Medicaid
Medicaid will pay nursing home expenses to those who qualify. To qualify, income eligibility and resource eligibility must be established. For income, a single applicant’s gross monthly income may not exceed the Florida income cap, $2,982 per month as of January 1, 2026. Income above the cap can be handled with a Qualified Income Trust, also called a Miller Trust. With respect to assets, a married applicant and his or her spouse are allowed to keep a home, personal effects, a car or two, and other assets, up to the community spouse resource allowance, $162,660 as of January 1, 2026, while the applicant’s own countable resources may not exceed $2,000. Eligibility on benefit rules changes often, at least twice each year. Be sure to check with our office before making any decisions or plans based on these numbers.
On February 8, 2006, the value of a single person’s homestead becomes relevant to the eligibility process. Single applicants may not have home equity greater than the federal limit, $752,000 as of January 1, 2026. The home equity cap does not apply to a married applicant with a community spouse residing in the homestead property. Exceptions may exist and other planning tools may make this less of a concern.
In the past, part of thoughtful planning involved divesting assets. But property transfers, including transfers to trusts, are examined closely, and frequently the transferred property is still considered part of the assets for determining eligibility.
On February 8, 2006, the federal government expanded the time frame for examination of any gifts of property that are made prior to the Medicaid application from thirty-six months to sixty months. Florida implemented the federal law changes effective November 2007.
As a result of this change, gifting has become more complex. The assistance of an elder law attorney can help you sort through the complexity of the law changes based on the individual facts of your case.
Accessing Medicaid benefits has become somewhat controversial. Many individuals are concerned that they will not receive the same level of care at a facility that accepts Medicaid as they would if they were private pay patients. The reality is that Medicaid pays for a large share of the patients in nursing home facilities. These same patients are mixed into the same facilities with private–pay patients. This is like two passengers seated side-by-side on an airline, one might have paid $250 for a ticket, the other $1000. Which one would you rather be? Employing strategies to protect your assets is a legitimate way to protect you and your spouse’s financial future.
Even if you are in an assisted living facility or remain at home for your care, you may be eligible for Medicaid benefits under the Statewide Medicaid Managed Care Long-Term Care program, Florida Statutes section 409.978, which replaced the Nursing Home Diversion Program and now operates in every Florida county. The financial standards that govern Medicaid eligibility in a nursing home govern this program too. To qualify, you must be 65 or older, or 18 or older and eligible for Medicaid by reason of a disability, and you must be found to need a nursing facility level of care through the state’s CARES assessment (Comprehensive Assessment and Review for Long-Term Care Services). Enrollment begins with a screening by the Aging and Disability Resource Center, and applicants may be placed on a waiting list ranked by priority score until a slot is released. The goal of the program is to keep people in the community for as long as possible.
Eligible services include adult companion care, adult day health care, assisted living services, homemaker and personal care services, home-delivered meals, and respite care. As with most government benefits, it is a useful program that can be a bit difficult to understand without advice from an elder law attorney.
Finally, if you have been discharged recently from a hospital and your care is being paid by Medicare, this is an optimal time to consult with our office to maximize your benefits.