ICP Medicaid Planning Facts for Florida's Institutional Care Program (ICP Medicaid)

 

The Basic Rules of Nursing Home Medicaid Eligibility

 

 

THE ASSET RULES

 

            The applicant may have no more than $2,000 in “countable” assets in his or her name. “Countable” assets do not include (1) personal possessions, such as clothing, furniture, and jewelry; (2) one motor vehicle (valued up to $4,500 for unmarried recipients and of any value for community spouses); (3) the applicant’s principal residence (if it is in Florida); and (4) assets that are considered inaccessible for one reason or another.

 

• Medicaid Qualification

•          Single

•                     –Countable Assets less than $2000

•          Married with community spouse

•                     –Community Spouse Resource Allowance*

•                                                                   $117,240.30

•  

 

 

      *Community spouse is permitted to keep 100% of the couple’s combined assets, up to the minimum Community Spouse Resource Allowance (CSRA) of $117,240.30.

 

Community Spouse

             Minimum Resource Allowance $23,448

             Maximum Resource Allowance $117,240

 

"SNAPSHOT DATE"

             ---Date that Medicaid uses to determine the total countable assets for purposes of calculating the Community Spouse Resource Allowance.
             ---Resource assessment as of first day of the month of institutionalization of the nursing home spouse in the hospital or long-term care facility with subsequent 30-day stay. (If not institutionalized, use date Medicaid determined the individual met medical requirements.)

 

After the institutionalized spouse qualifies for Medicaid long-term care assistance, the community spouse’s resources are no longer deemed available to the institutionalized spouse.

 

Conversion of Countable Assets to Exempt Assets:



• Purchase or upgrade principal residence

• Purchase savings bonds (up to $20,000/yr per person)

• Purchase or upgrade vehicle

• Purchase household furnishings

• Purchase irrevocable funeral plan & burial plot

• Purchase life estate (12 month residency required)

• Purchase Medicaid-qualifying annuity in the name of the Community Spouse

• Purchase Medicaid-qualifying promissory note in the name of the Community Spouse



 

 

The Home

 

             The home will not be considered a countable asset so long as the applicant preserves the "intent to return home" after the nursing home stay.

 

THE TRANSFER PENALTY

 

            If an applicant (or his or her spouse) transfers assets, he or she will be ineligible for Medicaid for a period of time beginning on the date of the transfer except if the transfer is to:

 

(1)  a spouse (or anyone else for the spouse’s benefit);

(2)  a blind or disabled child;

(3)  a trust for the benefit of a blind or disabled child; or

(4)  a trust for the benefit of a disabled individual under age 65 (even for the benefit of the applicant under certain circumstances).

 

            The applicant may transfer his or her home to:

                         (1)  a child under age 21;

                         (2)  a sibling who has lived in the home during the year preceding the applicant’s institutionalization and who already holds an equity interest in the home; or

                         (3)  a “caretaker child,” who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant’s institutionalization.

 

             In most states there is a 60 month look back penalty that will assign a penalty for any gifts made in the previous 60 months. (not California)
                            •Penalty is calculated by dividing the amount of the gift by the average private pay rate of a nursing home. (about $7500)
                            •The quotient, rounded down, is the number of months of ineligibility.

 

 

Example: Virginia Patient

 

                            •Gifts $80,000 to grandson in January of 2014.

                            •7500/80,000 = 10.6666

                            •Round down to give us Virginia a penalty of 10 months.

                            •Applies for benefits January of 2015.

                            •In most states she will have to wait until 10 months (November 2015) after her application for Medicaid before she will be eligible for benefits.

 

ESTATE RECOVERY

 

             The state has the right to recover benefits paid to the Medicaid recipient after death from the estate. This would include the home if the home is in the probate estate but not if it is not in the probated estate such as when the home  is jointly owned, in a life estate, or in a trust.

 

 

TREATMENT OF INCOME

 

             When a nursing home resident becomes eligible for Medicaid, all of his or her income, less certain deductions, must be paid to the nursing home. The deductions include a $60-a-month personal needs allowance, a deduction for any uncovered medical costs (including medical insurance premiums), and, in the case of a married applicant, an allowance he or she must pay to the spouse that continues to live at home.

 

Community Spouse Income Allowance

                               Minimum Monthly Maintenance Needs Allowance $1,938

                               Maximum Income Allowance $2,931

 

PLAN FOR MEDICAID NOW WITH GIFTING TO LOVED ONES SUCH AS CHILDREN, THROUGH USE OF AN IRREVOCABLE TRUST

 

Irrevocable Trust
          •Get Step up at Death
          •121 Exclusion
          •Protected from Creditors of Beneficiary
          •Income generated by trust assets can be excluded from Share of Cost
          •Trust Assets are Protected from Medicaid Recovery
          •SNT (special needs trust) and Spendthrift Provisions for Beneficiaries possible

 

 

*servicing Port Charlotte, Punta Gorda, Ft Myers, Boca Grande, Sanibel, Placida, Naples, Orlando, Ft Lauderdale, Boca Raton, Miami, and all cities throughout Florida.