Will Medicaid Pay for your Nursing Home Care?


All states, including Florida, have a Medicaid program for qualified individuals who need nursing home care; this program is called Institutional Medicaid.

Institutional Medicaid may pay for a stay in a nursing home if you need a nursing home level of care or meet nursing home functional eligibility criteria and have income and assets below certain guidelines, discussed in some detail below.

If you qualify for Institutional Medicaid, you will be able to keep a small amount of your monthly income for a personal allowance (currently in Florida the personal allowance amount is $130 per month). You will have to pay the remainder of your income to the nursing home unless you qualify to divert some income to your spouse.

Institutional Medicaid has a look-back period of up to five years. This means that Florida will count any assets you transferred (for example, transfers include selling, gifting, retitling to a trust, etc.) in the past few years when determining your eligibility. If Medicaid determines that you transferred assets in violation of the Medicaid rules, it can penalize you by not paying for part or all of your nursing home stay.

The current income and asset requirements for Florida Institutional Medicaid are outlined here:

Income Requirements

  • Medicaid Applicant:  The Medicaid applicant’s gross monthly income cannot exceed $2,250.00 (effective Jan.1, 2018).
  • Medicaid Applicant’s Well Spouse: There is no limit on the well spouse’s gross monthly income. If the well spouse’s gross monthly income is below $2,058.00 (effective July 1, 2018), a portion of the applicant’s income may be diverted to the well spouse.

Asset Requirements

  • Medicaid Applicant: The Medicaid applicant cannot own countable assets in excess of $2,000.00 in addition to exempt and countable assets. Countable assets can include bank accounts, investment accounts, life insurance policies, etc.
  • Medicaid Applicant’s Well Spouse: The Medicaid applicant’s well spouse may retain up to $123,600 (effective Jan. 1, 2018) in assets plus exempt, non-available and income-producing assets.

If you or your spouse have excess income or excess assets, many legal steps may be available to qualify you for Medicaid without spending your savings on the nursing home.  Be sure to consult with an attorney who is familiar with Medicaid planning and asset protection options.

Questions about qualifying for Medicaid and protecting your assets?  Call me to discuss your options. 

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