Can You Use Medicaid for Long Term Care Nursing Home Costs?

As people get older, their care needs increase exponentially, especially when they need long-term care such as assisted living or nursing home services. Many people believe that Medicare will cover the cost of nursing home or assisted living facility care. This is not true. Medicare will only pay a limited benefit for skilled nursing for 100 days and provides no coverage for long-term care, non-skilled care, assisted living, or custodial activities. With the average nursing home cost in Florida averaging above $8,000 per month, most individuals’ life savings will be wiped out. Attorney Melissa Williams is a Medicaid expert who provides Medicaid planning for clients who wish to preserve their life’s savings by obtaining Medicaid benefits for nursing home or assisted living facility care.

Florida’s Managed Long-Term Care Programs

Medicaid is a joint federal and state program, which means the federal government and the state both contribute to the benefits, but states have the ability to be flexible and control their rules individually, including what the program will pay for and who qualifies. This is particularly important to keep in mind because only a Florida elder law attorney can help you qualify for Florida Medicaid benefits. There are two different program in Florida that provide Medicaid benefits for long-term care needs:

  • Medicaid Waiver Program: This program provides benefits for in-home and assisted living care. The applicant must be Medicaid-eligible and must need nursing home level of care. The Medicaid Waiver Program is currently underfunded and many individuals who apply for the Waiver Program end up on long wait lists before they ever receive benefits. An elder law attorney who is a Mediciad expert can help you navigate the intricacies of the Medicaid Waiver Program, reduce time on the wait list, and obtain approval for Medicaid Waiver benefits faster.
  • Institutional Care Program (Medicaid ICP): This program provides benefits for individuals who need skilled nursing care. You must meet the following basic criteria to be eligible for Medicaid ICP benefits:
    • You must be a resident of Florida and a U.S. citizen or have proper immigration status.
    • You must be at least 65 years old, blind, or disabled and need care for more than 30 consecutive days.
    • Your monthly income cannot be greater than the imposed income limit.
    • Your assets cannot be greater than the imposed asset limit.

Many people believe that if they have income or assets over the imposed limits they cannot receive Medicaid benefits for nursing home or assisted living care. In most cases, this is not true. An elder law attorney who is a Medicaid expert can conduct a thorough analysis of assets and income, propose a plan to ethically restructure assets and income to help the individual qualify for Medicaid benefits while also preserving assets, and assist the applicant and their family in submitting and processing the Medicaid application.

In order to find out if you qualify, or to learn more about how we can help you create a plan for your assets so that you can qualify, we invite you to speak with a St. Petersburg elder law attorney at our office.

Call us today at (727) 280-6837 to schedule a consultation.

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