Medicaid is the nationwide health coverage program that was established on July 30, 1965, extending health services to those who have a low income and minimal assets. Jointly funded by federal and state governments and administered by each state, Medicaid provides primary, emergency and long-term health services at no cost to individuals who meet coverage criteria.
In Florida, Medicaid is administered by the Agency for Health Care Administration. Florida residents who qualify for Supplemental Security Income benefits are automatically enrolled in SSI-Related Medicaid coverage.
To qualify for no-cost Medicaid with long-term care coverage, seniors aged 65 and older can earn up to $2,313 per month ($4,626 per couple) and own up to $2,000 worth of countable assets ($3,000 per couple).
Some specific assets are Medicaid exempt, including a home that the applicant and/or their spouse lives in that’s worth up to $585,000, a non-revocable burial trust, one vehicle and personal effects, such as clothing, collectibles and household furnishings.
If only one spouse is applying for long-term Medicaid, the non-applicant spouse, known as the community spouse, can own up to $126,420 worth of the couple’s countable assets. The non-applicant isn’t expected to pay their spouse’s care costs, therefore, the income of the community spouse isn’t considered.
Qualified Income Trust
Seniors with earnings that exceed Medicaid income limits may be able to establish a Qualified Income Trust to enroll in Medicaid.
Commonly called a Miller Trust, a QIT is an irrevocable legal agreement between the applicant and the state. Income that exceeds the Medicaid limits, exempt is a personal needs allowance of $130 and any money paid towards the community spouse income, is deposited into the QIT.
The state is named as the beneficiary, and when the trust holder dies, the state is paid back for any care provided to the senior through Medicaid.
For more information on Florida Medicaid and the QIT program, contact ACCESS Florida, Northwest Region at 866-286-3609.
Statewide Medicaid Managed Care Long-Term Care Program
Florida Medicaid participants aged 65 and older who require the level of care normally given in a nursing facility may qualify for community-based, long-term care services provided within an assisted living facility under the Statewide Medicaid Managed Care, Long-Term Care Program.
The SMMC LTC is a nursing home diversion program that allows seniors to age in place in a community setting by funding enhanced medical and nonmedical care and supports, such as:
- Personal care
- Access to an emergency call system
- Homemaker services
- Transportation
- Physical, occupational and speech therapy
For more information on the SMMC LTC or to request a CARES assessment, contact the statewide Elder Helpline at (800) 963-5337.