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What Is Long-Term Care Medicaid?

Long-term care. A text label in the planning folder. A health care payment program that ensures well-being.

As we age, the need for long-term care becomes increasingly likely, with many seniors requiring assistance with daily living activities such as bathing, dressing, and eating. The cost of long-term care, whether provided at home, in an assisted living facility, or in a nursing home, can be exorbitant, quickly depleting a lifetime of savings. The costs hit home in Florida, where the median cost of a private room in an assisted living facility runs $48,000, and a private room in a nursing center is more than twice that much.

This is where Long-Term Care Medicaid comes into play, offering a financial lifeline for eligible seniors in Florida. Read on as we delve into the intricacies of Medicaid and Long-Term Care, helping you understand its benefits, eligibility criteria, and application process. For help planning to qualify for Medicaid as part of your overall strategic estate planning process, contact Shalloway & Shalloway, P.A., to visit with a West Palm Beach specialist in Medicaid planning for long-term care.

Long-Term Care Medicaid Explained

Long-Term Care Medicaid is a joint federal and state program designed to assist individuals with limited income and assets in covering the costs associated with long-term care services. In Florida, this program is particularly crucial for seniors who require ongoing medical or personal care but cannot afford the expenses out-of-pocket. Long-Term Care Medicaid covers a range of services, including nursing home care, assisted living facilities, and home health care services, ensuring that individuals receive the care they need without facing financial ruin.

You might never have thought of yourself as a person who would qualify for Medicaid, or need to. We cannot stress enough that although it is a needs-based program, Medicaid is not just for poor people who can’t afford better care. It’s a myth that only low-quality nursing homes accept Medicaid patients, and using Medicaid benefits doesn’t mean you’ll be warehoused in some dismal place. Planning for Medicaid to cover the costs of long-term care means you are facing the reality that such care is cost-prohibitive; availing yourself of government available government programs is a smart way to ensure care for yourself while maximizing care and comfort for your spouse and leaving a legacy to your children and grandchildren.

Eligibility Requirements for Long-Term Care Medicaid in Florida

To qualify for Long-Term Care Medicaid in Florida, applicants must meet specific financial and medical criteria:

  1. Income Limit: As of 2024, an individual’s monthly income must not exceed $2,829. There are legal strategies, such as the use of a Qualified Income Trust (QIT), to help individuals whose income exceeds this limit still qualify for Medicaid.
  2. Asset Limit: The asset limit for an individual is $2,000. However, certain assets are considered exempt, such as the primary residence (up to an equity limit), one vehicle, personal belongings, and prepaid funeral arrangements.
  3. Medical Necessity: Applicants must demonstrate a medical need for long-term care services, as assessed by the Comprehensive Assessment and Review for Long-Term Care Services (CARES) program in Florida.

Application Process for Long-Term Care Medicaid

The application process for Long-Term Care Medicaid involves several steps:

  1. Gather Documentation: Applicants must collect financial and medical records to prove their eligibility, including income statements, asset documentation, and medical records.
  2. Submit the Application: The application can be submitted online through the ACCESS Florida system, by mail, or in person at a local Department of Children and Families (DCF) office.
  3. Undergo Assessment: The CARES program will conduct an assessment to determine the applicant’s medical eligibility for long-term care services.
  4. Await Approval: After submitting the application and completing the assessment, applicants will receive a decision regarding their Medicaid eligibility.

Planning Ahead With an Elder Law Attorney

Navigating the complexities of Long-Term Care Medicaid can be daunting, especially when facing the challenges of aging and healthcare needs. Consulting with a Florida estate planning attorney who specializes in Medicaid planning and long-term care planning is essential. An experienced attorney can guide you through the eligibility requirements, application process, and legal strategies to protect your assets while ensuring you receive the care you need. In West Palm Beach, call Shalloway & Shalloway at 561-686-6200 to speak with a Board-Certified estate planning specialist.

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