Florida Medicaid In Home Care

Income Requirements For Florida Medicaid

There are income requirements for Medicaid in Florida. You need to earn an income that is within the federal poverty level for your group. This is calculated by a specific system that is known as the Modified Adjusted Gross Income, or MAGI.

Basically, before taxes, income needs to be under these amounts, according to Benefits.gov:

Household Size Maximum Income Level

1 $15,000

• Speech-language pathology, respiratory, physical, and occupational therapy services

To Qualify For Medicaid Assistance For Nursing Home Expenses You Must:

• Reside in Florida
• Be a U.S. national, citizen, or have satisfactory immigration status
• Need health care and insurance assistance
• Meet certain low income and asset tests and
• Be one or more of the following:
• be age 65 or older
• pregnant or have a child 18 or under
• blind or disabled or have a blind or disabled spouse, child, or parent living in your household.

Florida Medicaid applicants 65 or older must have a limited income and assets to qualify for Medicaid coverage however, there are ways for some seniors to transfer their money and property to become eligible. In situations such as these, it is important to take extra precaution, as the applicant may need funds for future nursing home care, and the transfer could make them ineligible or delay their ability to collect benefits.

At our firm, we help clients to the extent possible in seeking the maximum Medicaid benefits to which they may be entitled through long-term Medicaid planning, asset transfers, and other strategies for those who will soon be going into a nursing home, as well as those who may already be in a nursing home.

What Does Medicaid Cover In Florida

The amount and type of services that will be covered by Medicaid will depend on things like how old the beneficiary is, which program the beneficiary is actually enrolled in, and even the type of services that will be necessary medically. These services might include community behavioral health, prescription medications, visual, dental, transportation, hospice, nursing home, home health care, family planning, hospital, doctor visits, and more.

Recommended Reading: Will Medicaid Pay For Portable Oxygen Concentrator

Unitedhealthcare Connected For Mycare Ohio

UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .

Bonus Lie: The Nursing Home Will Take All Of Mom’s Money

While the nursing home can be very expensive, it never actually “takes” anyone one’s money. The resident must simply pay for their stay until they become eligible for Medicaid benefits. If you have the money to pay, you can just pay. If you want to protect assets from the nursing home, you should see a good elder law attorney. It is never too late to protect assets and apply for Medicaid!

Remember, if a family member or other loved one is in a nursing home or assisted living facility, it is never too late to get good advice on asset protection, estate planning and care planning. Call us today to schedule a consultation or attend one of our free monthly seminars on Medicaid and estate planning!

You May Like: New Mexico Medicaid Provider Portal

Floridas Requirements For Medicaid Qualification

In order to get Medicaid in Florida, you have to meet certain eligibility requirements. You have to be a certain type of patient for one thing. These include:

• Pregnant women
• Parents or relatives who are caretakers
• Families who might have lost Medicaid because of an increase in income or alimony
• Florida residents who receive SSI through the Social Security Administration
• Patients who are disabled or over the age of 65
• Children under 21
• Those who are eligible to receive Temporary Cash Assistance
• People under age 26 who were in a foster home
• People in nursing homes or those who receive community or home-based care.

You also have to be a Florida resident who has a valid social security number and a citizen of the U.S.

Florida Medicaid Home Care Services

Medicaid is a social health program for certain families and individuals with limited resources. There are specific programs for elders within Medicaid. Medicaid is jointly run by the federal government and the states and there are a number of different programs available within Medicaid for different populations/needs. Qualifications and what is covered also vary by program.

Many states have begun offering new programs through waivers from the federal government, particularly focused on managed care programs. The Florida Medicaid program includes the Statewide Medicare Managed Care , which means that recipients who are eligible must choose a managed care provider to manage a host of possible services. The SMMC long-term care program serves a number of elders and disabled adults. For more information about Florida Medicaid Managed Care visit the website, which offers more about the programs as well as Florida Medicaid Managed Care enrollment.

EasyLiving is proud to be part of this program, offering an array of homemaker, companion and in-home care services to clients through the following Medicaid managed care organizations: Humana-American Eldercare, Molina and Sunshine.

Contact us to learn more about Florida Medicaid SMMC Long-Term Care Program, home care services and other programs and benefits for Florida elders. If you are enrolled in the SMMC program, we welcome the opportunity to serve you through the managed care networks listed above.

Read Also: Washington State Medicaid Residency Requirements

How Can I Obtain These Florida Long

If you or your loved one’s assets are not currently under $2,000.00 and/or if their income is not currently below $2,349.00 , then it is imperative that you contact an experienced elder law attorney who focuses on Medicaid planning. We can show you how to legally and ethically protect your income and assets without having to wait five years, without having to sell your house, and without having to go broke first.

Additional information on what Medicaid Long-Term Care covers in Florida can be found at: â

Could My Loved One Get Nursing Home Care Through Medicaid

Medicaid was created to ensure that people who have very few resources can still get the late-in-life care they need. In Florida, Medicaid can be used to pay for an elderly relatives nursing home, assisted living facility, or in-home nursing care. Medicaid pays a fixed daily rate to cover costs such as a patients room, meals, staff care, and medical supplies, possibly for the remainder of their life.

However, Medicaid will only pay for nursing home care if your loved one meets the programs eligibility requirements, including:

Even if you meet these requirements, you may still have trouble securing a nursing home residency. For one thing, not all nursing homes and assisted living facilities accept Medicaid payments . Medicaid also counts any gifts and property transfers made up to five years before the date of application, which could delay your eligibility and force you to pay for immediate costs of care out of your own pocket.

Its possible to secure the care you or a loved one needs without sacrificing everything you have built over your lifetime. By starting the Medicaid planning process early, an experienced elder law attorney can redirect income and assets over the Medicaid limit, keeping your heirs inheritances safe while you receive long-term care.

Recommended Reading: Does Medicaid Cover Substance Abuse Treatment

How To Qualify In Florida

To qualify, one must meet the following criteria:

• If you are under the care of an attending physician and have a physicians order for home health services
• If a medical condition or disability that substantially limits your ability to perform everyday living activities
• Require services that can be safely, effectively, and efficiently provided in the home or other authorized setting
• If you are certified homebound by your doctor/nurse

Medicaid Penalties In Florida

Medicaid applicants in Florida can have their benefits delayed or denied if they willfully transferred any assets to their loved ones in the five years prior to submitting their Medicaid application. These uncompensated transfers are categorized as gifts, and they can have a major impact on a persons Medicaid eligibility.

Because Medicaid applicants are required to meet certain income and asset limits, its not uncommon for some seniors to transfer their asset in an effort to qualify for coverage. To deter this, Medicaid has established penalties for those who try.

If a person makes uncompensated transfer during their look-back period, Medicaid will not approve coverage until the persons penalty period ends. Medicaid determines a persons penalty period by dividing the number of gifts theyve given during the look-back period by $8,944, which results in the number of months Medicaid will wait before they step in.

Its important to note that there is no exception for small gifts, such as Christmas presents, when Medicaid calculates penalties. They assume all uncompensated asset transfers during the look-back period are done in an attempt to qualify for Medicaid, making it especially crucial for seniors to do careful Medicaid planning before they transfer any assets.

Read Also: Braces Place That Take Medicaid

Who Is Eligible For Medicaid In Florida

To qualify for an SMMC program, an individual meet a set of predefined criteria. A person must:

• Be a legal Florida resident
• Be at least 65 years of age, or be between the ages of 18-64 and qualify as disabled
• Require a nursing home level of care
• Meet the financial criteria set forth by Medicaid

A person who qualifies for Supplemental Security Income is automatically eligible for Medicaid coverage in Florida, and they need not apply to receive benefits.

How We Are Compensated

We charge a very reasonable fee based on what the applicants needs are depending on the complexity of your customized Medicaid plan. Also, as a Florida Licensed Financial Advisor and Insurance Agency, we provide Medicaid compliant annuities and guaranteed issue life insurance, when appropriate, to preserve and protect assets as part of our value-added products consulting services. We receive commissions from the financial institution issuing the annuity or life insurance as part of our compensation.

Recommended Reading: Vermont Medicaid Dental Fee Schedule

Florida Medicaid Long Term Care Financial Eligibility

Florida is an income cap state. What that means is there is a maximum amount of income the applicant can receive or they do not qualify. The good news is that if the Medicaid applicant is over the income cap there is something that can be done to become eligible and it ultimately makes no difference in the amount paid to the provider of long term care. It is no big secret, its publicly published information and the cure for being over income is publicly released as well. You need an attorney to overcome this problem legally. We have been working with the same attorneys for years that will fix this problem for the right price that will enable you to be under the income cap. Dont worry its not as bad as it sounds. As for assets, we have provided many pages of information for your review in the REQUIREMENTS section of our website so you can dive deep into this if you like. Please Call if you have questions.

Starting in 2014, The Department of Children and Families implemented something new for Nursing Home Medicaid by establishing the Statewide Medicaid Managed Care Long-Term Care Program. You may review these changes in our REQUIREMENTS or RESOURCES section of this website

Lie #: Having Your Name On The Elders Assets Can Protect Them From The Nursing Home

Having your name as a co-owner of the elder’s assets when she goes into the nursing home does not protect these assets. Medicaid considers any asset that your loved one as co-owner as their sole asset. If your name is on these assets, you must prove that these assets are yours in order to exclude them for Medicaid purposes. The basis for the rule is that many elders add their children to their assets as a matter of convenience. Thus, even if you are a co-owner of your loved ones bank accounts, 100% of the asset is countable for Medicaid purposes unless you can show otherwise.

Read Also: Eye Doctors In Traverse City That Accept Medicaid

Lee Health: Plans Underway For A New Lee Health Hospital Campusyour Browser Indicates If You’ve Visited This Link

Bringing our plans for this new hospital campus to fruition will take a few years. But we are ready to take the first steps in the process thanks to the recent approval from the Lee Health Board of Directors to proceed with Request for Qualifications for an architectural design firm,

Naples Daily News on MSN.com

Next Step For Your Nursing Home Medicaid Application

If you choose to have Medicaid Eligibility, Inc. become the Designated Representative for your family member applying for Medicaid for a nursing home, we will perform the following services:

• Assist family member with document collection.
• Complete the Medicaid Request for Assistance application, and submit it to the Department of Children and Families.
• Represent the client at any required interviews/meetings with the Medicaid caseworker, and present all case items needed for approval.
• Follow up on any additional information the caseworker may require, and see the application through to approval.
• We keep you, and the nursing home informed throughout the process, until approval.

Read Also: How Does One Get Medicaid

Florida Provides Assisted Living Facility And Nursing Facility Care Homemaker/chore Services And Medical Equipment To Those Who Qualify Through Long

By Douglas Witten

Florida’s Medicaid Long-Term Care Managed Care plans cover the costs of assisted living facility and nursing facility care, homemaker/chore services, nursing care, and medical equipment and supplies for those who qualify. There are two parts to qualifying for a LTCMC plan: needing a nursing home level of care and financial eligibility.

Unitedhealthcare Dual Complete Plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

You May Like: Blue Choice Healthy Connections Medicaid

Hiring An Elder Law Attorney May Be Vital

Even if the elder’s income or assets are above the minimum , an elder law attorney can assist the elder and the family in making the correct decisions. The good elder law attorneys know the ways to access Medicaid more quickly, which will help the elder leave the nursing home faster and get to the assisted living facility. A good elder law attorney can also know ways to advocate to move the elder up the assisted living waitlist, as well. Relying upon the nursing home to do the Medicaid application is not always the best idea due to the many complexities. If the elder has income or assets above the policy limits, an elder law attorney can be vital to legally protecting assets, reducing income, and more. Our law firm, no matter where you live in Florida, can help with your application.

Home Care For The Elderly Program

Home Care for the Elderly is an interesting program, in that it provides support directly to the caregiver instead of the care recipient. To be clear, caregivers are not compensated by the hour for the care they provide as they would be with the Florida Medicaid program discussed above. Instead, HCE, which is a non-Medicaid program, provides financial support for services that help the caregiver in their efforts. Often this support offsets spending that would otherwise have come directly from the caregivers pocket. For example, support from HCE can be used for adult day care, incontinence products, and home delivered meals.

While the caregivers receive support, most of the eligibility requirements of the Home Care for the Elderly Program apply to the care recipient, not their caregiver. Care recipients must be Florida residents, 60+ years of age, and at-risk for nursing home placement were their caregiver not providing support. They also must be financially eligible. In 2019, the care recipient must have less than $2,313 per month in income and less than $2,000 in countable resources.

Readers should be aware that one cannot concurrently receive support from the HCE Program and the SMMC LTC program . Also, worth noting is that the HCE Program is not an entitlement, funds are limited, and waiting lists may exist. Read more.

Also Check: Air Purifier Covered By Medicaid

Can I Give Money Away For Medicaid Qualification

No! I had a call recently where Mom/Dad were both coming off of the wait list and were finally going to be able to qualify for Medicaid. The problem was that Mom/Dad had over $70,000 in the bank – which is some $67,000 over the asset limit for a married couple. The representative from the Aging Resource Center told the family that Mom and Dad could give this money away and apply for Medicaid – but that was just plain wrong. You cannot give money away within 5 years of a Medicaid application! Here, an elder law attorney can help legally protect assets and apply for Medicaid – hiring the attorney will more than pay for itself.