ATTENTION MEDICAID BENEFICIARIES

Medicaid Simplified

Medicaid programs are available to people with limited incomes and assets who need nursing home care, long-term care services, and home health care services. Some states also have programs for individual adults who don’t fit any of these categories. There are several different Medicaid long-term care programs for which Florida seniors may be eligible. These programs have slightly different eligibility requirements and benefits:

  1. Institutional / Nursing Home Medicaid – is an entitlement, which means that anyone who is eligible will receive assistance. Benefits are provided only in nursing homes
  2. Home and Community-Based Services (HCBS) – long-term care services are provided at home, adult day care, adult foster care homes, and in assisted living residences via a managed care system, which allows program participants to receive all Medicaid benefits via one administering agency.
  3. Regular Medicaid for Aged and Disabled (MEDS-AD) – is an entitlement, meaning all persons who are eligible will receive services. Benefits are provided at home or adult day care

Each state uses financial eligibility guidelines to determine whether you are eligible for Medicaid coverage. Generally, your income and assets must be below a certain amount to qualify, but this amount varies from state to state and from program to program. You are eligible for Medicaid if you fall into an eligible group and meet that group’s financial eligibility requirements.

Florida Medicaid Eligibility Requirements – January 2020:

  • 65 years of age, blind or disabled
  • U.S. citizen or qualified alien
  • Florida Resident
  • Maximum Resource Allowance for an Individual
    (Asset Amount Person in Nursing Home/ALF Can Keep) $2,000
  • Maximum Community Spouse Resource Allowance
    (Asset Amount the Stay at Home Spouse Can Keep) $128,640
  • Maximum Income Cap Amount
    (Income Amount Person in Nursing Home/ALF Can Have) $2,349
  • Minimum & Maximum Monthly Maintenance Needs Allowance (Income Amount the Stay at Home Spouse Can Have) $1,261 – $4,698

 

Type of Medicaid

Single

Married (both spouses applying)

Married (one spouse applying)

Income Limit

Asset Limit

Level of Care Required

Income Limit

Asset Limit

Level of Care Required

Income Limit

Asset Limit

Level of Care Required

Institutional / Nursing Home Medicaid

$2,349 / month**

$2,000

Nursing Home

$4,698 / month (Each spouse is allowed up to $2,349 / month)**

$3,000

Nursing Home

$2,349 / month for applicant**

$2,000 for applicant & $128,640 for non-applicant

Nursing Home

Home and Community Based Services

$2,349 / month

$2,000

Nursing Home

$4,698 / month (Each spouse is allowed up to $2,349 / month)

$3,000

Nursing Home

$2,349 / month for applicant

$2,000 for applicant & $128,640 for non-applicant

Nursing Home

Regular Medicaid / Aged Blind and Disabled

$961 / month

$5,000

None

$1,261 / month

$6,000

None

$1,261 / month

$6,000

None

Type of Medicaid : Single

Income Limit

Asset Limit

Level of Care Required

Institutional / Nursing Home Medicaid

$2,349 / month**

$2,000

Nursing Home

Home and Community Based Services

$2,349 / month

$2,000

Nursing Home

Regular Medicaid / Aged Blind and Disabled

$961 / month

$5,000

None

Type of Medicaid : Married (both spouses applying)

Income Limit

Asset Limit

Level of Care Required

Institutional / Nursing Home Medicaid

$4,698 / month (Each spouse is allowed up to $2,349 / month)**

$3,000

Nursing Home

Home and Community Based Services

$4,698 / month (Each spouse is allowed up to $2,349 / month)

$3,000

Nursing Home

Regular Medicaid / Aged Blind and Disabled

$1,261 / month

$6,000

None

Type of Medicaid : Married (one spouse applying)

Income Limit

Asset Limit

Level of Care Required

Institutional / Nursing Home Medicaid

$2,349 / month for applicant**

$2,000 for applicant & $128,640 for non-applicant

Nursing Home

Home and Community Based Services

$2,349 / month for applicant

$2,000 for applicant & $128,640 for non-applicant

Nursing Home

Regular Medicaid / Aged Blind and Disabled

$1,261 / month

$6,000

None

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