What is my eligibility for Medicaid?

| Feb 17, 2021 | Uncategorized

Florida seniors who are looking at long-term care options may be worried about being eligible for Medicaid if their estate is valued above the qualifying limit, or if combined income goes beyond the monthly limit. While Medicaid is a federal program, it is administered at the state level, so the minimum income needed to qualify varies.

Medicaid in Florida is managed under the Statewide Medicaid Managed Care (SMMC) program, with long-term care and all other health care options managed separately. Depending on whether seniors are single or married, there are income and asset caps for either category.

Without additional planning, individual applicants must have less than $2,000 in countable assets and less than $2,382 gross monthly income from all sources, including Social Security, pension, IRA’s, or dividends. Couples who are both seeking eligibility have a cap of $3,000 in assets and $4,764 combined monthly income.

What is a Qualified Interest Trust?

Although Medicaid is intended as a health care program for low-income individuals of any age, seniors or their spouses who are facing costly medical procedures or needing to move into a long-term facility know that the costs will deplete the estate assets that they need for retirement.

For seniors who wish to safeguard their estate without losing Medicaid eligibility, one option is a Qualified Income Trust (QIT). Sometimes called a “Miller Trust”, income in excess of the qualifying limit is diverted to the trust to maintain the recipient’s eligibility. QIT’s are irrevocable and can only be set up on behalf of the Medicaid recipient.

An appointed trustee has legal authority to manage the funds in the trust, which can be used for specific reasons, such as medical bills, a personal needs allowance and Medicare premiums. Upon the death of the Medicaid recipient, the state of Florida must be named to receive the balance of the trust.

Do I have other options?

There are other ways to qualify for Medicaid in Florida for applicants over 65. The Medically Needy Program allows those with high medical costs to “spend down” the part of their income that is in excess of the Medicaid limit in order to pay medical bills each month. Once the excess income is spent, Medicaid kicks in to pay the remainder of the bills.

Medicaid planning is another option, but this requires a considerable amount of advanced planning, and there is a look-back period. For Coral Springs residents, it is wise to plan ahead and seek experienced estate planning advice on options.