Medicaid Benefits Planning

For those individuals who require medical and/or nursing home treatment, Medicaid is a federal and state program which can significantly assist those who can show true need. Once qualified, a person may be eligible for the state of Florida to pay the difference between their monthly income and the monthly medical / care expenses. Benefits may be available for in-home and assisted living facility care and are always available for skilled nursing home care for those who qualify.

If you meet the following requirements, you may be able to receive specific benefits for Florida Medicaid.

• Age 65 or older, or blind or disabled.
• Resident of the state of Florida.
• Physical Limitations – you must need support with some daily living activities in order to be considered for Medicaid. Those activities may include needing help with walking and standing, feeding, getting dressed, bathing and performing basic toilet and hygiene functions.

Keep the following information in mind when determining whether or not you or a loved one qualifies for Medicaid assistance: If you possess substantial assets, you may be able to make transfers or gifts in order to decrease your countable assets however you will then be subject to a five-year look back period from the date the asset(s) is transferred – meaning you will be responsible for your own or your loved one’s care bills until the five year penalty period from the date of the transfer has ended.

The income of the person applying for Medicaid benefits in 2019 may not surpass $2,313 per month. When considering assets, the assets considered non-exempt may not exceed a value of $2,000.  The spouse of a married applicant who resides in the same community is allowed assets up to the amount of $126,420 in addition to the exempt assets below.

Your home (up to $572,000 in value) and one vehicle of unlimited value are exempt assets according to Medicaid.  This means they do not count as assets and can be kept in addition to the $2,000 mentioned above for the person needing care and the $126,420 for the spouse in the community.  In addition to these, there are additional exemptions.  Please call Byrski Estate & Elder Law at (941) 833-9262 for a consultation to find out what else can be categorized as an exempt asset under Medicaid rules.

Unfortunately, many people desperately require Medicaid coverage in order to meet the considerable expenses of nursing home care, but will not immediately meet the asset and income test. These cases benefit the most from the services of a highly knowledgeable attorney who can develop strategies to allow qualification. These strategies may include the following:

1. Qualified Income Trust—Should your monthly income exceed the cutoff of $2,313, an irrevocable qualified trust, also known as a Miller Trust should be considered. Once such a trust is created and the benefits for Medicaid are approved, your income will be deposited into this trust monthly and distributed as follows:
   • • A personal needs allowance in the amount of $130 is retained by the applicant.
     • For married applicants whose spouse’s income is below the stated Monthly Maintenance Income Allowance of $2,057.50, the difference between the spouse’s income and the MMIA will be paid to the community spouse.
     • Some health insurance premiums may qualify under the Qualified Income Trust rules.
     • The remainder of the applicant’s income is paid to the nursing home or other facility which provides care and is known as the patient’s responsibility.

   The most crucial issue surrounding a Qualified Income Trust is management of the trust, meaning the income received monthly must be properly managed each month. Creation and implementation of the trust must be in place prior to the Medicaid application being processed.

2. Personal Service Contracts—One popular method of satisfying the asset eligibility test for Medicaid is through a personal service contract. This is most often necessary when the applicant’s assets exceed the allowable amount of $2,000 and exempt assets have been exceeded or are not an option. A service contract allows assets to be effectively transferred to a trusted family member or friend in exchange for services not provided by the nursing home or other facility. Such services could include personal shopping, weekly visitation, paying and managing exempt assets and bills, and care coordination and meeting with facilities. Please note however that monies paid under a Personal Service Contract are taxable as income to the person receiving the payments.

Let us help you determine the best Medicaid planning strategy that will work for your particular situation. Please call us at (941) 833-9262 and schedule a consultation before you proceed with spending down, gifting away or retitling assets.