Long-Term Care Planning Attorneys

Florida Medicaid is a joint state and Federal program that provides health coverage for eligible individuals with low income in Florida. Administered by the Florida Agency for Health Care Administration (AHCA), the program seeks to ensure access to essential medical services for those in need.

Some of the specific benefits offered by Florida Medicaid services for low income individuals include:

• Medical Services: Medicaid covers a wide range of medical services, including a physical exam / doctor visit, hospital care, physical therapy, laboratory services and prescription drugs.
• Preventive Care: The program also emphasizes preventive care, covering services such as immunizations, screenings and wellness check-ups.
• Long-Term Care: For eligible seniors and individuals with disabilities, Florida Medicaid provides coverage for Long-Term Care, including nursing home care and home- and community-based services.
• Maternity and Pediatric Care: Pregnant women and children are eligible for comprehensive coverage for prenatal care, delivery, postpartum care and pediatric services.
• Behavioral Health Services: Medicaid includes coverage for mental health and substance abuse treatment services, ensuring access to vital behavioral healthcare.
• Dental Services: While dental coverage for adults is limited, Medicaid includes comprehensive dental care for children, promoting good oral health from an early age.

Florida Medicaid Look Back Period

Because it’s designed to serve low-income individuals, the state’s Medicaid program operates on strict eligibility criteria. Florida Medicaid has a “look back” period of 60 months, which equates to five years prior to the date of the Medicaid application. This look back period determines an individual’s eligibility for Medicaid benefits, particularly for Long-Term Care services. During this timeframe, any uncompensated transfers or gifts made by the applicant can lead to a penalty period, affecting their eligibility for Medicaid coverage.

The purpose of the look back period is to prevent individuals from strategically transferring assets to meet the program’s financial eligibility requirements. If an applicant has “given away” assets within the specified look back period, they may face a penalty that could delay their access to Medicaid benefits for Long-Term Care.

Understanding the implications of the Medicaid look back period is essential for individuals seeking Medicaid coverage, especially for Long-Term Care services, as it directly impacts their eligibility based on asset transfers within the defined time frame.

Medicaid Planning

Because the Medicaid program is so vital, especially in the effort to cover Long-Term Care for older adults, consulting an Elder Law attorney with extensive knowledge of the program and experience helping people qualify for the program is crucial. With the cost of nursing homes in Florida increasing, and the average cost of a private room in a nursing facility in Florida at over $100,000 a year, it makes sense to plan for Long-Term Care now to avoid spending your savings and worrying if you’ll have enough money for paid care.

Engaging in Medicaid Planning early with the assistance of an Elder Law attorney enables you to design a plan that anticipates various health problems like cognitive impairment and contingencies like increasing Long-Term Care costs. Waiting until you need government programs like Medicaid to meet income limits and pursue effective treatments for health concerns can lead to severe consequences, such as an extended waiting period to qualify and potential penalties.

A Medicaid planning attorney can help you devise a financial plan that anticipates the potential cost of health care in a nursing home and helps you qualify for the Medicaid program.