How to Qualify, Obtain and Maintain Medicaid Benefits
Ruth C. Rhodes • November 7, 2022
The average nursing home costs in Florida might shock you. As a senior needing nursing home care, you'll need to be prepared to pay between $8,654 and $9,627 monthly.
As seniors near the end of their lives, often those amounts are insurmountable. They could never have saved enough to afford this potential cost. This is especially true because you can never know how long you'll need this type of care.
What does a senior do when their Medicare stops paying but needs to remain with nursing home care? For many, it means turning to Medicaid.
Medicaid benefits can be so important for those in need. It's essential to consider Medicaid planning in Melbourne, FL, for the future. Read on to learn more about Medicaid benefits in Florida.
Medicaid in Florida
It's important to understand the basics of Medicaid because it's a wide-sweeping program providing important services for many people who need it.
Medicaid in Florida is a state and federal program providing health care services for low-income individuals in the state.
Medicaid provides services for many in need, including:
- Pregnant women
- Children
- Senior residents needing long-term care
Medicaid helps seniors to pay for care in nursing homes, adult foster care homes and assisted living facilities. They also provide some necessary funding for non-medical needs for seniors in need who are homebound.
How Are Medicaid and Medicare Different?
When considering seniors needing assistance, many confuse Medicare vs. Medicaid. It's not uncommon for people to assume the two are the same.
While both can provide important services for seniors, they are not the same.
Medicare is an entitlement program developed for seniors and some disabled citizens. You become eligible for Medicare at age 65 if you've been paying into the system while working.
So, how is Medicaid different? Medicaid is a need-based program. It can help seniors and those with a disability with long-term care beyond the scope of Medicare.
Instead of age and paying in like with Medicare, you're eligible for Medicaid based on financial need and your medical necessity/disability.
Income and Asset Limits for Florida Medicaid
To qualify for Medicaid, you must meet a series of criteria through the State of Florida and the federal government.
First, you must meet age, citizenship, and residency requirements. Next, if you need care from a nursing home, you must be disabled, blind, or of advanced age.
You'll need to show that you need a nursing home level of care. The Department of Elder Affairs (Cares Units) is part of the assessment for eligibility.
Medicaid Planning
To obtain Medicaid and maintain Medicaid benefits, you must be prepared to jump through some hoops when applying. Many people who anticipate a future need will do Medicaid planning to set up their finances, so they support Medicaid eligibility.
Medicaid planning might include:
- Spending down your assets, then buying replacement assets that are not counted toward Medicaid asset limits
- Transferring assets to your children
- Transferring assets to a spouse who doesn't need long-term care
- Creating a Medicaid-qualifying income trust (a "Miller Trust")
You might also be able to create a Florida Medicaid trustor to shield some income or assets while you're in long-term care.
Get the Help You Need With Medicaid Planning in Melbourne, FL
Programs like Medicaid are important when you need care the most. They're especially important to those who can't pay for long-term care themselves.
If you anticipate the need for Medicaid planning in Melbourne, FL, we can help. Let us use our experience and knowledge to guide you through the process. Contact us today to get started.
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An Aging Adult with Cognitive Decline One of the most common reasons for guardianship is when an older adult develops conditions such as dementia or Alzheimer's disease and can no longer safely manage daily activities, medical care, or financial matters. Guardianship may be needed if the individual: Forgets to take medications Is vulnerable to financial exploitation Cannot understand important decisions Is unable to provide for their own safety 2. A Person with a Developmental Disability Some adults with developmental disabilities may require ongoing assistance with decision-making. While many individuals can live independently with support, guardianship may be appropriate when a person lacks the capacity to make critical life decisions and no less restrictive alternative is sufficient. 3. Serious Mental Illness or Cognitive Impairment Individuals experiencing severe mental illness, traumatic brain injuries, or other cognitive impairments may be unable to consistently make informed decisions regarding their health, safety, or finances. In these situations, guardianship may provide legal authority for a trusted individual to step in and assist. 4. A Minor Without Available Parents Guardianship is often necessary when a child's parents are deceased, incapacitated, incarcerated, deployed, or otherwise unable to provide care. A legal guardian can then: Make educational decisions Consent to medical treatment Provide housing and daily care Act in the child's best interests 5. Emergency Situations Courts may appoint temporary or emergency guardians when immediate intervention is necessary to protect an individual from harm. Examples include: Urgent medical decisions Risk of financial abuse Unsafe living conditions Sudden incapacity following an accident or illness When Guardianship May Not Be Necessary Courts generally prefer less restrictive alternatives whenever possible. Guardianship may not be necessary if the individual has already established legal tools such as: Durable powers of attorney Healthcare powers of attorney Advance healthcare directives Revocable living trusts Supported decision-making agreements These arrangements often allow assistance without removing significant legal rights. How Courts Determine Whether Guardianship Is Needed Before appointing a guardian, courts typically examine: Medical evaluations and expert opinions The individual's ability to understand decisions The person's functional limitations Available alternatives to guardianship The extent of assistance required The court's goal is to protect the individual while preserving as much independence as possible. 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Conclusion Legal guardianship is typically necessary when a person cannot adequately care for themselves or make informed decisions, and no less restrictive legal option can provide the needed protection. Whether the situation involves an aging parent, an adult with a disability, or a child without parental care, guardianship can offer an important legal framework for ensuring safety, stability, and proper decision-making. Because guardianship affects fundamental rights, it should be pursued thoughtfully and only when truly necessary. At Rhodes Law, P.A., we believe in proactive planning whenever possible. We encourage clients to establish advance directives, such as powers of attorney and healthcare surrogates, to help avoid the need for guardianship proceedings and ensure their wishes are honored in the future. Please contact Rhodes Law, P.A. to schedule your free estate planning consultation so we can advocate for you in the event of incapacity!
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Navigating the Nuances of Florida Homestead Law - Perhaps the most significant shock for many professionals moving to Brevard County is the complexity of Florida Homestead Law. This is a proprietary legal concept unique to Florida that provides three distinct benefits: asset protection from creditors, property tax exemptions, and strict restraints on how you can devise (leave) your primary residence in a Will or Trust. If you have a spouse or minor children, Florida law may limit your ability to leave your home to anyone else—even if your out-of-state Trust says otherwise. Failure to align your estate plan with Florida’s Constitutional requirements regarding homestead property can lead to your home being tied up in probate, or worse, being distributed in a way that contradicts your actual wishes. A Melbourne, FL elder law attorney or estate practitioner can help you structure your Trust to ensure it harmonizes with these protections rather than conflicting with them. 2. Qualifying Your Personal Representative - In many states, you can name almost any trusted individual to serve as the Executor or Personal Representative of your estate. Florida, however, is significantly more restrictive. Under Florida statutes, a Personal Representative must be either a Florida resident OR a blood relative (or certain other close relatives). If you moved from the Midwest and named a lifelong friend from your hometown as your Executor, and that friend is not a resident of Florida and not related to you by blood, the Florida probate court will disqualify them from serving. This frequently results in the court appointing someone you did not choose to manage your private affairs. Updating your plan ensures your chosen representative meets local statutory requirements. 3. The Shift in Durable Power of Attorney Standards - Florida’s laws regarding Powers of Attorney underwent a massive overhaul in 2011. 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