Seniors in need of long-term care often struggle with the cost. Fortunately, help is available. The Florida Medicaid program covers nursing home expenses for qualified seniors. Applicants must meet the medical, income and resource requirements to be eligible for coverage. Florida residents can apply for Medicaid by visiting the Department of Children and Families.
Medicaid applicants must have a medical need requiring the specialized care provided by a nursing home. Nursing home care is available to individuals who are unable to carry out daily living activities. The activities include bathing, cooking and taking medication. Applicants must be examined by a doctor or in some cases, several doctors. A physical therapist, occupational therapist, speech therapist and even social worker may need to evaluate the patient. Doctors submit the information to The Department of Health and Rehabilitative Services (HRS) to make a decision.
To be eligible, the applicant must fall below the income limit. There are no income limits for a healthy spouse who is not entering the nursing home. A healthy spouse is often referred to as a community spouse. In 2010, the applicant's gross income cannot exceed $2,022 a month. If the applicant has a healthy spouse with an income of $1,822 a month or less, Florida Medicaid laws allow the spouse to request a portion of the applicant's income, known as income diversion. The income diversion limit is $2,739. For example, if the person entering the nursing home receives $3,000 a month and the healthy spouse has an income of $1,800, $939 of the applicant's income can be diverted to the healthy spouse. All sources of income, both earned and unearned, are calculated in the total gross monthly income.
An applicant must not exceed the allowed amount of countable assets. The home, vehicle, personal property and prepaid funeral or burial expenses are exempt. Liquid assets, including cash, bank accounts and property, are countable assets. In Florida, there is a 60-month look-back period. Medicaid will verify all accounts and assets to make sure assets were not transferred or given away to qualify for coverage. As of 2010, allowed assets must be $2,000 or less. If the applicant earns less than $808 a month, the resource limit is raised to $5,000. The healthy spouse is allowed to maintain $109,560 in assets.
The nursing home must be approved by Medicaid. You can locate a Medicaid-approved nursing home by visiting the Nursing Home Compare section of the Medicare website. Narrow your search by selecting "Medicaid."