

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