Funding Long-Term Care – Medicaid Eligibility for Nursing Home Residents

Studies have revealed that at least 40 percent of all people will require a period of care in a nursing home. The average stay in a nursing home is a little over 2 years.  Most nursing home residents require assistance paying for their care and may utilize Florida’s Medicaid benefits, as the average monthly cost of a nursing home in Florida is $6,540, based on double-occupancy.

Statistics show that at least 60 percent of nursing home residents are funded by Medicaid benefits. However, like many other states, Florida has certain eligibility requirements. Additionally, benefits can only be used to reside in a state Medicaid-approved facility.

Overview of Florida Medicaid Eligibility Requirements

  • The resident’s gross income must be below $2,094.00 per month, there is no limit on a well-spouse’s income
  • Residents may not possess assets valued beyond $2,000.00
    • Assets must be liquidated to pay for care
    • Residents and their well-spouses may retain one motor vehicle and a home valued below $536,000, and basic personal assets
    • Valuable jewelry and fine art is not exempt and must be liquidated
    • Home value may exceed $536,000 if a well-spouse or child (under age 21 or disabled) resides in the applicant’s home.
    • A well-spouse may retain up to $115,920.00 in assets, plus certain exempt items.
      • Certain assets, such as income-producing properties, are exempt from this requirement
      • Look-back period restrictions: If any assets are transferred to family members within 5 years of admission to a nursing home, the state calculates a percentage of their value for which the resident will be responsible in order to establish Medicaid eligibility.
        • Assets must be transferred well before care is needed or the percentage liability will be applied. NOTE: this only pertains to assets beyond the minimum exemption requirements and the look-back applies to transfer, not recent purchases, such as a new home.

Full details on Medicaid eligibility can be found at the Florida Department of Children and Families or the Florida Department of Elder Affairs.

References:

FDEA 

FL DCF

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