Florida Nursing Home Medicaid Rules

Florida Nursing Home Medicaid Rules can be complex and confusing, especially for families who are just trying to obtain benefits for their loved one so they can receive the care they need.  There are a number of different rules regarding income, assets, and gifting.

Understanding Florida Nursing Home Medicaid Rules. Read More to Understand How It Works.

Florida Nursing Home Medicaid Rules state that an individual applicant must have $2,829 or less in monthly income.  This is income from any and all sources, including but not limited to social security income, retirement pensions, VA benefits, IRA/401k/annuity distributions, etc.  If an applicant receives more than $2,829 in monthly income, steps must be taken to artificially lower their income.  This is completely within The Department of Children and Families’ rules.  The most common way to “lower” income when it is over the limit is by using a Qualified Income Trust.  Excess monthly income plus a buffer is added to the Qualified Income Trust every month.  While this money is still used for the applicant’s health needs, it is not considered income for qualification purposes, which means that according to DCF, the applicant is then within the income limit.

Florida Nursing Home Medicaid Rules state that the countable asset limit is $2,000 for an individual applicant.  “Countable” means that the Department of Children and Families will consider those assets when determining eligibility.  The goal is to convert excess assets from the “countable” category to “non-countable”, or “exempt”.  The exempt category is preferrable, because the state cannot try to collect on exempt assets, whereas they can with non-countable assets.  The name of the game is rearranging assets so that they fit within Florida Nursing Home Medicaid Rules so that the applicant can qualify.

Another area in which it is crucial to understand Florida Nursing Home Medicaid rules is gifting.  The Department of Children and Families looks at the 5 years (60 months) prior to a Medicaid application to see if gifting has occurred.  The reason that The Department of Children and Families looks at this is to try to ensure that applicants were not trying to give away large portions of their assets to people, presumably friends or family, in order to try to qualify for Medicaid by being under the countable asset limit.  They consider financial gifts for holidays, birthdays, etc. gifting, as well as selling assets for less than fair market value.  Florida Nursing Home Medicaid Rules state that any gifting that exceeds $10,300 will result in a period of ineligibility.  However, according to Florida Nursing Home Medicaid Rules, steps can be taken to correct this gifting.


Platinum Benefit Services has an expert understanding of Florida Nursing Home Medicaid Rules and can help guide you through the process.  We have obtained over 14,000 approvals for our clients over 27 years of service.  We stay up to date with Florida Nursing Home Rules to ensure we make the best decisions for our clients, resulting in correct approvals for their Medicaid applications.  If you need help navigating these rules, contact Platinum Benefit Services today!

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