Careful Medicaid Planning May Be Essential To Affording Long-Term Care
The average cost of skilled nursing care in Florida is over $100,000 annually, and assisted living care is nearly $40,000 a year. Unless significant private funds or a comprehensive long-term care insurance policy are available, these costs are more than most seniors can afford without quickly depleting their resources. Medicaid is often the only source of funds available to pay for the care expenses of many seniors. Like most government programs, however, Medicaid has strict eligibility requirements: no more than $2,000 in countable assets for an individual and similarly strict limits on monthly income.
At Feldman & Feldman, Counsellors at Law, P.A., we believe that no one should be pauperized just to meet their basic living expenses and health care needs. Our experienced elder law attorneys can help your family navigate the maze of Medicaid regulations and qualify your or a loved one for benefits while protecting assets, both to supplement care needs and to provide a legacy for future generations.
Table Of Contents
How Medicaid Planning Works: An Overview
Preparing For Your Medicaid Planning Consultation
What Will Be Addressed During Your Consultation
What Will Not Be Addressed During Your Consultation
Answers To Common Questions About Medicaid Planning
How much does Medicaid planning cost?
Can all of my assets be protected?
What are Medicaid planning companies, and are they legitimate?
What is the difference between Medicare and Medicaid?
What is the five-year rule for Medicaid in Florida?
What disqualifies you from Medicaid in Florida?
When should you start Medicaid planning?
Don’t Act On Medicaid Myths – Talk To An Attorney Instead
Learn About Your Options By Speaking To An Experienced Medicaid Planning Lawyer
How Medicaid Planning Works: An Overview
There are two types of Medicaid planning: long-term care planning and crisis planning. Long-term care planning is appropriate when there is no immediate need for Medicaid benefits. A plan may then be implemented that both protects assets and qualifies the senior for benefits in the future when needed. Crisis planning is required when benefits must be obtained immediately, such as when a senior faces imminent placement in an assisted living facility (ALF) or skilled nursing facility. The seniors are faced with paying for such care out-of-pocket unless they are qualified for Medicaid.
There are four steps to Medicaid planning:
- An initial consultation to assess the client’s needs, inform the client about available public benefit programs, discuss the planning process in greater detail, and answer the client’s questions about available benefits or planning.
- Preparing a written asset protection plan which provides the client with their options to qualify for Medicaid while protecting as much of their remaining assets as possible. An experienced elder law attorney will fully inform the client about each option so that an informed decision may be made about which qualification strategy to pursue.
- Implementing the planning option(s) selected by the client. This may require the elder law attorney to prepare trusts, powers of attorney, deeds and other legal instruments; or it may require overseeing the proper implementation of gift transfers, loan arrangements or other strategies. Every client’s situation is unique, and there is no “one size fits all” solution.
- Overseeing submission of a Medicaid application at the appropriate time. An experienced elder law attorney will coordinate their efforts with the client’s treating physician, the care facility, and other professionals (such as geriatric care managers, accountants and financial planners) to see that the application process runs smoothly and benefits may be approved as quickly as possible.
While each client’s plan is unique, Medicaid planning often involves the creation of one or more trusts, including qualified income trusts or QITs.
What Are The Benefits Of Medicaid Asset Protection Planning?
Medicaid planning with a qualified elder law attorney allows individuals to:
- Receive assistance with paying for the cost of long-term care at home, in an assisted living/memory care facility or in a skilled nursing facility.
- Preserve funds for the non-Medicaid spouse, including a diversion of income from the Medicaid spouse in addition to keeping their own sources of income.
- Preservation of assets for the benefit of the Medicaid recipient, their spouse, as well as dependents.
- Supplement care: Protected resources can be used for expenses Medicaid does not cover such as private rooms, enhanced therapies or personal items.
- Provide a legacy: Thoughtful planning can help ensure a legacy for the benefit of children or grandchildren and avoid exhausting these hard-earned assets paying for the cost of long-term care.
- Avoid costly mistakes: Improper transfers or missed deadlines can cause long delays in eligibility or outright denial of benefits.
Our firm manages every stage of the process to prepare an appropriate Medicaid plan for the client, implement any necessary planning strategies to qualify the Medicaid applicant and protect resources, and submit a Medicaid application with the Department of Children and Families.
Common Medicaid Planning Mistakes And How We Help You Avoid Them
The rules governing Medicaid are complex and the application process is managed by a large government agency, the Florida Department of Children & Families. Submitting a Medicaid application without proper guidance often results in a delay or denial of benefits, as well as the loss of significant funds paying for private care which could have otherwise been avoided. Working with the elder law attorneys at Feldman & Feldman, Counsellors at Law, P.A. can help families avoid these outcomes through structured planning and careful oversight.
One common planning mistake is confusing the annual gift tax exclusion with making gifts for Medicaid spend-down purposes. While the IRS allows individuals to make certain exempt transfers each year for estate and gift tax purposes, this allowance is wholly separate from the rules related to Medicaid planning. Gifts to most family members or third parties will trigger penalty periods that delay benefits, sometimes for months or even years, if made within 5 years of the submission of a Medicaid application (the “look back” period). As part of the Medicaid planning process, our attorneys review prior transactions and apply lawful strategies to reduce or eliminate penalties when possible.
Another common mistake is relying on inexperienced or unqualified “Medicaid planners”. These are often social workers, financial planners, or insurance salespeople (if they are credentialed at all). While these planners often charge fees far less than those charged by the average elder law attorney (sometimes working entirely on the commission generated by the insurance products they sell), they often lack the experience and knowledge to provide appropriate planning services. These planners are also prohibited from engaging in legal work and often engage in the unlicensed practice of law or partner with less-than-scrupulous attorneys who may never even meet with the “client.” Our office is often required to fix the mistakes of these “planners” who have cost their unwitting clients thousands of dollars. Individuals who wish to engage in Medicaid planning should retain an experienced elder law attorney and avoid “to good to be true” offers from these planning companies.
What Standards Must Florida Medicaid Applicants Meet?
To qualify for long-term care Medicaid in Florida, an applicant must meet specific criteria, including:
- Florida residency and status: An applicant must be a Florida resident, a U.S. citizen or a qualified legal alien, either 65 years or older or living with a disability.
- Medical need: The state requires a clinical assessment to determine if an applicant meets a nursing home level of care. This step confirms that the applicant’s medical needs justify the type of long-term care covered by Medicaid.
- Asset limits: Medicaid imposes a strict $2,000 limit on a Medicaid recipient’s “countable” assets. However, even those with resources that exceed this limitation can obtain benefits through proper planning. There are many tools available to reduce countable assets while protecting resources for the benefit of the Medicaid recipient or their spouse.
- Income limits: Applicants must have gross monthly income of less than $2,901 in 2025 to qualify for long-term care Medicaid (this limit increases over time). However. Even if a person’s income exceeds this limit, eligibility may still be obtained by using a Qualified Income Trust (“QIT”), pooled trust, or other appropriate planning strategies.
- Look-back period: Florida has a five-year “look-back” period, which imposes a penalty for certain uncompensated transfers of assets (gifts) made within five years before a Medicaid application. However, it is often possible to shorten or eliminate this penalty period even after these transfers have been completed.
Our elder law attorneys specialize in the complex rules of Medicaid eligibility helping our clients qualify for benefits while structuring their assets and income with the goal of achieving maximum preservation of resources for the Medicaid applicant and their loved ones.
Preparing For Your Medicaid Planning Consultation
You may feel more at ease about Medicaid planning after a consultation with Feldman & Feldman, Counsellors at Law, P.A.. We will do our best to assist you and your family through this often difficult process. What follows is a summary of what you can expect during your consultation with one of our elder law attorneys.
What Will Be Addressed During Your Consultation
- We will review the medical and financial requirements to qualify for Medicaid.
- We will review the HCBS/ALF Waiver waitlist process (if applicable).
- We will review the Medicaid application and fair hearing process.
- If the Medicaid applicant is not capable of retaining our firm directly, we will determine whether anyone else has the legal authority to retain us on their behalf.
- We may provide a cursory review of any documentation provided, if it is deemed helpful to the attorney during the consultation.
- We will outline the steps involved in Medicaid planning (e.g., providing a written plan, implementing the plan and submitting the application).
- We will provide our Medicaid planning questionnaire so that we may obtain the relevant information to produce a Medicaid plan.
- We will quote an initial retainer fee for step one of our planning efforts and provide an estimate of the total required fee based upon the Medicaid applicant’s circumstances (e.g., long-term care planning, crisis planning).
What Will Not Be Addressed During Your Consultation
- We will not provide specific planning recommendations that may qualify the applicant for Medicaid (this will be provided in our written Medicaid plan).
- We will not provide an in-depth review or analysis of any documentation provided prior to or during the consultation. This review and analysis will be performed after we have been retained to provide Medicaid planning services.
- We will not provide “piecemeal services” – our Medicaid planning services require that our office handle all aspects of the planning and application process, including the initial analysis of the client’s situation, implementing the Medicaid planning options selected by the client, and submitting the Medicaid application.
- We will not provide medical or health care services. Our clients should consult with their primary care physician or a care manager to determine the extent of their care needs.
- We will not provide assistance with placement or transitioning to an assisted living facility or skilled nursing home. Our clients should consult with a care manager to assist with placement and the transition process to an appropriate community.
You can schedule your consultation by calling our Coral Springs office at 954-228-6074.
Answers To Common Questions About Medicaid Planning
While we would be happy to answer any questions you may have during your initial consultation, we’ve also provided answers to some of the most frequent questions we receive from prospective clients.
How much does Medicaid planning cost?
Can all of my assets be protected?
What are Medicaid planning companies, and are they legitimate?
What is the difference between Medicare and Medicaid?
While they can offer overlapping benefits and are often confused with one another, Medicare and Medicaid are very different programs with differing eligibility requirements (although it is possible to be eligible for both).
Medicare is a government insurance program, eligibility for which is based upon your work history. Benefits are generally paid to those 65 years of age or older or to the disabled. Medicare insurance premiums are deducted from your Social Security payment each month. Benefits include doctor visits, hospital stays, the cost of prescription drugs, rehabilitation care and hospice care. Contrary to popular belief, Medicare will not pay for long-term care in an assisted living or skilled nursing facility. Medicare benefits are paid 100% by the federal government.
Medicaid is a public assistance program which provides benefits to the very poor. These benefits include medical services, the cost of prescription drugs, as well as custodial care in a nursing home or ALF. Additional benefits are also available to Medicaid recipients, which vary from state-to-state. Medicaid eligibility has strict asset and income requirements, which also vary from state-to-state. Medicaid benefits are a shared expense of the federal government and individual states.
What is the five-year rule for Medicaid in Florida?
What disqualifies you from Medicaid in Florida?
Common disqualifying factors include exceeding asset or income limits, improper asset transfers during the look-back period, and failure to meet medical necessity requirements. Errors in the application process or missing documentation may also result in denial. With proper legal guidance, many of these issues can be addressed through planning strategies designed to bring applicants into compliance.
When should you start Medicaid planning?
Ideally, Medicaid planning should begin well before long-term care is needed. Early planning provides the greatest flexibility and asset protection opportunities. However, even families facing immediate care needs can benefit from crisis planning. Speaking with an experienced elder law attorney early allows you to understand your options and avoid costly mistakes that could affect eligibility and long-term financial security.
Don’t Act On Medicaid Myths – Talk To An Attorney Instead
When it comes to large and complex programs like Medicaid, there is always a lot of misinformation, confusion and myths floating around. Here are some common Myths about Medicaid:
- You can qualify by transferring assets to your kids. In reality, Medicaid may impose a penalty for doing something like this and you’ll end up waiting longer to get coverage.
- You won’t qualify for Medicaid until you are broke. One of the main goals of Medicaid planning is to help you qualify without completely destroying your finances or depriving your heirs of an inheritance.
- You’ll lose your home on Medicaid or won’t qualify because you have a home. In most cases, your home is not counted as an asset for purposes of calculating eligibility. It also won’t be taken away.
Medicaid is complex, and even if you heard about a rule that applied in the case of a friend or neighbor, it may not apply to you. Before making any decisions about your property, contact us for case-specific advice and guidance.
Learn About Your Options By Speaking To An Experienced Coral Springs Medicaid Planning Lawyer
To discuss Medicaid planning in a consultation with one of our attorneys, call our office in Coral Springs at 954-228-6074 or fill out our online contact form. We serve clients throughout Florida.