Medicaid Planning Attorney

According to Florida Health, about 25 percent of Florida’s population is enrolled in Medicaid. Although this might sound like a significant number, many residents sit on the sidelines – struggling to get access to Medicaid due to a range of challenges. With help from a Medicaid planning attorney, applicants can approach these hurdles with confidence and efficiency.

The first step in this process is to understand the value of Medicaid planning – a strategy that streamlines the pathway to crucial, affordable medical care in Florida. Medicaid planning can address issues involving medicaid applications, medicaid eligibility, long-term care, and asset protection for your loved ones. To discuss the most appropriate Medicaid planning strategy based on your unique situation, consider a consultation with a qualified Medicaid planning attorney at the Medley Law Firm.

Why Medicaid Planning Is Essential

Medicaid planning is essential for several reasons. That being said, each Florida resident approaches Medicaid with unique needs and priorities – and it may be helpful to discuss your specific situation alongside a Medicaid planning attorney. 

Medicaid Offers Extensive Benefits

Medicaid planning is essential because it can give you access to a range of low-cost or free medical services. These are not necessarily limited to critical, life-saving treatments, and they can even include dental care. Access to Medicaid may be especially important for seniors, as it sometimes covers nursing home care, hospice care, home healthcare, medical transportation services, and more. These treatments can potentially help seniors “age in place” without leaving the comfort of their own homes – a key priority for most elderly individuals in Florida. 

Medicaid Eligibility Might Be Easier than You Think

Many seniors assume that because they have certain levels of wealth, they are ineligible for Medicaid. However, this isn’t always true – and it is possible to qualify even if you have reliable income and lucrative assets. An experienced elder law attorney can guide you on qualifying for medicaid. Before you completely dismiss the possibility of coverage, you may want to discuss your financial situation in more detail with a Medicaid planning attorney.

Remember, a standard room in a nursing home or assisted living facility can cost you or your family tens of thousands of dollars each year. Even if you consider yourself to be a relatively high-net-worth individual, these costs can quickly lead to financial turmoil. An attorney can guide you on whether you might be able to spend down some of your assets to qualify.

Medicaid Policies Can Change Without Warning

The need for effective Medicaid planning became clear after the COVID-19 pandemic. In 2023, millions of Florida residents suddenly faced the possibility of losing access to Medicare due to changes in federal policy. During the pandemic, this policy kept people enrolled in Medicare without requiring them to prove eligibility. With the expiry of this program, Florida announced plans to assess eligibility once again – potentially leading to the loss of coverage for many people. This situation shows how quickly Medicare policies can change, and it highlights the need for effective Medicaid planning. 

People Are Living Longer

Medical technology is constantly advancing, and this is leading to longer average lifespans for Florida residents. While this is certainly worth celebrating, it also creates a number of new issues that families have never before encountered in American history. You may have calculated your healthcare and retirement budgets based on a much shorter average lifespan, and your savings may be inadequate. Longer lifespans also put more strain on the health care system across Florida, and it may be essential to secure access to treatment through Medicare. 

Medicaid Planning: Eligibility Issues

Medicaid planning can help you approach various eligibility issues: 

General Requirements for Medicaid in Florida

To qualify for Florida Medicaid, you must meet several requirements. First, you must be a resident of the State of Florida. New arrivals to Florida or the United States may need to prove this residency, and certain waiting periods may apply. Next, you must be at least 65 years of age. If you are not yet 65, you must be blind or disabled. Finally, you must show that you need help with everyday tasks. 

Financial Eligibility Requirements for Medicaid in Florida

Because Medicaid primarily targets low-income individuals, there are several financial requirements to consider as well. However, these requirements do not apply if you are already eligible for Supplemental Security Income (SSI). 

• Income: The income limit for Medicaid eligibility changes each year based on inflationary pressures. In 2024, this income limit is $19,392 per year. If you earn more than this per year, you are technically ineligible for Medicaid. However, this income limit depends on how many people are in your family. If you are applying for Medicaid alongside a spouse, for example, the per-household limit is a combined sum of $26,228. Note that these limits can change with each passing year, and it is best to consult with a Medicaid planning attorney for up-to-date information. 
• Assets: If you are not married, you can only apply for Medicaid with nonexempt assets worth $2,000 or less. However, there are many caveats and exemptions to consider. If you own a family home, that asset is generally exempt from Medicaid calculations – as long as the value is below a certain level. This “home equity cap” changes from year to year, and in 2024 it is $713,000. Any outstanding debt on the property is subtracted from this value. Other exempt assets include furniture, life insurance, one vehicle, and certain funeral costs. 

The Medicaid Planning Process Explained

When a spouse engages in the Medicaid planning process, they typically adjust their financial situation in a way that helps them qualify. A range of strategies can help spouses address various barriers to Medicaid enrollment. Here are a few examples:

Spousal Refusal

Spousal refusal is one of the most common Medicaid planning strategies, and it addresses asset eligibility limits. In Florida, spouses are allowed to give each other cash gifts without any penalties. If one spouse does not yet need Medicaid while the other is receiving extensive care (perhaps in a nursing home), a gift transfer can eliminate asset limits.

The patient receiving care can transfer most of their assets to their spouse, and the other spouse can then legally “refuse” to pay for continuing treatment. As a result, the patient immediately becomes eligible for Medicaid – even though the family estate has assets that exceed normal Medicaid limits. 

Qualified Income Trusts

In other situations, a patient may receive annual income that exceeds Medicaid limits. Note that many Florida residents earn income even after retirement, and this is often passive in nature. Examples include dividends, Certification of Deposit (CD) yields, and rental income. Even if spouses earn modest returns on these passive income strategies, they can easily exceed Medicaid’s income eligibility limits. 

A qualified income trust (QIT) can help address this issue. Generally speaking, you no longer “own” assets after you transfer them into a trust. With this legal barrier in place, you can distance yourself from your income and qualify for Medicaid. 

Pre-Crisis Long-Term Care & Medicaid Planning

When it comes to healthcare, a proactive approach is almost always better than a reactive approach. In other words, Medicaid planners should consider their health care needs before tragedy strikes – and not after. This is why it is important to qualify for Medicare as soon as possible. Without a proper pre-crisis plan in place, the financial cost of long-term care can be ruinous. 

Contact a Medicaid Planning Lawyer Today

While online research highlights the need for effective Medicaid planning, no amount of reading will actually implement any of these strategies. To get started with a real Medicaid plan, consider working with qualified elder law attorneys. Reach out to the Medley Law Firm today and schedule a Medicaid planning consultation at our Pensacola office. 

Frequently Asked Questions

A number of questions frequently arise during the Medicaid planning process:

1. What is Medicaid planning, and what does it involve?

Medicaid planning helps people in Florida approach virtually every aspect of the Medicaid process. This includes not only the application process, but also strategies involving asset protection, tax planning, and estate planning. 

2. Is Medicaid only for people with significant financial needs?

While Medicaid is primarily geared toward low-income families, other individuals may also be eligible. These include pregnant people, elderly individuals, and disabled individuals. With help from a Medicaid planning attorney, it is possible to qualify even if you own certain assets that are not normally exempt. 

3. How long will it take to become eligible for Medicaid?

If you meet the eligibility requirements, you become eligible for Medicaid immediately. However, it may take up to 45 days for the Medicaid agency to process your application – perhaps even longer if your application has issues. If you are an immigrant, you may need to wait five years before applying. There is also a five-year lookback period that may apply to asset and income calculations for Medicaid. 

4. How does Medicaid planning work?

Medicaid planning helps you qualify even if you are ineligible at first. With help from a Medicaid planning lawyer, you can become eligible by carefully adjusting certain aspects of your finances – including income and assets. 

5. How can Medicaid help me?

Medicaid covers a range of medical services – including visits to your doctor, outpatient care, medical supplies, and preventative medicine. It may also cover prescription drugs, physical therapy, and occupational therapy in some cases. With Medicare coverage, these medical services may be free or low-cost. 

6. What are the most important Medicaid benefits?

Most of Medicaid’s benefits involve acute care, which is treatment for serious diseases, injuries, and illnesses. Another important benefit involves long-term care for seniors. For pregnant individuals, the most important benefits of Medicare involve giving birth. In recent years, Medicaid has expanded to include preventative medicine.