Medicaid Planning & Eligibility


The Medicaid eligibility attorneys at Dine Elder Law can help you and your loved ones review your choices for care.

The cost of long-term care is increasing and most seniors will require some form of insurance coverage or payment method. The options available to you are long-term care insurance, private pay care and Medicaid. If you were fortunate enough to have planned ahead and purchased long-term care insurance, you still need to be aware of what your policy covers and any potential gaps.

Some individuals may not even be able to afford or qualify for long term care insurance altogether, placing them in a vulnerable position as they get older.  Even if you are moderately wealthy enough to afford private pay care, the cost may wipe out all of your savings, due to longer life expectancies and the increased costs of care. This is why many seniors turn to Medicaid to pay for their long-term care, and our firm can assist you in assessing Medicaid eligibility, handling the application and, if necessary, the appeals process, and planning for your future.

Do You Qualify For Medicaid?

Medicaid is a public benefits program, which is administered jointly by the federal government and each state. In Florida, a Medicaid applicant must be a U.S. citizen or resident alien who has medical needs requiring nursing home placement, or must be physically or cognitively impaired to a degree that nursing home placement is required. There are also income and asset requirements in the application for you and your spouse, which are discussed in more detail below.

Eligibility is determined on a case by case basis and there are a many rules and regulations that must be followed in order for you to qualify. The attorneys at Dine Elder Law have knowledge of look-back periods, income caps, transfer penalties and waiting periods to put Medicaid planning into practice for your personal situation.

How Dine Elder Law Assists Clients With Medicaid Planning Strategies

Every client’s situation is unique, but Medicaid planning generally falls into two categories: 1.) advanced Medicaid planning and 2.) emergency Medicaid planning. We can use strategies for you such as gifting, asset transfers, irrevocable trusts and “spend-downs” that can be used in advanced planning situations. In some circumstances, emergency or crisis planning for Medicaid purposes involves the use of last-minute tools to protect assets.

Both types of Medicaid planning are legal techniques that can assist your family if you are struggling to pay for long term care expenses, but before you take any action, be sure you consult with an attorney well-versed in this area of law, such as a Dine Elder Law expert.

Medicaid Income Requirements

To be eligible for Medicaid, your gross monthly income cannot exceed $2,313 (effective 1/1/2019).  A Qualified Income Trust is one tool we can use to help you qualify for Medicaid when your income exceeds the limit.  If you have a healthy spouse their income is not counted, and if their income is below the $2,313 limit, a portion of your income can be diverted to your healthy spouse.

Medicaid Asset Requirements

Your assets are either considered countable, non-available, or exempt. Your countable assets cannot exceed $2,000 (effective 1/1/2018). If you are married, your healthy spouse can retain up to $126,420 in assets, in addition to exempt, non-available and income-producing assets.

Your countable assets are considered for Medicaid eligibility purposes.  Non-available assets are assets that produce fair market income, such as a rental property, and are counted as for income eligibility but not asset eligibility.

Exempt assets are not counted for Medicaid asset eligibility and are limited to:

  • A homestead
  • Certain motor vehicles and personal property
  • Life insurance policies
  • Burial plans up to a certain value
  • Retirement plans that are being drawn from on a monthly basis


Look-back and Penalty Periods for Transfers

Transfers made by you or your healthy spouse are subject to a “look-back” period of 5 years. All transfers that fall within the 5 year “look-back” period are subject to a penalty which delays the Medicaid eligibility of the applicant for certain number of months according to the penalty formula.   The intricacies of these criteria require that you have a knowledgeable Medicaid planning attorney assist you with qualification.

Dine Elder Law: Attorneys Providing Clients With Medicaid Eligibility & Appeals  in Manatee, Sarasota & Desoto Counties

Because Medicaid eligibility criteria for nursing home long-term care is complex and the rules change frequently, it is important to consult a Medicaid planning attorney to assist you. The attorneys at Dine Elder Law can conduct an in-depth review of your financial and medical situation and develop a strategy that is best suited for your and your family. There may be time limits to consider, so we recommend a proactive approach to establish a plan which avoids having to plan in a crisis.