How are Medicaid and Estate Planning Connected?

Dec 15, 2021 | Uncategorized


There are nearly 41 million Americans aged 65 and over in the United States. Of these, nearly 70 percent will require some type of long-term care with advancing age. While some seniors may be able to provide for themselves, there are still at least 15 million seniors who only have enough savings to live a comfortable life, but not enough to pay for long-term care.

Today, the average cost for long-term care per year in the United States averages about $120,000, and the costs are going up each year. This can quickly deplete any savings that a senior might have. For many of these seniors, if they ever need long-term care, they will either need to purchase long-term care insurance, pay from their own pocket, or turn to government agencies for assistance.

Medicare does not offer much in terms of long-term nursing home care; therefore, most seniors will need to turn to Medicaid at some point. You should make finding a Medicaid planning attorney in Florida a priority.

Meet CARES Requirements

Medicaid has very rigid criteria for qualifications and many seniors may be rejected. Medicaid benefits are reserved for people with little-to-no assets and little-to-no income. The program was designed to help those most in need.

To qualify for Florida’s long-term nursing care program, you need to have documentation from a healthcare provider that you need to be in a nursing home, or your condition is severe enough to need 24/7 nursing care at home. The Community Aging and Retirement Services (CARES) program screens all candidates requesting long-term nursing care.

The director will ask you numerous questions on your disability, physical and mental restrictions, and what type of long-term care you need. Once you are deemed to be a candidate for Florida’s long-term care program, you will need to meet the eligibility criteria for Florida Medicaid.

Baseline Florida Medicaid Requirements

  • Must be a resident of Florida
  • Be a U.S. citizen
  • Must have assets and income below the Medicaid cap
  • Be at least 65 years of age
  • Must have documented proof of long-term care needs
  • A single person cannot have more than $2,000 in cash, bonds, stocks, or other liquid assets. Married couples can have $3,000 in assets.
  • A single person can only have an income of up to $2,382 a month; married couples can have a monthly income of $4,764.
  • Disabled and blind seniors are allowed higher asset levels.

While these eligibility criteria appear straightforward, many seniors have income and assets that total more than the Medicaid cap. In addition, some seniors may have two homes and/or several cars. This automatically means you are not a candidate for Medicaid.

Finally, you simply cannot give away your money and other assets to your family and friends to qualify for Medicaid. The agency has a five-year look-back period where they check all your bank accounts, all your income, etc., to ensure that you have not recently transferred your assets in an attempt to qualify for Medicaid.

Per Medicaid rules, you can only have one home and one car, and you can’t have a lot of liquid assets. What’s next?

To qualify and meet Medicaid’s eligibility criteria, you need to have Medicaid estate planning. In general, Medicaid goes hand-in-hand with estate planning. You need to see a lawyer who specializes in estate law; these professionals can help protect your assets and, at the same time, ensure that you can maximize your chance of becoming eligible for Medicaid. This is all legal and within the letter of the law.

What is Estate Planning for Medicaid?

To become eligible for Medicaid long-term care, you need Medicaid estate planning. At the same time, this will help protect our assets for your family.

Estate Planning Vs. Medicaid Planning

Estate Planning

With estate planning, the individual usually does the following:

  • Sets up an estate that will safeguard assets.
  • Ensure that the estate will be distributed to the beneficiaries, according to the decedent’s wishes.
  • Sets up a trust so that the beneficiaries will only pay the minimum amount of tax.
  • The estate will be set up in such a way so that the transfer of the estate to the beneficiaries will be without any problems.

As part of estate planning, the individual will also make a will and name an executor who will be responsible for managing the estate and ensuring that the assets are distributed according to the decedent’s wishes.

A Medicaid planning attorney in Florida can also include setting up a durable power of attorney, which is a legal document that states the name of an individual who will make decisions on behalf of the individual in case he or she becomes mentally or physically handicapped.

While estate planning is not always linked to Medicaid planning, especially for younger people, seniors should consider estate planning at the same time as Medicaid planning to help in the event that the individual requires long-term care in the future.

Medicaid Planning

When a senior has assets and/or income above the cap (limits) set by Medicaid, planning is necessary. It is important to understand that Medicaid is a program to support poor or low-income seniors who need long-term nursing care. If you have a higher income and several assets, you most likely will not qualify for Medicaid.

Therefore, you need to consult with an estate lawyer who can help with Medicaid planning. The ultimate goal of Medicaid planning is to restructure your assets so that your income falls below the Medicaid cap and make you eligible for Medicaid’s long-term care funding.

In addition, when you undertake Medicaid planning, this also helps protect your assets for transfer to your heirs after your death. Therefore, some aspects of estate planning are also a part of Medicaid planning.

The main reason you need to undertake Medicaid estate planning ahead of time is that the agency has a five-year look-back period. During this timeframe, Medicaid will look at all your finances to ensure that you have not given away your assets to friends and family just to qualify for Medicaid. Plus, you can’t simply spend the money just to qualify.

For example, you cannot buy a second vacation home, install an indoor swimming pool, or purchase the latest RV for touring. Medicaid considers such spending down frivolous as a way to decrease your savings just to meet the assets limit. If you have done so, you can be disqualified and even be charged with Medicaid fraud.

It is vital to undertake Medicaid estate planning ahead of time so that during the look-back period, nothing unusual is found. When you undertake Medicaid estate planning ahead of time, you will be able to meet the income and asset caps of Medicaid without any repercussions from the agency.

What is the Cost of Medicaid Planning?

The basic cost of Medicaid planning depends on the size of your estate and how much restructuring is required. The overall cost is based on a percentage of the value of your estate, which can vary from $7,000 to $20,000. The cost may seem a little high, but, in the end, your family inheritance is preserved and you will also be able to qualify for Medicaid long-term care.


If you are a senior, you should consider talking with a Medicaid planning attorney in Florida early on as the future can be unpredictable. With proper planning, you can pass your inheritance on to your beneficiaries without any problems. With early Medicaid estate planning, you can save your assets for your heirs and also, hopefully, qualify for Medicaid long-term care nursing care. Call Elder Law at 1-561-588-7512 and speak with an estate lawyer today.

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