Senior Woman At Home Being Pushed In Wheelchair By Female Care Worker In Uniform

What Is Medicaid and Who Can Qualify?

Medicaid is a joint Federal and State program which provides medical assistance to individuals who are 65 or older, disabled, or blind. Medicaid is the single largest payer of nursing home bills in America. Although Medicaid eligibility rules vary from state to state, Federal minimum standards and guidelines must be observed. Medicaid has several programs under its umbrella. One of the most commonly used is The Institutional Care Program (ICP). ICP pays for nursing home care. To qualify for the ICP program in Florida, the person applying for Medicaid must;

  • Be at least 65 of age or disabled
  • Be a US citizen
  • Be a Florida resident (physically in Florida at least one day)
  • Have a social security number
  • File for all other benefits available to the applicant
  • Notify the state of Florida of existing health insurance
  • Medically determined to be in need of a nursing home
  • Be placed in a nursing home that accepts Medicaid participants

To medically qualify for a nursing home, the person applying for Medicaid must be unable to perform three of the following five activities of daily living (AOL’S) determined by the physician.

  • Walking and standing
  • Dressing oneself
  • Feeding oneself
  • Bathing oneself
  • Going to the bathroom (incontinence)

Further, there are financial income and asset tests to qualify for the Florida Medicaid Program. Please refer to the “Medicaid At A Glance” card or visit us online at LongTermCareSolutionsLLC.com/Medicaid/ for the latest income and asset qualifying numbers. When seeking information about obtaining Medicaid benefits, it is advisable to speak with a specialist who focuses on (Florida Medicaid eligibility).

Is Medicaid planning legal?

Yes. The Medicaid laws are written with several provisions which are favorable to those individuals who are presently applying for Medicaid as well as those who are planning for the future. These provisions protect certain assets and/or income depending on the facts of each case.

When Medicaid is approved, will my father receive “substandard” care in the nursing home?

No. Medicaid pays for a semi-private room. Your father could be sharing the room with a person paying privately or has long term care nursing insurance benefits. Typically, the nurses and nurse’s aides have no idea which residents are Medicaid or private pay. It’s always a good idea to visit your father frequently and at different times.

Is it important to have updated Advance Directives (Power of Attorney, Living Will, Health Care Surrogate) for the Medicaid filing process?

Yes, absolutely! Depending on the specific plan of action, a comprehensive Power of Attorney is used many times to assist the nursing home resident with movement of assets, title changes, gathering documents, etc.

Please visit our website at LongTermCareSolutionsLLC.com and download the FREE Advance Directive forms (Power of Attorney, Living Will, Health Care Surrogate) to have notarized and witnessed.

Is it a good idea to ask my neighbor who dealt with nursing home Medicaid planning a few years ago on how to qualify my mother for Medicaid now?

No. Medicaid guidelines change frequently. Everyone’s qualifying situation is different. An individual plan that is tailor-made to your mother’s specific needs is best.