The purpose of Florida Medicaid is to provide medical coverage to low-income individuals and their families. The costs of the program are shared between the State and Federal governments. Medicaid services in Florida are administered by the Agency for Health Care Administration. However, eligibility is determined by the Department of Children and Families. There are many types of Medicaid. The Parri Law Firm primarily deals with Medicaid for those who are disabled or in need of long term care assistance.
How does someone get Medicaid? There are generally two ways to get Medicaid in Florida. One, if you receive Supplemental Security Income (SSI), you automatically get Medicaid. This is commonly called community Medicaid. All Medicaid programs in Florida are now HMOs. They cover things that a normal HMO policy might cover, except that your network of doctors and providers might be smaller than some other privately available insurance plans. Don't get SSI and SSDI (Social Security Disability Insurance) confused. SSDI is for individuals who have worked at least 40 quarters and paid into the system. SSDI does not have an asset cap and approximately 2 1/2 years after the date of disability the recipient will get Medicare. SSI has a asset limit of $2,000 for an individual and $3,000 for a couple.
If you are not eligible for SSI or need Florida long term care/nursing home Medicaid, you can apply directly to the State of Florida for Medicaid assistance. Community Medicaid no long has an asset limit however income can still be an issue. On the other hand, Florida's nursing home Medicaid program generally has the same asset limits as SSI. It also has income limits, however using a Medicaid Income Trust properly can overcome this hurdle.
There are two main types of programs for long term care for Florida Medicaid. Nursing home Medicaid and the Long Term Care Waiver or Nursing Home Diversion program. The two programs work in opposite ways. For instance, if the Medicaid rate for a nursing home is $7,000 and the nursing home resident has $1,000 of income, the State of Florida bill pick up the extra $6,000. Alternatively, the waiver program essentially provides a stipend of lets say $1,000. If the Assisted living or care in another setting costs $3,500, the individual is responsible for paying the additional $2,500 even if their income is only $1,000.
See the Asset Protection page for a brief discussion of some of the planning techniques that can be used to help someone become eligible for Florida Medicaid.
If you would like the guidance of an Clearwater elder law attorney who has dealt with these issues personally and has helped many Florida families successfully plan for Florida's nursing home Medicaid, please call today. (727) 586-4224
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The Parri Law Firm
Elder Law & Special Needs Planning