FLORIDA MEDICAID

Although ensuring your estate plan with probate-avoidance in mind is a crucial step in planning for your future, there are other steps that need to be taken to ensure long-term success in the later years of your life. One of the most overlooked aspects of individual’s goals in planning for the future involve long-term care coverage, primarily, planning for Medicaid benefits.

Florida Medicaid is a government assistance program that provides coverage assistance for individuals who satisfy the eligibility requirements, which will be discussed in depth in this section. In Florida, eligibility Medicaid coverage for an individual’s long-term care is determined by calculating the applicant’s (and the applicant’s spouse’s) income and assets. An experienced Medicaid planning attorney, like the attorneys at Gorman & Jones, PLC, can assist you in ensuring that you are on the right path to be eligible for Florida Medicaid benefits for long-term care coverage.

Florida Medicaid Eligibility

As stated above, the eligibility for Florida Medicaid is based upon the applicant’s income and assets. This means that an applicant can only be eligible if they are a low-income individual, since the Florida and federal governments share the costs of that long-term care coverage. There are other eligibility requirements, such as United States citizenship, Florida residency, a valid Social Security number, and proof of identity. Additionally, three other criteria must be met to be eligible for Medicaid benefits, which are medical needs, financial needs, and disability, age, or blindness.

Medical Needs Criteria

Florida’s Medicaid assistance program has a needs-based requirement for an applicant’s eligibility. Under their requirements, Florida Medicaid allows its care to be custodial in nature, meaning that the applicant needs to have a medical ailment or condition which limits their activities of daily living. This satisfies Florida Medicaid’s nursing-home level of care requirement.

This requirement is determined by several factors, such as: whether the applicant requires around-the-clock nursing home care in a skilled facility, whether the applicant needs medical supervision for their medical care needs, whether the applicant requires daily care and monitoring, and whether the applicant requires hospital-level care. Determining whether you are eligible for Florida’s Medicaid assistance can be a complicated process, but the attorneys at Gorman & Jones, PLC can help assist you in this process. Call our office today at (813) 856-5625 to begin the process of applying for Florida Medicaid benefits and determining your eligibility status.

Financial Needs Criteria

To be eligible for Florida Medicaid benefits, the applicant must have a financial need for the assistance. Although there are many different components to this determination, the focus revolves around the applicant’s income and assets.

The applicant’s assets refer to their savings, retirement accounts, real property, personal property, among others. However, there are certain assets that are not counted towards this determination, such as the applicant’s primary residence, among other assets. The main issue that applicants face when trying to satisfy the asset test is what is referred to as the “lookback penalty” for transferring assets to gain eligibility. The experienced attorneys at the law firm of Gorman & Jones, PLC can help you shelter and protect assets to meet the eligibility requirements for Florida Medicaid assistance, so call our Tampa office for a free initial consultation today at (813) 856-5625 to discuss your options.

The applicant’s income refers to how much money they receive, either being earned income or unearned income. There are limits as to how much income an applicant may receive to still meet the eligibility requirements, which is why hiring an experienced Medicaid planning attorney, like the attorneys at Gorman & Jones, PLC, is crucial in ensuring you meet the requirements needed to receive Medicaid assistance.

Disability, Age, or Blindness

In addition to the medical and financial needs requirements previously detailed, a Florida Medicaid applicant must also meet the disability, age, or blindness requirement to be eligible to receive Florida Medicaid benefits. This means that the applicant must be over 65 years of age, or must be disabled (as determined by Social Security or Disability Medical Review Team standards), or the applicant must be legally blind.

Eligibility with Income and Asset Issues

In applying for Florida Medicaid benefits, the applicant must meet the income requirements. Florida is an “income cap” State, meaning that an individual receiving Florida Medicaid benefits can only receive a certain amount of income each month to remain eligible to receive the benefits. However, if a Florida Medicaid recipient is receiving income every month which would disqualify them from receiving their benefits, an Income Cap Trust can be created and used to meet the requirements to receive for Florida Medicaid benefits without disqualification.

The gross monthly income that a Florida Medicaid applicant must not exceed under the income test is $2,313.00 as of 2019. This means that a Florida Medicaid applicant cannot qualify for benefits if they receive more than this amount every month in gross income unless their income is artificially reduced by means of an Income Cap Trust.

An Income Cap Trust (also referred to as a Qualified Income Trust) is a trust created to receive income that an individual would be entitled to that would otherwise count towards that individual’s monthly income. An experienced Medicaid planning attorney, like the attorneys at Gorman & Jones, PLC, can assist you in creating an Income Cap Trust for Florida Medicaid benefits. Call our office at (813) 856-5625, conveniently located in Tampa, for a free initial consultation today.

Eligibility with Income and Asset Issues

In applying for Florida Medicaid benefits, the applicant must meet the asset requirements. In meeting this requirement, the applicant cannot have “countable” assets, which include money, real property, certain items of personal property, certain investment accounts, among others. The value of countable assets that a Florida Medicaid applicant must not exceed is $2,000.00. However, this amount can be offset by “exempt” and “non-countable” assets. Additionally, if the Florida Medicaid applicant is married, the non-applicant spouse can retain $126,420.00 in assets as well as the exempt and non-countable assets

Exempt assets

Since exempt assets are exempt from seizure for repayment by the State of Florida upon the death of an individual, these assets are not counted towards the applicant’s asset value. These assets include, but are not limited to:

  1. Primary residence
  2. Primary motor vehicle
  3. Personal property (but not of unusual value, such as jewelry or art)
  4. Life Insurance policies (and life insurance policies with a face value of $2,500.00, as of 2019, or less)
  5. Prepaid Funeral and Burial Plans

Non-Countable Assets

There are four distinct categories of non-countable assets, which are the assets that are not included when determining whether a Florida Medicaid applicant meets the asset eligibility requirements. These categories include income-producing assets (such as rental properties or business assets that are needed to self-support), real property that has been listed for sale, unavailable resources (such as property for sale), and items lacking meaningful value.

Determining whether you are eligible for Florida’s Medicaid assistance can be a complicated process, but the experienced attorneys at Gorman & Jones, PLC can help assist you in this process. Call our office today at (813) 856-5625 to begin the process of applying for Florida Medicaid benefits and determining your eligibility status.

Florida Medicaid Planning and Trusts

There’s a saying that goes “Proper Preparation Prevents Poor Performance.” The same can be said about Florida Medicaid planning, since there are several resources and methods available to applicants who would otherwise not meet the Florida Medicaid eligibility requirements. However, many of these actions and avenues can be complex. Therefore, hiring an attorney who is experienced in Medicaid eligibility to help protect as many assets of the applicant as possible should be trusted to assist in this process, such as the attorneys at Gorman & Jones, PLC. The most common method of meeting Florida’s Medicaid eligibility requirements is creating an irrevocable trust, since the applicant would relinquish all beneficial interest in the trust’s assets. Therefore, these assets would not be considered as the applicant’s countable assets. There are a few different types of trust that can be created which would help a Florida Medicaid applicant meet the eligibility requirements, which will be discussed as follows:

Income Cap Trusts

As stated in the Eligibility with Income and Asset Issues portion of this Section, the gross monthly income that a Florida Medicaid applicant must not exceed under the income test is $2,313.00 as of 2019. This means that a Florida Medicaid applicant cannot qualify for benefits if they receive more than this amount every month in gross income unless their income is artificially reduced by means of an Income Cap Trust. An Income Cap Trust works in reducing the income of a Florida Medicaid applicant by diverting income that would be counted towards the applicant to be deposited into the Income Cap Trust instead.

There are four requirements that must be met in utilizing an Income Cap Trust to qualify for Florida Medicaid benefits, which are:

  1. The Income Cap Trust must have been created on or after October 1, 1993,
  2. It must be irrevocable in nature,
  3. It must only be comprised of the applicant’s income, and
  4. The Income Cap Trust must carve out a portion of the funds to be distributed to the State of Florida upon the applicant’s death.

Once the applicant creates the Income Cap Trust, he or she must begin depositing the excess income they receive every month into the Income Cap Trust. This must be done every month that the applicant is receiving the Florida Medicaid benefits to maintain their income qualifications. Additionally, because the applicant must meet the income and asset requirements for Florida Medicaid at the time they apply, this means that they must be utilizing their Income Cap Trust before they submit their application to ensure they satisfy the requirements.

The experienced attorneys at the law firm of Gorman & Jones, PLC can help you create an Income Cap Trust to meet the eligibility requirements for Florida Medicaid assistance, so call our Tampa office for a free initial consultation today at (813) 856-5625 to discuss your options.

Irrevocable Trusts

Another method of meeting the asset and income requirements for Florida Medicaid benefits is the valid creation and funding of an irrevocable trust. This is a trust which, as the name suggests, cannot be amended or revoked after it has been created. Once an irrevocable trust has been established, the applicant will transfer the disqualifying assets into the irrevocable trust and will relinquish all beneficial ownership and control over those assets. Therefore, the irrevocable trust will own the assets – not the applicant.

There are numerous types of irrevocable trust that can be created to help an applicant meet the asset and income requirements for Florida Medicaid benefits. One of these irrevocable trusts include an Irrevocable Asset Trust. An Irrevocable Asset Trust will hold title to assets owned by the applicant, including assets which are income-producing, to prevent loss of that asset and/or future income as well as ensure the assets and income are protected for the applicant’s heirs. However, it is important to recognize that this type of asset transfer is subject to a five-year look-back period for Florida Medicaid eligibility. Therefore, is it of utmost importance to hire an experienced irrevocable trust attorney who has extensive knowledge of Florida Medicaid eligibility, such as the attorneys at Gorman & Jones, PLC, to assist in the creation and funding of your irrevocable trust for Florida Medicaid purposes. Call our office today at (813) 856-5625 to discuss your eligibility and options, including the impact of the five-year look-back period on your Florida Medicaid planning.

Florida Medicaid Application Process

Many potential applicants have one main fear: applying for Florida Medicaid benefits and being denied. Therefore, knowing when to apply can be one of the most crucial decisions a Florida Medicaid applicant can make.

Because the applicant process for Florida Medicaid benefits is complex and complicated, it is important to begin the application process by seeking a professional familiar with the application process. This is also important because the application process can be lengthy and a professional can help prevent any unnecessary delay in the process or receiving the benefits. Additionally, only the applicant or the applicant’s designated representative may apply for Florida Medicaid benefits for the applicant.

The timing of applying for Florida Medicaid benefits hinges primarily upon the applicant’s financial situation, the application’s health, and the applicant’s marital status. If the applicant’s financial situation is within the guidelines for Florida’s Medicaid eligibility requirements, the application process can typically begin as soon as the need for benefits arises. When the application is submitted, the Florida Medicaid agency will conduct an assessment to determine whether the applicant needs the benefits. If the assessment reveals that the benefits are warranted, then the application is processed. This typically takes under fifty days. If the assessment reveals that the benefits are not warranted, the agency will provide the reason for ineligibility and the application process must restart. If the Florida Medicaid benefits are granted, the applicant must undergo an annual assessment of their eligibility status to continue receiving their benefits.

Contact the law offices of Gorman & Jones, PLC in Tampa at (813) 856-5625 for a free initial consultation to discuss your Florida Medicaid eligibility and determine the best time to submit your application.

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