What are the restrictions for Medicaid eligibility?

On Behalf of | Oct 25, 2022 | Medicare

Medicaid planning becomes important for lower-income seniors because it is the only way they can qualify for this essential coverage. For many people, getting this insurance coverage is how they afford long-term care and rising medical costs as they age.

However, the program is incredibly strict on its requirements to qualify. Benefit.gov explains there is only a very limited group of people eligible for the coverage, and they must meet income restrictions.

Eligible people

You are only able to get Medicaid if you are 65 or older, have a child under the age of 18, have a disability or a household member has one or you are pregnant. Anyone who does not meet one of these criteria cannot get the coverage. Obviously, seniors can qualify, but they must meet the income hurdle, which is often difficult.

Income limitation

Income limitations depend on family size. They change annually based on the cost of living and count income before taxes. In addition, the state also counts assets. Some may be exempt, but there is a low threshold. For example, owning a home that has any significant value will push you right out of the qualification range. And you cannot simply get rid of assets to qualify because the state will look back over a period of time before you applied for benefits and count any assets you sold, gave away or otherwise got rid of during that time.

For this reason, it is often difficult for seniors to qualify for Medicaid unless they plan well ahead of time to disburse assets and ensure they are under the limits. This is not an easy process, so it is always wise to seek help from someone who has experience in Medicaid planning and understands the regulations associated with it in Florida.