Medicaid is a nationwide health insurance program that provides low-income, low-asset Americans with limited access to services and supports that promote health and wellness. Medicaid is a joint program between the federal and state governments, and in Florida, the Agency for Health Care Administration, a branch of the Florida Department of Children and Families, administers Medicaid.
Florida seniors aged 65 and older must meet strict income and asset criteria to qualify for Medicaid coverage. Individual seniors can earn no more than $2,313 a month and own no more than $2,000 in countable assets, while couples applying together can earn no more than $4,626 per month and own no more than $3,000 in countable assets.
Under Medicaid rules, countable assets include cash, bonds and investment real estate, while income from all sources includes wages, pension, stock dividends and alimony. Some assets are excluded, such as personal effects, furniture, one vehicle and a principal residence valued at $585,000 or less.
Like all states except California, Florida has a five-year Medicaid asset look-back period. Seniors who apply for Medicaid may be subject to penalties on any assets they transferred or gifted during the 60-month period prior to their Medicaid application. Medicaid look-back penalties are assigned based on a calculation that divides the total value of the uncompensated transfers divided by the average monthly cost of a private-pay nursing home to determine the Medicaid ineligibility period.
Seniors in Florida who meet the criteria for Medicaid coverage and have needs that would normally require nursing home placement may be eligible for additional assistance through the Florida Statewide Medicaid Managed Care, Long-Term Care Program, or SMMC LTC.
The LTC program is designed to reduce statewide nursing home admission rates by providing seniors with long-term care services in their homes, the community or an assisted living facility. These services are distributed according to the seniors’ long-term care plan and may include:
- Attendant care and adult day care
- Homemaker
- Medication administration and management
- Personal care
- Skilled nursing
- Respite care
- Transportation
- Physical, speech and occupational therapy
To learn more about Medicaid and the Florida Statewide Medicaid Managed Care and Long Term Care Program, call the Agency for Health Care Administration at (877) 711-3662 or the Florida Elder Helpline at (800) 963-5337.