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St. Augustine, Florida 32084

Medicaid Long-Term Care Planning

One area that generally falls under the elder law umbrella is Medicaid long-term care planning. Unlike the Federal health insurance program Medicare, Medicaid is governed by each State. Families in Florida who have to make the difficult decision of admitting a loved one into a nursing home or an assisted living facility quickly find out how financially straining it can be. According to the Florida Health Care Association, the median cost of care for a private room in a Florida nursing home is over $90,000.00 a year. The median cost for care for a private room in a Florida assisted living facility is nearly $40,000.00 a year. Medicare and Medicaid will generally combine to cover up to 100 days in a nursing home (a little over 3 months). After day 100, Floridians and their families can quickly deplete their life savings trying to keep up with the high costs of care. To help make these necessary skilled nursing arrangements affordable, Medicaid offers financial assistance beginning after day 100, if you qualify.

Medicaid-planning attorneys typically group this type of case into one of two categories: pre-crisis planning and crisis planning. Florida’s Medicaid program has a five-year look-back period on certain transfers. Simply stated, pre-crisis planning begins before an individual is admitted into skilled nursing care (and ideally more than five years before admission). Pre-crisis planning generally involves a review of the individual’s income and assets (if married, all assets of the couple are reviewed) and ends with a personalized plan which may include transferring assets now into irrevocable trusts and/or converting countable assets to non-countable or exempt assets.

On the other hand, crisis planning means that the individual has been admitted into skilled nursing care and the 100-day clock is running. This does not mean that all is lost. A Medicaid-planning attorney can still assist by preparing a Qualified Income Trust (“QIT”) in order to get the applicant below the strict Medicaid income threshold and divert income to the well-spouse for necessary living expenses. A Medicaid-planning attorney can also determine if certain assets can be transferred with or without incurring a penalty. Even if you or a loved one have already been admitted into a skilled nursing facility, you may still be able to qualify for Medicaid long-term care benefits.

The end goal of Medicaid planning is to qualify an individual for Medicaid long-term skilled nursing benefits before that individual’s life-savings is depleted. Our attorney can walk you through the complex Medicaid process and help you or your loved one qualify for long-term skilled nursing care while protecting your family and preserving your resources.