How to Qualify for Medicaid in Florida

As you or your loved ones age, health care becomes a significant concern. While you may be managing your current medical needs, have you considered what would happen if you required long-term care? It’s a scenario many prefer not to contemplate, but planning for it can provide invaluable peace of mind.

Long-term care, whether in a nursing home, assisted living facility, or even in your own home, can be incredibly costly. These expenses have the potential to quickly deplete your life savings, potentially leaving you without the resources for quality care. This is where Medicaid for long-term care in Florida can be a crucial lifeline.

In this blog, we’ll provide an overview of how to qualify for Medicaid in Florida when it comes to long-term care. At Family First Firm, our Medicaid attorneys have helped thousands of Floridians successfully obtain Medicaid eligibility. Our team understands the nuances of Florida’s Medicaid rules and can help you explore the various “Medicaid-friendly” ways to manage your assets that are available in the Sunshine State. We can guide you through the entire process, from assessing your current financial situation to implementing strategies that could help you qualify for benefits while preserving as much of your hard-earned savings as possible.

What is Medicaid Long-Term Care in Florida?

Medicaid Long-Term Care in Florida is a comprehensive program designed to assist low-income seniors and individuals with disabilities. It offers various care options, ranging from nursing home services to in-home and community-based care.

The goal is to provide comprehensive care options that allow many recipients to remain in their homes or communities when possible, offering alternatives to traditional nursing home care. This approach not only helps control costs but also aims to enhance quality of life for those needing long-term care.

Through various managed care options, these programs work to ensure quality care while managing expenses, providing peace of mind for you or your loved ones during retirement years.

Eligibility for Medicaid Long-Term Care in Florida

To be eligible for Medicaid long-term care in Florida, you must meet several criteria:

• Be a Florida resident
• Be a U.S. citizen or qualified non-citizen
• Be aged 65 or older, or be disabled if under 65
• Meet the level of care requirement
• Meet financial eligibility criteria

Let’s break down these requirements further.

Residency and Citizenship

You must be a Florida resident with the intention to remain in the state. You also need to be either a U.S. citizen or a qualified non-citizen, with proper documentation to prove your status.

Age and Disability Requirements

If you’re 65 or older, you may qualify based on age alone. If you’re under 65, you’ll need to meet the Social Security Administration’s definition of disability.

Level of Care Requirement

To qualify for long-term care Medicaid, you must require a nursing home level of care. This means you need substantial assistance with daily living activities like bathing, dressing, eating, and mobility. The state will assess your needs through its Comprehensive Assessment and Review for Long-Term Care Services (CARES) program.

Financial Eligibility

Meeting financial eligibility criteria is often the most challenging part of qualifying for long-term care Medicaid. There are two main components to consider: income limits and asset limits.

Income Limits

As of 2024, the monthly income limit for an individual applying for long-term care Medicaid in Florida is $2,829. If your income exceeds this limit, don’t lose hope. You can still qualify through a Qualified Income Trust (QIT), sometimes called a Miller Trust. This legal arrangement allows you to redirect excess income, making you eligible for Medicaid.

Asset Limits

The asset limit for an individual is $2,000. However, not all assets count towards this limit. Your primary residence (up to a certain equity value), one vehicle, personal belongings, and certain burial funds are typically exempt.

For married couples where only one spouse needs care, the rules are different. The spouse not needing care (the “community spouse”) can often keep a higher amount of assets.

Most importantly, it doesn’t matter if you are over that limit.  Medicaid lawyers can help you legally protect your assets and get the benefits you need.

The “Medically Needy” Program

If your income is above the limit for standard Medicaid eligibility, you might still qualify under Florida’s “medically needy” program. This program is available for seniors needing long-term care and individuals who are blind or have disabilities. It allows you to deduct your medical expenses from your income to potentially meet eligibility requirements.

Planning Ahead

It’s crucial to understand that Florida has a 60-month “look-back” period for asset transfers. When you apply for Medicaid, the state reviews your financial transactions for the past five years. If you’ve given away or sold assets for less than fair market value during this time, it could result in a penalty period.

This is why planning ahead is so important. If long-term care may be in your future, start considering your options well in advance with the help of experienced Medicaid attorneys. They can help you navigate the complex rules and avoid potential penalties.

The Florida Medicaid Application

Completing the Florida Medicaid application can be a complex process, but following these steps can help guide you:

Step 1: Choose How You’ll Apply

You can apply online through the ACCESS Florida portal by creating a MyACCESS account. This allows you to check eligibility and complete the application. You can also apply in person at a Department of Children and Families (DCF) office or seek help from a DCF community partner agency. If you prefer, you can request a paper application or apply by phone at 1-850-300-4323.

Step 2: Collect the Required Documents

Before applying, gather key information such as:

• Your full name, Social Security number, and proof of citizenship or residency
• Income, asset details, and information on expenses like housing and medical costs

Step 3: Submit and Track Your Application

After submission, keep your ACCESS number to track your application’s status. Processing may take up to 60 days, and DCF may request more information or an interview. If approved, you’ll receive a Medicaid card; if denied, you’ll be referred to other programs.

It’s important to note that denials are common with Medicaid applications.  This doesn’t mean you can’t get Medicaid – it just means that it may take more work to get it approved.

Seeking Professional Guidance

Given the complexity of Medicaid rules and the high stakes involved, many find it beneficial to seek professional help. An experienced Medicaid attorney can guide you through the process, helping you understand your options and develop strategies to qualify while protecting your assets.

A knowledgeable attorney can assist with:

• Evaluating your eligibility
• Developing strategies to meet eligibility criteria
• Preparing and reviewing your application
• Appealing a denial if necessary

Remember, it’s often best to consult a professional before you begin the Florida Medicaid application process. This way, you can anticipate and address potential issues proactively.

Remember, while this blog provides an overview, Medicaid rules can be complex and subject to change. Always verify current information with official sources or seek professional advice from a Medicaid attorney for your specific situation.

Get Help from Family First Firm with Medicaid Planning

Have you been searching online for a “Medicaid attorney near me” because you’re concerned about long-term care costs? At Family First Firm, we know that every family’s circumstances are different, and there’s no one-size-fits-all approach to Medicaid planning. Our team of experienced Florida Medicaid attorneys will work closely with you to assess your current financial situation, explore eligible asset protection strategies, and develop a customized plan that aligns with your long-term care goals. We’ll guide you through the entire Florida Medicaid application process, ensuring all requirements are met.

With our guidance, you can make informed decisions about your long-term care options while preserving your hard-earned assets. Don’t let the complexities of qualifying for Medicaid in Florida overwhelm you. Contact Family First Firm today for your FREE consultation. Whether you’re planning for yourself or a loved one, we’re here to help secure your future and ensure access to the care you may need.

At Family First Firm, we’re known for our compassionate approach, understanding the emotional challenges of long-term care planning. Our expertise has helped countless Floridians successfully qualify for Medicaid, and we’re dedicated to finding the best solution for you and your unique situation.

Take the first step towards peace of mind. Call us at (407) 574-8125 or fill out our confidential online form to schedule your consultation. Let Family First Firm help you turn Medicaid eligibility requirements into a clear path forward for your future care needs.

At Family First Firm, we’re always by your side to provide simple yet creative legal solutions to protect your family’s legacy. You Don’t Have To Go Long-Term Alone!