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Criteria for Florida Medicaid - Aging Wisely

The following are some of the general eligibility criteria for long term care Medicaid in the state of Florida. There are many Medicaid programs each with different eligibility criteria, the information below covers the primary programs for long term care, including the Nursing Home program (ICP), Long Term Care Diversion, and the Medicaid Waiver for Assisted Living. These Medicaid Criteria cover 2009 and change yearly.

  1. The person must be a resident of Florida. Anyone residing in a Medicaid certified nursing home in Florida is considered a resident of Florida.
  2. Be a citizen or alien who has been admitted as a permanent resident.
  3. Be at least 65 years of age or disabled or blind (some programs require the person be 60 or 65 years of age regardless of disability).
  4. Meet the “level of care” criteria as determined by the Department of Elder Affairs CARES team. Standards set by the Department of Children and Families require that a person need assistance with certain activities of daily living (varies by program).*Aging Wisely can help you better understand these criteria and assess whether you might qualify.
  5. Monthly gross available income under $2,022 (for 2009). If your gross income is greater than $2,022 we can refer you to an Elder Law Attorney to complete a Qualified Income Trust which enables you to become eligible for benefits.
  6. Countable assets of less than $2,000 at least one day of each month of Medicaid eligibility (or if the gross income is less than $808/month, the individual can have up to $5,000 in assets). If married, the community spouse asset allowance is $109,560.

There are several assets which are “exempt” or do not count towards the $2,000 limit. Some of these include homestead property (a value limit of $500,000 or less if single), one vehicle regardless of age or value and an additional vehicle if over 7 years age (not a collectible), irrevocable prepaid burial contracts, $2,500 designated for burial expenses (burial contracts or bank accounts designated for burial by designation in the title, etc.).

There are various planning opportunities available to individuals who may be over the asset or income limits. Aging Wisely will help direct you to an elder law attorney who specializes in this area, and help your understand the criteria and programs that may help you or your loved one.

It is important to understand the complete picture of your loved one’s needs. Many of the Medicaid and government funded programs have limited funding and help may not be immediately available. Depending on your financial situation, personal and medical issues, and the type of care you need and desire, you may find better options outside of Medicaid. Aging Wisely’s care managers help you to look at all the options, know what you might qualify for, know how to access government-funded as well as private pay resources, and come up with the best plan for you to get the help you need. As you apply for Medicaid programs, our Medicaid specialists can help you navigate the process, pull together paperwork and complete applications.

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