Applying For Medicaid In Florida
by Bill Kohn | Sep 16, 2018
Medicaid is a state-administered program for low-income and disabled U.S. citizens and legal aliens. Although many of the coverage details are determined by individual states, each state must provide certain services, such as specific hospital and doctor services.
Its possible to be eligible for both Medicare and Medicaid. If you think you might qualify, you need to fill out a Medicaid application. If you do qualify, Medicaid can help pay for your Medicare premiums, deductibles, and/or coinsurance.
What Happens After I Apply For Medicaid In Florida
After you submit your Florida Medicaid application, you may be required to attend an interview with a Department of Children & Families case worker.
Whether you will required to attend an interview depends on your situation:
If you are applying for Medicaid for your child alone, then no interview will likely be required.If you are applying for any other benefits at the same time, then an interview will likely be required.
During this interview, you will be required to bring documents that prove the information that you provided on your initial Florida Medicaid application.
See above for the list of documents that may be required during the interview.
Once you complete this interview, you will receive a call or a letter in the mail that will tell you whether you were approved or denied.
If you are denied benefits, you have the right to appeal but that appeal must be filed within a certain timeframe. As your caseworker for details.
How Much Does A Medicaid Lawyer Cost
Many senior citizens and their families are fearful that they cannot afford a Medicaid lawyer. However, an experienced Medicaid lawyer can save time, frustration, and substantial amounts of money over the long-term. In fact, having to forgo Medicaid nursing home coverage for even a single month can be more costly than hiring legal counsel.
At our firm, we provide affordable, cost-effective Medicaid planning. Once we know more about your personal situation, we can explain the matters that may need to be undertaken for your case.
Read Also: Medicaid Cost Sharing With Medicare
How To Apply For Long
For those applicants who are already at or below the income and asset levels, it is very typical that the nursing home does the application for you/the resident. Typically, the business office and/or social worker can do this when the resident’s income and assets are already below the applicable limit. If you/the elder is at home and looking to apply for Medicaid, then you would call your local Aging Resource Center to get placed on the long-term care wait list. There is no waitlist for nursing home Medicaid but there is a very long waitlist for assisted living and in-home Medicaid assistance.
If the elder’s assets are above the minimum level, then it is highly likely that the family will want to consult a good elder law attorney to learn legal ways to protect assets. Here, the elder law attorney would do the application for the elder after assets are legally protected, when appropriate.
How Do I Enroll In Medicaid In Florida
Review Floridas eligibility criteria, and if you believe you are eligible to enroll in Medicaid you have several options:
- Enroll at Healthcare.gov .
- Apply online at ACCESS Florida, or fill out a paper form. Use this application for low-income children, pregnant women, families, and aged or disabled individuals who are not currently receiving Supplemental Security Income .
- Use this application to apply for food or cash assistance in addition to Medicaid. You should also use this form if you currently receive SSI or if you are applying for home-based and community services, hospice care, or nursing home care.
- Submit a paper application submitted by mail, fax or in person to a local service center.
For help with the application process, call 1-866-762-2237.
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Do You Have Questions
We are happy to help you. Call Staywell toll-free at 1-866-334-7927 , MondayFriday, 8 a.m.7p.m.
You can visit us too! We have Welcome Rooms throughout the state of Florida. Representatives are there to answer your questions. They can help with things like:
- Updating your address
- Changing your Primary Care Provider
- Ordering over-the-counter items and more
Medicaid For The Aged Or Disabled
Any Florida resident who is eligible for Supplemental Security Income is also automatically eligible for Medicaid. There is no need for a separate ACCESS Florida application unless nursing home services are needed.
There are many SSI-Related Medicaid programs and coverage groups, each with different financial and disability requirements. For information on what coverage these programs provide and to find out which coverage group you fit into, read the Florida Department of Children and Families SSI-Related Medicaid Programs Fact Sheet, which you can find here:
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Is Inheritance Considered Income For Medicaid
When a Medicaid recipient receives an inheritance, it is counted as income in the month that it is received. Not only must a Medicaid applicant meet this asset limit in order to qualify for benefits, he / she must maintain his / her assets at, or below, this level.
I Would Like To Change My Health Or Dental Plan
Change Health or Dental Plans Online
Log in to the FL Medicaid Member Portal to change your Health or Dental Plan. We will walk you through the process of changing your plan.
Why should you sign up for a FL Medicaid Member Portal account?
- You can check your Medicaid eligibility and enrollment status
- View and update your address
- Request help using secure messaging
- Enroll in a plan or change plans
- File complaint and see what is happening with your complaint
- Go paperless. Choose to only get letters from Medicaid electronically
- Receive email or text message alerts
Other Ways to Change Your Health or Dental Plan
If you are unable to change Health or Dental Plans online at this time, there are several other options available to you.
Read Also: Who Is Not Eligible For Medicaid
Medicaid’s Dual Eligibility With Medicare
Elderly and disabled individuals that receive Medicare can still qualify for Medicaid based on income and disability. Medicaid can then be used to cover expenses not covered by Medicare. For expenses that may be covered under both programs, they must be paid first through Medicare, and Medicaid can be used to cover the difference. The dual eligibility standards are different than the Medicaid eligibility standards. The following income tables show the monthly income limits for dual eligibility for low income elderly and disabled individuals and couples.
Can I Qualify For Medicaid After Im In A Nursing Home
Even if you are already living in a nursing home, you can still qualify for Medicaid. While your benefits may be less than if you had engaged in Medicaid planning prior to moving into a nursing home, nonetheless it is still usually beneficial to take actions that may result in Medicaid assistance.
Over two-thirds of all Florida nursing home residents pay for their care through Medicaid. If a Floridian is already in a nursing home, the nursing home has a designated Medicaid bed available, and the individual meets the financial and health eligibility requirements, the applicant can receive Medicaid to help cover care expenses.
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Which Medicaid Plan Is Best In Florida
Each Medicaid plan in Florida comes with the same core benefits which are listed here. You can also compare the performance data for the various plans in your area by using what is known as the Medicaid Health Plan Report Card. You will also have to consider things like the types of services that might be needed along with how many doctor visits that will be necessary, the plan that is accepted by your doctors, the types of doctors you will need, and what extra benefits will meet your needs.
Example Of How Penalty Period Is Calculated
Diane transfers $97,030 to her son in December 2019 and $97,030 to her daughter in January 2020. She then applies for Medicaid in January 2020, at which point she meets all eligibility requirements except for the uncompensated transfers. The penalty period begins to run at that point. Medicaid would deem her ineligible for benefits for the next 20 months . She will be eligible for Medicaid benefits, assuming she still meets all other criteria, in September 2021.
In the event that an applicant and his other family face a situation where gifting is going to create a delay in Medicaid eligibility, or if Medicaid has been denied and the delay of eligibility has been determined by the Department of Children and Family Services, legal steps may be taken to eliminate or reduce the period of ineligibility. Contact our Florida elder law attorneys.
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Medicaid For Different Groups
While Medicaid programs vary by state, they also can vary with the amount of aid and program benefits provided to different groups. Here we have listed some of the most common groups and different types of medical needs that Medicaid looks to support.
- Medicaid For Dogs
- Medicaid For Pregnancy and Pregnant Mothers
- Medicaid For Providers
- Medicaid For Nursing Home Residents
- Medicaid For College Students
- Medicaid For Adults
- Medicaid For Children
Kansas provides Medicaid benefits through its Medical Assistance Program. Eligibility is determined by income level and health needs, such as childhood care, pregnancy or disability.
Which Medicaid plan is best in Kansas?Your plan choices depend on your eligibility level for Medicaid assistance. Kansas provides plans for children through its Childrens Health Insurance Program that are available to families for no to limited cost. Pregnant women, parents and caregivers, seniors, and people with disabilities also may face additional eligibility requirements that impact their level of benefits.
To apply for Kansas Medicaid benefits, visit the KanCare website.
No Aca Medicaid Eligibility Expansion In Florida
Florida is one of 12 states that has not expanded Medicaid eligibility as allowed under Affordable Care Act . The ACA doesnt provide subsidies for people with income below the poverty level, because the law called for them to have Medicaid instead. But in states that have refused Medicaid expansion people who arent eligible for Medicaid and whose income is too low for exchange subsidies are in whats called the coverage gap.
Floridas eligibility standards are:
- Children up to 1 year old: 206% of the federal poverty level
- Children ages 1-5: 140% of FPL
- Children ages 6-18: 133% of FPL
- Pregnant women: 191% of FPL
- Adults with dependent children: 27% of FPL
People who qualify for Supplemental Security Income automatically qualify for Medicaid in Florida. See more information in the SSI-Related Programs Financial Eligibility Standards.
Medicaid For Aged Or Disabled
This program will have limits for both income and assets. You have to be poor. If you are not a senior and yet on disability, they will have to determine if you are disabled. This generally takes a few months. If possible, it may be helpful to submit an RFC form from your doctor and any other documentation you can get. Please Remember: This is a different application than Social Security. You will need to ask who is handling your Medicaid decision and send this information directly to that person. Heres where you can apply for Florida Medicaid for Age or Disabled.
Who Is Eligible For Medicaid In Florida
The following people may qualify for Florida Medicaid if they meet certain financialrequirements:
- Infants and children under the age of 21
- People who are aged 65 or older
- People who are blind or expected to be disabled for at least a year
- Recipients of Supplemental Security Income
- People who need nursing home care or home and community-based care
- People who are on Medicare
- Aliens and refugees under a special assistance program
- Individuals who are medically needy
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Florida Medicaid Waivers For Kids
If your child has disabilities, check out Medicaid Waivers for children in Florida. There are medicaid waivers for certain conditions. The income of the parents will not matter. Many excellent extra services are available through waiver programs.
Hint: Many parents run into problems because the person processing their application does not know about waivers and does not exclude the parental income, so their application is denied. Make sure to speak directly to someone in charge of processing waiver applications.
Rhode Island Medicaid Eligibility
Rhode Island provides Medicaid benefits to assist low-income individuals and families, as well as seniors and people with disabilities, in receiving the healthcare they need.
Which Medicaid plan is best in Rhode Island?
Rhode Island provides many Medicaid-related programs that help low-income households with healthcare costs, though like many states, what benefits are available to you depends on your health needs and financial situation.
You can apply for Rhode Island Medicaid assistance by completing an online application.
Rhode Island Medicaid Application:
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What Items Do I Bring When Meeting With A Lawyer To Assist With The Medicaid Application In Florida
In this initial medicaid lawyer consultation article, I explain what items are needed to make the most efficient use of your time with the medicaid attorney who will be assisting with your medicaid application in Florida.
If you do not have all of the requested information and documents, as long as you have an educated estimate as to the value of assets and income sources, you can have a meaningful meeting with the lawyer. Items can always be gathered and produced later and the initial medicaid planning consultation should not be delayed.
If You Get Ssi Disability And Dont Have Medicaid
You can apply for Medicaid coverage. But whether you need to apply depends on your state
- In many states, SSI recipients automatically qualify for Medicaid and dont have to fill out a Medicaid application.
- In other states, your SSI guarantees you Medicaid eligibility, but you have to sign up for it.
- In a few states, SSI doesnt guarantee Medicaid eligibility. But most people who get SSI are still eligible.
If you have SSI Disability and dont have Medicaid, you can apply for Medicaid coverage 2 ways:
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Medicaid Through Ssi Disability
SSI automatically comes with Medicaid. SSDI does not come with Medicaid, however, if you are under the income limit for Florida Medicaid for Age or Disabled, you can get Medicaid with SSDI.
If you are applying for disability and you are looking for ways to improve your application, and increase your chances of getting approved, check out: The Sleepy Girl Guide to Social Security Disability.
Modified Adjusted Gross Income
MAGI is your adjusted gross income with tax-exempt social security, interest, or foreign income added in if you have any of these. The total amount is your modified adjusted gross income. Your adjusted gross income is your total income minus specific deductions. If you have multiple sources of income, they must all be added together in order to get your gross income.
Common Florida Medicaid Application Mistakes
Medicaid laws are difficult to navigate alone and it is easy to make mistakes when filling out a Medicaid application. One common mistake is simply applying too early. Medicaid reviews your assets and income â and if you have not engaged in proper Medicaid planning, you could subject yourself to unnecessary delays and penalties.
Another common Medicaid-application mistake is trying to play amateur Medicaid-planning lawyer. Many people will attempt to give away all their assets in an effort bring themselves below the Medicaid-ICP qualification threshold. It is a rude awakening when they realize that Medicaid specialists know of this and specifically investigate gifts for the five years prior to the medicaid application being submitted.
Trying to hide this from Medicaid is a felony and when the investigating Medicaid-application processing specialist inevitably does find evidence that money or other assets were gifted away, there is a penalty period imposed.
Our Medicaid planning law firm knows what Medicaid is looking for and how best to present your case to qualify you as efficiently as possible. To discuss some of the other common Florida medicaid application mistakes, or to just get some general medicaid application guidance , schedule a consultation.
When Applying For Medicaid In Florida: Divide And Conquer
As Florida elder care lawyers and Medicaid-planning attorneys, we try to do as much of the heavy lifting for you as possible. But there are certain required Medicaid-planning items that make sense for the client to handle since time is of the essence. For example locating previously-executed Will and Trust documents powers of attorney bank account information, retirement account, and brokerage account statements are tasks that just make logical sense for the client to retrieve, rather than the elder-law attorney.
However, once these items are obtained and presented to the elder law or Medicaid-planning attorney, all the heavy lifting is done on our end, including preparing all necessary documents, deploying Medicaid-qualification strategies, and filling out and following through with the Medicaid application until it is approved. We even provide you with detailed instructions on your obligations after you have been approved for Medicaid and what you need to do in order to maintain Medicaid eligibility.
When applying to the Home and Community Based Services Waiver program, there is an interview process. We can coach you through the Medicaid screening to improve your placement on the Medicaid waiver wait list.
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