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  • Ryan J. Smollar

Common Documents Used in Florida Medicaid Planning?

For Florida seniors thinking about Medicaid planning, it is important to be aware that there are several Medicaid programs in the state. Outside of healthcare insurance for low-income individuals and families, the disabled or handicapped, and children, Medicaid also offers assistance to seniors for long-term nursing care. Also known as the Medicaid Waiver Program, it does cover some or all the costs of long-term nursing care for seniors.


Using the ACCESS system, all eligible seniors can apply for Florida Medicaid online and complete the application form. The assistance of a lawyer knowledgeable about Medicaid rules and regulations can be very helpful in understanding the process and completing the form.


It is important to know that Medicaid does have many rules and regulations, the application process can be complex, and providing the wrong asset information can lead to charges of fraud. It is highly recommended you consult with a Medicaid professional for guidance and answers to any questions. This will not only lead to an error-free application but the chances of the application being approved are also greater because lawyers know exactly what Medicaid needs in the application.


What are Common Mistakes Made When Applying for Medicaid?


  1. Applying for Medicaid assistance is a complex procedure, and the rules vary significantly. Medicaid generally looks at each application thoroughly to ensure that the senior has met the eligibility criteria. Any mistake in the application usually leads to a quick rejection. Lesson number one is that you should take your time completing the application and/or have an experienced lawyer help you.

  2. A common mistake is completing the application without fully understanding the rules about assets. To be eligible for Medicaid, the senior cannot have more than $2,000 in assets if single or $3,000 if married. Most seniors receive social security and may have investments and other income but if they do not know what assets they can legally exempt, the application may be rejected. It is vital to have Medicaid planning done by an experienced lawyer so that your assets are below the maximum amount placed by Medicaid to legally be considered.

  3. If you omit some income or do not mention your investments, Medicaid can charge you with fraud, which often means a permanent ban from future applications and even a monetary fine, even if the omission was accidental.

  4. Some seniors may listen to their siblings and play the role of an amateur sleuth to overcome the Medicaid asset cap. They may give away their assets to their siblings or children to show Medicaid that their assets are worth $2,000 or less. However, be forewarned, Medicaid will always do a thorough check-up on your finances over the last five years to ensure that you have not given any assets/gifts just to meet the Medicaid limits of $2,000/$3,000. If Medicaid does find that you have engaged in deceit, you will face a monetary penalty and may not ever be eligible for Medicaid benefits.


What Documents Do You Need to Apply for Florida Medicaid Planning?


When applying for Florida Medicaid, you will need extensive documentation to provide to Medicaid that the senior is eligible for long-term nursing care benefits. If the applicant is married, then documentation is required from both the applicant and the spouse. The following documents are necessary to complete the application:


  1. Proof of U.S. citizenship, green card, or residential status in the U.S.

  2. Photo ID

  3. Social Security card

  4. Medicare Card or Medicare D and HMO card

  5. Birth certificate or a document showing your date of birth

  6. Copy(ies) of your marriage(s) licenses

  7. If you have recently downsized your home, you need to maintain these records for possible inclusion to Medicaid as part of the documentation required.

  8. If your child or relative is helping organize your real estate, make sure all documents are preserved.

  9. Documents of any transactions regarding the sale of any residential estate(s) over the past five years must be kept. The actual value of the home and the resale value of the home must be presented.

  10. Statements from the bank(s) and financial agencies where you have active checking accounts, saving accounts, safety deposit boxes, stocks, CDs, bonds, annuities, IRAs, investments, etc.


A Note About a Personal Service Contract


A personal service contract between a caregiver, whether it’s an adult child of the person needing care, or another family member or friend, is essential in Florida to prevent jeopardizing the individual’s potential application for Medicaid assistance.


If you live in Florida and pay a caregiver for services directly, there is a “look back” period that Medicaid assesses, and any monies paid to a caregiver directly are considered “gifts” and can lower or reduce Medicaid eligibility for a time or eliminate the possibility of it altogether. Speak to a lawyer today to discuss the advantages of a Personal Service Contract.


A Note About Qualified Income Trust (QIT)


If the Medicaid applicant’s income exceeds the limits allowed, it is possible to put the overage amounts into a Qualified Income Trust. To exercise this option, very specific rules regarding trust must be followed. Speak to an attorney about the details of a Qualified Income Trust.


Conclusion


It is highly recommended that you consult with an attorney who specializes in Medicaid. The lawyer can first determine if you are eligible and, secondly, suggest ways to re-allocate your assets so that you can meet the Medicaid asset cap criterion. Thirdly, the lawyer can help you complete the application so that there are no errors.


Finally, be aware that if you are applying for Florida Medicaid Waiver, there are many other seniors who are also applying, and hence there may be a waiting list. The sooner you consult with a lawyer, the faster your application can be filed and approved by Medicaid. Call Elder Law today to speak with a knowledgeable professional.


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