For people 65 and older or with a disability, Medicaid in Florida can provide valuable medical care. Florida Medicaid provides low-cost or free health coverage for Floridians with low incomes. Medicaid services in Florida are administered by the Agency for Health Care Administration. Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI recipients).
We will now look at the different eligibility requirements for Florida Medicaid programs and how Medicaid planning can help you qualify for Medicaid should you need it.
The Agency for Health Care Administration manages the Statewide Medicaid Managed Care program in Florida. This program has three parts:
Florida has several LTC programs with varying eligibility criteria:
We will discuss these further below.
Florida Medicaid has specific eligibility requirements. First, applicants must be Florida residents, and U.S. citizens, nationals, permanent residents, or legal aliens.
Applicants also must be pregnant, or:
Lastly, applicants must meet financial requirements based on their income, assets, and marital status. This is where many people have questions about eligibility and can benefit from Medicaid planning.
Since Medicaid is a needs-based program, recipients cannot have income or assets that exceed certain amounts. Income includes:
It does not include payments such as COVID-19 stimulus checks, though. Medicaid defines assets as:
Belongings, automobiles, and financial entities such as irrevocable burial trusts or special needs trusts do not count as assets under Medicaid.
Here are the income and asset requirements for Florida Medicaid LTC programs:
To qualify, a single person cannot earn more than $997 a month and own more than $5,000 in assets. Married people, applying either jointly or individually, cannot earn more than $1,343 per month and own more than $6,000 in assets.
A single person must earn less than $2,523 per month and own $2,000 or less in assets to qualify. A married couple applying jointly can earn no more than $5,046 per month and cannot own more than $3,000 in assets. If only one spouse applies, the applicant can earn no more than $2,523 a month and cannot own more than $2,000 in assets; their spouse can own no more than $137,400 in assets.
A single person must earn less than $2,523 per month and own $2,000 or less in assets to qualify. A married couple jointly must earn less than $5,046 per month and own $3,000 or less in assets. A married person applying individually faces the same asset and income limits as Institutional or Nursing Home Medicaid.
If you are unfamiliar with applying for Medicaid, this detailed process can seem overwhelming. For some people, Medicaid planning encompasses collecting and preparing documents, while for others, it involves restructuring financial assets so that the applicant’s eligibility remains intact while still having the resources to supplement these benefits or pass them on to loved ones.
You can also establish an entity such as a Pooled Trust or Qualified Income Trust which requires legal and financial expertise to ensure compliance with state law, especially if your family situation involves one spouse who requires long-term care and another who can live independently. These trusts also have specific guidelines for using the money, even after a beneficiary’s death. An estate planning attorney can help you look at all your options.
At Denise Jomarron Legal Group in Miami, Florida, we help individuals and families design customized plans to ensure protection for their loved ones in case they are incapacitated or pass away. We can also help guide you or your loved one through the Medicaid process. Call us today to schedule your free 20-minute consultation at (305) 402-4494.
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The information in this blog post (“post”) is provided for general informational purposes only and may not reflect the current law in your jurisdiction. No information in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting based on any information included in or accessible through this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction.
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