Florida Medicaid Q & A

Income

Q: Must all of an institutionalized person's income be paid to a nursing home for their care?

A: Not all. A person may keep $35/month for personal needs. A spouse or other qualifying dependent will also be allocated a monthly allowance. The rest of the institutionalized person's income will be paid to the nursing home.

Q: Will I have to use my income to help pay for my spouse's nursing home care who is Medicaid qualified?

A: No. If your spouse is Medicaid qualified, only his/her income will be used to pay for nursing home care minus the $35/month for personal needs.

Q: If my income is above Medicaid's income guidelines, will I be required to help pay for the nursing care facility for my spouse?

A: No. The income of the spouse living at home is not considered. You will not need to use your income to pay for your spouse's nursing home care.

Q: What is considered income?

A: Any income such as pensions, alimony, Social Security, rental property, VA benefits, annuity pay outs, and IRA distributions.Any income counts toward countable income when qualifying for Florida Medicaid.

Q: My disabled child lives at home with me. If I go into a nursing facility will he be able to keep my income for his support?

A: When a disabled child lives at home, there are guidelines that will allow him to receive part or all of your income.

Q: As a single person if I go into a nursing home can my income be used to pay for my home expenses?

A: If you qualify for Medicaid and you are single, your entire income minus the $35/month for personal expenses must be paid for nursing home care.

Assets

Q: Does Medicaid follow the same rules as the IRS in regards to assets?

A: No. Medicaid has its own set of rules. It does not follow the same rules as the IRS.

Q: What are considered assets?
A: Assets are anything of value such as real estate, vehicles, financial accounts, life insurance policies, and some trusts. An IRA with the RMD (required minimum distribution) set up will not count as an asset.

Q: My father and I have a joint bank account. Can I take half of the money before he applies for Medicaid.

A: Only if you can prove that you contributed to half of the money that is in the account. Otherwise, no. Without documentation for your contributions, Medicaid will view all joint bank accounts and investments to be hers.

Q: I have a disabled child living in my home; can I give any of my assets to her?

A: Yes. Medicaid considers disabled children of any age who are living at home and need financial assistance.

Q: Is my winter home in another state considered a countable asset?

A: Yes. All real estate are considered assets. However, there are allowable exceptions.

Q: Will Medicaid take my house that is homesteaded?

A: No. Your primary home is protected in Florida from all creditors including Medicaid. However, depending on the amount of equity in the home, an individual may be ineligible for a nursing facility unless a spouse or dependent or disabled child resides in the home.

Q: My mother has a second home that is rented. Will the home count as an available asset if she should go into a nursing home?

A: No. As long as it is rented for fair market value, the rental property is excluded as an asset. However, the income minus expenses will go to the nursing home to help pay your mother's patient responsibility.

Q: Is the cash value of my life insurance policy considered a countable asset or is that exempt?

A: Medicaid only allows for a $2,500 face value exemption. Values greater than $2,500 are considered countable assets.

Q: Are the limitation on purchasing a pre-need burial planning?

A: There are no limitations if the burial contract is irrevocable. For contracts that are revocable, Medicaid allows for $2,500 burial contract that is not viewed as an asset.

Transfers & Gifts

Q: What is the look back period?

A: Medicaid will require information to be provided for all assets given away within the past five years..

Q: Am I allowed to give my two children every year the allowable $13,00 tax exemption?

A: No. That is an IRS guideline, not Medicaid. Medicaid has no such allowable transfer.

Q: What if I already gave money to my children and now need nursing home care?

A: All transfers and gifts need to be disclosed to the Department of Children and Family Services. Senior Information Centers will work with elder law attorneys to explain your options.

Q: My husband just entered a nursing. Will I be required to provide bank statements dating back five years?

A: No. Typically you will need to provide statements for the past three months.

Q: I have been living with my son and contributing to household expenses. Is this money considered a transfer?

A: Not if the amount you paid is considered fair and reasonable. If so, it will be considered normal living expenses.

Q: If I am penalized for recent transfers and gifts, what will Medicaid do?

A: Medicaid has a calculation to determine the penalty period.

EXAMPLE: Assuming Jane otherwise qualifies for Medicaid and she transfers $10,000 in November 2008 and $8,500 in December 2008 for a total transfer of $18,500, her penalty period is 3.7 months. This is calculated by dividing $14,500 by $5,000. Multiplying the .7 times 30 days results in 21 days. Jane applies for Medicaid benefits for January 1, 2009. Because of the transfers, she is disqualified for January, February, March, and 21 days in April during 2009.