2015 Medicaid Qualification Criteria for Florida Residents

What are the 2015 Medicaid Qualification Criteria for residents of the state of Florida?

Answer:  Here are the Monthly Income Limits, Total Assets Limits, and information about Transfers as they pertain to Florida’s Medicaid Qualification Criteria for 2015. 

Monthly Income Limits

• Medicaid Applicant’s (MA) income cannot exceed $2,199.00 gross income per month. If income exceeds $2,199.00 gross income per month, then a qualified income trust (QIT) must be established and the bank account funded in the month of application and ongoing.
• If Medicaid Applicant (MA) is married, the spouse’s income is NOT available for eligibility purposes. Spouse’s income is only considered after MA qualifies and for purposes of diversion of some of MA’s income to the community spouse (aka well spouse) at home for expenses.
• Income includes social security, civil service, pensions, VA pension, interest, annuity income and mortgage income annuity income.

Total Assets Limits

• “Countable assets” = savings accounts, checking accounts, money market accounts, certificates of deposit, stocks, corporate and municipal bonds, U.S. savings bonds, real property other than homestead (includes instate and out-of-state real property), limited amounts of whole life (cash value less than or equal to $2,500).
• “Exempt Assets” = Homestead property, 1 automobile, household furnishings, wedding ring, burial space, prepaid funeral contract, designated burial fund account ($2,500 maximum) or funeral trust ($15,000 maximum), unlimited amounts of term life insurance.
• Medicaid Applicant’s assets cannot exceed $2,000 + “exempt” assets.
• If Medicaid Applicant is married, and applying for nursing home (ICP) program, the community (aka well-spouse or at home spouse) spouse’s assets may be an additional $117,240 + exempt assets.
• If the community spouse’s assets produce very little income (less than $1939 per month), he or she may receive income from the institutionalized spouse and if a shortfall exists, the community spouse may be entitled to a greater Community Spouse Resource Allowance (CSRA) (up to $2,931) through appeal processes.

Transfers

• Transfers between husband and wife or wife and husband are unlimited and do not create a penalty period.
• Transfers or gifts made to anyone other than a spouse within the last 5 years result in a penalty period. If a penalty period is imposed by DCF, then no Medicaid benefits will be paid during the penalty period.
• Calculation of Penalty period-take the value of all gifts that fall within the penalty period and divide by $7,638. Suppose that the total gifts equal $15,276, and then dividing $15,276 by $7,638 would be a 2 month penalty period.
• A Medicaid Application is now required to be filed in order to trigger a penalty period. New rule effective 11/01/2011.
• A penalty period can only be triggered if an individual is “otherwise eligible” for Medicaid. New rule effective 11/01/2011.