Florida Elder Law & Estate Planning Blog

Two Florida Medicaid Changes to Know About

Florida nursing home Medicaid benefits

The eligibility criteria for Florida Medicaid benefits are always changing. Our Florida elder law attorneys stay current with every change. With expert planning from The Karp Kaw Firm’s attorneys, your loved one may qualify for benefits without you having to go broke – even if your loved one is already residing in a long-term nursing care facility. Here are the latest changes from Florida Medicaid.


Minimum Monthly Maintenance Needs Allowance

The minimum monthly maintenance needs allowance increased to $2,178 effective July 1, 2021 (was $2,155). The minimum monthly maintenance needs allowance is quite a mouthful, so let’s just call it the MMMNA. If a nursing home applicant is married, the well spouse (also known as the “community” spouse) may retain all of his/her own personal income, without affecting the applicant’s Medicaid eligibility. There are no limits on the well spouse’s income. The MMMNA is the minimal amount of income Medicaid considers necessary for the well spouse to avoid impoverishment. If the well spouse’s income falls below the MMNA, a portion of the nursing home resident’s income may be diverted to bring his/her income up to the MMMNA.

Example of how the MMMNA works: Medicaid applicant John Doe is residing in a long-term care nursing home. He applies for Florida long-term care Medicaid benefits. His gross monthly income is $4,000. His wife Mary Doe has only one source of personal income: $1,000 in monthly Social Security, which is $1,158 below the current MMNA of $2,158. Medicaid will allow $1,158 of John Doe’s income to be diverted to Mary Doe in order to raise her income to the MMNA. Under certain circumstances, even more may be diverted to raise the level over the MMNA. The Karp Law Firm attorneys will advise you about the MMNA.


Penalty Divisor

Effective July 1, 2021, the penalty divisor is $9,703. When an individual applies for long-term care Medicaid benefits, Medicaid looks back five years to determine if the applicant made any transfers to others for less than fair market value. The value of these gifts, along with the penalty advisor, are used to calculate the penalty period, which is the amount of time an applicant who is qualified in all other respects must wait to receive benefits.

Here is an example of how the penalty divisor works: John Doe has had a debilitating stroke and now needs the care of a long-term care facility provides. He applies for long-term care Medicaid benefits on September 1, 2021. When he applies, Medicaid looks back at the five-year period preceding application. Medicaid sees that in 2018, he gave $30,000 to his daughter;  in 2021, he gave $20,000 to his son, for a total of $50,000. Medicaid divides $50,000 by the penalty divisor, $9,703, which yields 5.15.  Mr. Doe must wait  6 months (Medicaid always rounds up the figure) to begin receiving benefits. His benefits will commence February 2022. Until then, he will have to pay the nursing home out of his own pocket. However, our attorneys can show you legitimate methods to avoid or minimize the penalty period.


Start Planning Now

The annual median cost for a private room at a nursing home in Florida is now $117,804. For a semi-private room, $104,025 (Source: Genworth Cost of Care Survey, 2021). Whether your loved will soon need long-term nursing care or is already receiving it, or if you are just thinking ahead, talk with our elder law attorneys about plans you may make to protect your life savings.

To see a complete list of Medicaid eligibility requirements, click here.

To read about planning in advance with a Medicaid Asset Protection Trust, click here.