The Florida Medicaid Program

The Medicaid Assistance program (“Medicaid”) is a federal health insurance program administered by the states.  In Florida, the Department of Children and Families determines eligibility, and the Agency for Health Care Administration administers the program.

Program Eligibility Requirements

These are the requirements for Medicaid eligibility:

1.     65 years of age or older, blind or disabled

2.     A Florida resident

3.     A US citizen or an alien admitted for permanent residence

4.     The applicant must be medically needy and residing in a Medicaid qualified nursing facility within 45 days of application, and

5.     The applicant’s income and assets must not exceed certain specified levels

6.     Income Limitations:  Monthly income may not exceed $1,911 per month for 2008

7.     Assets Limitations:

a.      A single person may retain $2,000 in countable assets

b.     If married, the applicant may retain $2,000 in countable assets and the spouse living at home may retain $104,400 in countable assets in 2008

c.     A married couple where both are in the nursing home may retain $3,000 in countable assets

d.     Countable assets:  Bank accounts, certificates of deposit, stocks, bonds, retirement plans, IRA’s and Keogh plans, life insurance, and any other assets not otherwise exempt or excluded are countable assets for Medicaid purposes.

e.      Exempt assets: 

     1.  Homestead property  up to value of 
          $500,000 if the applicant intends to 
          return to house or the community
          spouse or a dependent relative is
          residing in the home.

                   2.  One car and a second car if 7 years  
                        old and is not a luxury car or antique.

3.     Household furnishings and personal effects up to $2,000 in value are exempt.

4.     Life insurance with a cash surrender value of less than $2,500 is exempt.  There is no limit on term insurance.

5.     Cemetary plots for the applicant or applicant’s family are exempt.

6.     Prepaid irrevocable burial contract with a cemetery or funeral home of any value are exempt.

Excludable or Noncountable Assets for Medicaid

7.     Non liquid assets which are unmarketable.  These may include a life estate in real or personal property which are determined to be unmarketable.

8.     The fair market value of income producing property essential to self-support.

9.     The value of pension plans, IRA’s, and Keogh plans which are being distributed to the applicant or the community spouse on an actuarial sound basis are excluded.

What will Medicaid pay?

The Medicaid program covers nursing home care, drugs, doctors, therapy, and medical equipment.