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How to handle Medicaid crisis planning

After an accident or acute illness, a family member may need immediate, long-term skilled nursing care in a residential setting. Without plans in place to fund this type of care, the family may struggle to provide for their loved one if he or she does not qualify for Medicaid coverage.

If your family is facing this situation, review this guide to Medicaid crisis planning in Florida.

Qualifying for Medicaid

Often, an individual who needs skilled nursing care is ineligible for Medicaid. He or she may have too much income or too many assets to meet the program limits. In Florida, the person must have no more than $2,000 in nonexempt assets. In general, the state will include bank accounts, investments, stocks and bonds in this calculation. Applicants can exempt up to $595,000 * of equity in a primary residence, along with most vehicles, retirement accounts and covered burial expenses. The monthly income limit in Florida is currently $2,349 * to qualify for Medicaid.

Using the Community Spouse Resource Allowance

The state’s CSRA program allows a spouse who does not need long-term care to keep up to $128,640 * in assets without affecting the other spouse’s Medicaid eligibility. Transferring these assets in accordance with Florida law can provide some leeway in a Medicaid crisis planning situation.

Understanding the “medically needy” designation

Even when an individual does not meet the Medicaid income and asset limits, he or she can qualify as medically needy. In Florida, the person must have a minimum amount of medical bills each month depending on household size to be eligible for this program. However, he or she must have less than $108 in monthly income and $5,000 in nonexempt assets.

Families can often protect their assets by planning for Medicaid before a crisis arises. Careful strategy can preserve your wealth while allowing individuals with medical needs to qualify for Florida Medicaid. Without this type of assistance, the person and his or her family must pay out of pocket for long-term skilled nursing care.

* Information based on 2020 Financial Eligibility Standards