BETTEN, MURPHY & WEISS
Attorneys, PA
Brevard's Elder Law Firm
1800 Penn Street, Suite 6
Melbourne, FL 32901-2625
Phone (321) 676-2525
What is ELDER LAW ?
Elder law is a relatively new area of the law which focuses on a variety of legal issues which face the elderly and which interact with one another. Some of these areas are Medicaid, nursing home regulations, estate planning, insurance coverages and elder abuse, neglect or exploitation.
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How do I pay for a Nursing Home?
Nursing Home care can be paid for in many ways including but limited to: private pay from your funds, Long Term Care insurance, Medicare(very limited) and Medicaid.
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What is a MEDICAID?
MEDICAID is a program set up by the Federal Government to assist people in paying for medical bills. Medicaid helps people who cannot afford medical care. These are people who have a low income or have limited assets.
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What is a MEDICAID ICP?
MEDICAID ICP (Institutional Care Program) is a program set up by the Federal Government to assist people in paying for Nursing Home care. Medicaid is a legal right under certain circumstances. The program is administered in Florida by the DCAF. MEDICAID ICP covers skilled nursing home care and does not cover custodial care.
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What is a MEDICAID ESTATE PLANNING?
MEDICAID ESTATE PLANNING or Asset Preservation is planning to save a significant portion of a family's lifetime savings from the debilitating high cost of nursing home care. MEDICAID ESTATE PLANNING combines the disciplines of Estate Planning with Financial Planning. MEDICAID ESTATE PLANNING can be done well before one enters the nursing home or after being there for a while. Nursing Home cost does not take long to wipe out a lifetime of savings.
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How do you qualify for MEDICAID?
MEDICAID has two sets of criteria for coverage under MEDICAID ICP. There are medical and financial criteria.
The medical criteria requires a person to need skilled nursing home care and NOT custodial care.
The financial criteria varies whether the person in the nursing home is single or married. There is an income and resource cap.
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What is the income cap for MEDICAID?
The applicant's income per month can not exceed $1,819.00 (2006-7). This includes gross Social Security (add back the Medicare premium), pensions, interest, dividends and many other forms of income.
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What if I have too much income to qualify for MEDICAID?
If the Applicant's income is above the cap, a Qualified Income Trust (QIT) can be created. The QIT is funded with the Applicant's income except for a personal needs allowance.
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What is the personal needs allowance?
The applicant is entitled to a $35.00 personal needs allowance each month. The allowance may be raised to $50.00
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What is the resource cap for MEDICAID?
The applicant's resources may not exceed $2,000.00. If the Applicant's income is below $614.00 per month the the Applicant may have up to $5,000.00 in resources. If married, the Community Spouse may have up to $95,540.00 (2006-7) in resources above the Applicant's $2,000.00.
In determining the total countable resources, DCAF uses a lookback period. For a Trust, the lookback period is 60 months. For an individual, the lookback period is 36 months. The lookback is to check to determine if resources were given away to qualify for Medicaid.
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Who is the Applicant?
The Applicant is the person applying for Medicaid and resides in a Nursing Home.
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Who is the Community Spouse?
The Community Spouse is the spouse of the applicant and resides in the community and not the Nursing Home.
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What is a resource?
Under Medicaid, resources are assets. Resources are categorized in three ways. Countable resources are used to determine if the cap has been exceeded. Exempt assets do not count against the cap. Examples are the Applicant's home, car and Funeral arrangements. Last are non-countable assets which do not count against the cap.
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What is DCAF?
DCAF is the Florida Department of Children and Families, formerly HRS. DCAF is the government entity that administers Medicaid ICP.
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What is Medicaid Estate recovery?
Medicaid Estate recovery ia a federal-state program designed to recover a portion of the Medicaid-funded medical costs from the estates of certain Medicaid beneficiaries
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If I give assets away am I ineligible for Medicaid?
No. Transfers of assets don't automatically make you ineligible. It depends on what the value and when you transferred the asset.
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Can my child take money out of our joint account without effecting my eligibility?
No. Any transfer of assets from a joint account, regardless of who makes the transfer, will be considered a transfer.
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Can I still give $10,000.00 a year away?
No, not without it being considered a transfer and the transfer penalty being applied. Many people mistakenly believe that because you can give away $10,000.00 per person per year under the tax code, that is the same case with Medicaid. Unfortunately it is not, and the $10,000.00 gift may adversely effect your eligibility.
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When I die does the State of Florida take my house?
No, if the house is your Homestead. The state is a creditor and has the right to recover money spent on your care in the nursing home.
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Is long term care insurance a good idea?
Absolutely. If you can afford long term care insurance, and meet the eligibility requirements, the purchase of long term care insurance is a way to control the cost of an extended stay in a nursing home.
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Do I have to have an attorney help me to apply for benefits?
No, however, an experienced elder law attorney can relieve the stress and anxiety surrounding the application process and advise you of options that others do not know.
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Should I wait until I need Medicaid benefits before I see an elder law attorney?
No. Many of the planning options available to you to protect your assets are best implemented when time is available. Therefore the greater the amount of time before the need arises the more options you have.
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If I have too many assets to qualify, but need Medicaid now, is it too late to protect any assets?
No. While you may have lost the opportunity to use some of the planning strategies, it is never too late to protect some if not all of the remaining assets.
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MEDICAID FAQs (frequently asked questions)
MEDICAID eligibility for a single person
MEDICAID eligibility for a married person