Are Nursing Homes in Florida Required to Accept Medicaid Payments?

Are you worried about the high cost of nursing homes in Florida for yourself or for a parent? Medicaid is the United State’s national health insurance and is a joint federal and state program that provides health coverage to millions of Americans, including elderly citizens. The federal government matches state Medicaid spending at a rate that varies by state. Not everyone qualifies for Medicaid assistance: there are asset eligibility caps to qualify for Medicaid, and Medicaid will pay for a nursing home only when it is medically necessary.

Florida’s Medicaid program is called Long-Term Care Managed Care (LTCMC) program. In Florida, not all nursing homes are required or licensed to accept patients on Medicaid. A Florida nursing home that accepts Medicaid must be licensed by the state and is subject to inspections to ensure they meet federal standards. Medicaid coverage of Nursing Facility Services is available only for services provided in a nursing home licensed and certified by the state survey agency as a Medicaid Nursing Facility (NF). Medicaid NF services are available only when other payment options are unavailable and the individual is eligible for the Medicaid program. See NF survey and certification requirements. 

How much does a nursing home in Florida cost?

Nursing home care is expensive, and the cost is rising. The average cost of a semi-private room in a Florida nursing home is more than $144,000 per year. According to Care.com, a recent survey says that compared to neighboring states and the country, Florida has the most expensive options for nursing home care. Care.com also says Florida seniors can expect to pay over $4,000 more for a room in a nursing home facility than receiving care in their own home.

What assets are included in determining Medicaid eligibility in Florida?

There are asset eligibility caps to qualify for Medicaid:
Medicaid counts these assets for eligibility:

• CD’s (certificates of deposit)
• Stocks and Bonds (Brokerage accounts)
• Checking and savings accounts
• Second homes/vacation homes not being rented out for fair market value
• Annuities
• Anything beyond one motor vehicle
• Cash value of life insurance if face value exceeds $2500
• Pre-paid funeral plans (if not irrevocable)

These assets are not counted toward Medicaid:

• Your primary home and primary vehicle
• Qualified Retirement Accounts (IRA or 401k)
• Income-producing properties
• Pre-purchased funeral plans
• Personal property and household belongings
• Life insurance policies with no cash value
• Up to $1,500 in cash earmarked for burial
• Assets with multiple owners
• Medicaid compliant annuities

What if I have too many assets to qualify for Medicaid?

Someone who has too many assets to be eligible for Medicaid can consult a Medicaid Planning Attorney for advice and guidance. With careful Medicaid Planning, you may be able to receive the financial help you need without losing your assets. Many people mistakenly believe they have too many assets such as their home equity or retirement accounts to qualify for government assistance, so they pay out-of-pocket for their Long-Term Care until their savings are gone.

Medicaid Planning is Long-Term Care Planning as part of your Estate Plan. The goal of Medicaid Planning is to manage your financial eligibility and to preserve as many assets as possible so that you can qualify for Medicaid as quickly as possible. 

What if my Medicaid application was denied?

There are many complicated rules about Medicaid income and assets eligibility. If your application was denied, you can apply again for Medicaid. An Elder Law Attorney knowledgeable in Estate Planning and Medicaid qualification can help you understand why Medicaid benefits were denied and help you reapply for benefits.

Trusted and Compassionate Florida Medicaid Planning Attorney

After a lifetime of hard work, you and your family deserve peace of mind and protection in your senior years. With 20 years of Medicaid Planning experience, South Florida Attorney Barry D. Siegel at The Siegel Law Group, P.A., knows firsthand what can happen if you are unprepared for life’s greatest challenges. A knowledgeable Medicaid Planning Lawyer can provide legal guidance throughout the Medicaid process. Call us toll-free at 855-FLA-ESTATE or at (561) 955-8515(561) 955-8515 or schedule a free consultation.