Medicaid is accepted at our community

Presenting some tips and tricks for navigating the sometimes complicated world of Medicaid

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For many, the answer to “How can I afford this,” comes through the help of the Medicaid/SA assistance program. 

A major requirement for Medicaid/SA eligibility is demonstrated financial need. For single applicants the monthly income limit is $2,500. For married couples — if both spouses are applying — it’s $5,046 per month. And there’s a limit on assets as well. 

For single applicants, the asset limit is $2,000. For married couples who are both applying the asset limit is $3,000. If only one member of a married couple is applying for Medicaid/SA the non-applicant is allowed to have $137,4000 in assets. (The applicant or applicants’ home and are excluded from this asset total.)  

Pre-planning is vitally important because all assets must be out of the resident’s name five years before they become eligible for Medicaid/SA. It’s important to be prepared because medical emergencies cannot be predicted. Vehicles, homes, real estate, all of it must be divested five years before you become eligible for Medicaid.

For many the option is a spend down, but there are requirements in place for that process. Money spent on the senior’s care, whether it’s a burial plot, gift certificates for hair dressing, and paying for medical care are all acceptable choices when it comes to spending down one’s assets.

Another thing to bear in mind when addressing the financial requirements of assisted living or memory care services is that there are a variety of price points available, depending on your preferred options. Whether it’s a deluxe single suite, a studio-style apartment, or the companionship that comes from sharing a semi-private room with a roommate, there is an option to fit every need — and every budget.

When you apply for Medicaid, the state of Florida will initiate what’s called a 60-month Medicaid Look-Back Period. What this means is that the state will examine all your asset transfers for the past five years to ensure no assets were sold or given away for less than fair market value. This includes asset transfers made by one’s spouse. If the state determines that the look back rule has been violated it’s assumed that that was done to meet Medicaid’s asset limit, and a penalty period of Medicaid ineligibility will be calculated.

An online spend down calculator can help you determine exactly how much of your assets must be spent down to be eligible for Medicaid long term care. It’s available here: medicaidplanningassistance.org/medicaid-spend-down-calculator.

Florida’s special assistance eligibility requirements are listed online at myflfamilies.com/service-programs/access.

A lawyer specializing in elder law can help you navigate the process.

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