To Qualify for Florida’s Long-Term Care (LTCC) Medicaid program you must meet the Income and asset limits, even if you meet the nursing home level of care (and are 18 years or older).
The income limit for an individual applicant is $2,742 in gross monthly income to qualify for the Medicaid Long Term Care benefit. Income includes money from pensions, wages, interest received from any source, IRA distributions, annuity payments, dividends, monthly rental income, and all monies received from social security. If you receive SSI, then you are already eligible. If you are over the Income Limit, then a referral would be made to a trusted Elder Law Attorney who would offer you the legal advice on how you could still qualify for Medicaid by using a Qualified Income Trust.
In general, the Medicaid rule for a nursing home resident is that the applicant must pay all their income to the nursing home except for $160 per month. The resident keeps $160 per month for their own “personal needs allowance” (PNA). Medicaid pays the remainder of the nursing home costs above the resident’s monthly income due to the nursing facility.
For Medicaid applicants who are married, the income of the community spouse is not counted when determining the Medicaid applicant’s eligibility. Only income counted in the applicant’s name is counted towards the Medicaid Income Limit. So even if the community spouse is still working and earning, say, $5,000 a month, this income is NOT counted towards the applicant’s gross income limit per Medicaid. The community spouse’s income will not be included in the amount due to pay the nursing home. However, if the community spouse’s income exceeds a certain level, then he or she would have to make a monetary contribution out of the Medicaid applicant’s income towards the cost of the nursing home care. The maximum amount of monthly income that Medicaid could require to be paid to the nursing facility is the Medicaid applicant’s gross income less $160 for the client’s personal needs. The community spouse’s income is not considered in determining the applicant’s eligibility, but it does affect if the community spouse qualifies to retain some of the applicant’s income with spousal diversion.
Spousal Diversion
When the community spouse applies for Spousal Diversion there is a complex formula that The Department of Children and Families uses to take into account the community spouse’s income versus the cost of household expenses and bills. Spousal Diversions protect the community spouse from becoming impoverished. When eligible for this benefit, Medicaid would pay the difference in the cost of care to the nursing facility and would allow the community spouse to maintain some or all the Medicaid recipient’s income.
WE CAN STILL HELP IF YOU DO NOT INITIALLY APPEAR TO QUALIFY:
We are NOT an attorney service and DO NOT OFFER legal advice. However, if you are over the gross income limit and are seeking acceptance into the Medicaid program, then Medicaid and More… can setup a FREE CONSULTATION with a trusted Elder Law Attorney who can discuss how you may still qualify for Medicaid with Medicaid Planning.
Medicaid and More… would continue to file and process the Medicaid application while you follow the Legal Advice of the Elder Law Attorney.
