Qualifying for Medicaid for nursing home care can be complex. For those Florida residents who are age 65 and over who don’t meet the eligibility requirements for Florida Medicaid Long Term Care Eligibility for Seniors, there are other ways to qualify for Medicaid. Here are some details on these options.
Medically Needy Pathway to Qualifying for Medicaid
An individual may still be eligible for Medicaid services even if he or she is over the income limit if he or she has high medical bills that meet a threshold.
These bills include health insurance costs, such as Medicare premiums and bills to cover medical services. The Medically Needy Program, which is also known as a “Share of Cost” Program or a “Spend-Down” Program, is based on a person’s “excess income.” That’s their income over the Medicaid eligibility limit (also called their “share of cost”) that’s used to pay their medical bills.
After a person has paid down their excess income to the Medicaid eligibility limit, Medicaid will apply for the month. This program gives them a way to spend down extra income to qualify for Medicaid.
However, the Medically Needy Pathway doesn’t help a person in spending down extra assets for Medicaid qualification. So, if an individual satisfies the income requirements for Medicaid eligibility but not the asset requirement, this program can’t help him or her in “spending down” extra assets. However, the individual can “spend down” assets by spending excess assets on non-countable assets—like home modifications, such as the addition of wheelchair ramps or stair lifts, prepaying funeral and burial expenses, and paying off debt.
And remember that you can’t just give away assets or sell them for significantly less than their value. Florida has a five-year Medicaid Look-Back Period that prevents applicants from doing this. If a person violates the look-back period, it can mean a period of ineligibility.
Most people considering Medicaid are “over-income” or “over-asset” or both, but they still can’t afford their cost of care. For those in this situation, there’s Medicaid planning that can help you in qualifying for Medicaid.
Medicaid planning attorney John Frazier can assist families in devising strategies to help them become Medicaid eligible.
If you have questions about Florida Medicaid and Medicaid planning, Attorney John Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer, click here now to send in a contact form, and we will get in touch with you.