Q. Will Medicare cover me in a nursing home?

Typically Medicare will only cover short-term stays in a nursing home. To be eligible for Medicare coverage at all, however, a patient must be qualified as receiving "skilled nursing" care as opposed to "custodial," which covers daily activities such as bathing and eating. In other words, Medicare is not a primary payer for nursing home coverage. Instead, seniors can expect to either pay privately or rely on some form of long-term care insurance or Medicaid. See the federal website Medicare.gov for more information.

Q. I have heard there is an income limit for Medicaid. Will my income disqualify me from Medicaid?

In 2014, the income limit for Medicaid is approximately $2100, adjusted annually for inflation. However, even if you are over this amount, an attorney can still qualify you for Medicaid by setting up a qualified income trust. Thus, your income will not stop you from qualifying for Medicaid, even if you are over the limit. (See http://www.dcf.state.fl.us/programs/access/docs/qualified_income_trust_factsheet.pdf for more information on qualified income trusts).

For married couples, also keep in mind that Medicaid will only count the income of the individual who is applying for nursing home coverage. Thus, the income of a spouse who is remaining at home can be unlimited as it will not count toward the applicant's income amount.

Q. Can I give my assets away in order to qualify?

No. Giving assets away, or transferring assets as it is called, will trigger a Medicaid penalty period during which the person who has transferred assets will be required to fully pay for his or her nursing home expenses. Occasionally transferring assets can be useful as part of a well-thought-out plan to qualify for Medicaid, but usually there is a much better approach to accomplish qualification while better protecting one's assets.

Q. Do I need a lawyer to apply for Medicaid?

No. An individual may apply for Medicaid on his or her own. Alternatively, nursing home staff will also submit applications on behalf of individuals who are admitted once after an individual's assets have been depleted. However, seeking an elder law attorney can help an individual get qualified before their assets have been depleted.

Q. Should I use an experienced elder law attorney when applying for Medicaid?

Yes. With the high cost of nursing homes, a mistake or delay in qualifying for Medicaid can easily cost tens of thousands of dollars. Further exacerbating the issues is that this area of law is constantly changing and varies from state to state. Nursing homes, friends and loved ones are often not trained in following the law and seriously misinformed about the options nursing home residents have to protect assets. The fee to work with an elder law attorney will be less than the cost of one month in the nursing home, yet they will likely save you tens of thousands of dollars and ensure that your loved one is most protected and properly looked after.

Q. What is a caregiver agreement?

A caregiver agreement, or contract for personal services, is an agreement whereby an individual in need of personal health care services can contract in advance with another person, usually a child or family member, for the rendering of services needed. Services may include transportation, meals, laundry, bill paying, health care monitoring and more. The agreement can be personalized to apply for both at-home and nursing home care. It can be very helpful to enter into a caregiver agreement as early as possible once a person's need for individual care arises, although the agreements can still be useful even after a person has entered into a long-term care facility.

Q. How can a caregiver agreement help us qualify for Medicaid?

Caregiver agreements can be a useful tool to recognize children or family members for their useful service and also pass on a portion of the in-need person's assets without disqualifying him or her from Medicaid. Determining whether a caregiver agreement is right for you will depend on several factors such as the age of the person needing care and the amount of assets involved. Finally, an attorney should help determine if this is the most proper strategy for your family because there are significant income tax consequences involved and there may be more cost-saving strategies available.

Q. What options are available to qualify for Medicaid?

There are many strategies available to help an individual to qualify for Medicaid and protect his or her assets. Strategies include pooled trusts, spousal refusal, caregiver agreements, real estate investment strategies and appropriate spending down of assets in certain circumstances. We invite you to contact our law offices for a free 20-minute phone consultation to find out if Medicaid planning can be beneficial for you.

Contact The Jacksonville Law Firm Of Tolson & Associates, P.A., Today

We have helped numerous Florida families plan for the long-term futures of their loved ones. Call (904) 269-0050 or contact us online to schedule a confidential consultation regarding your needs. Our law office hours are Monday through Friday from 9 a.m. to 12 p.m. and 1:30 p.m. to 5 p.m. Evening and weekend appointments are available upon request. We accept Visa, MasterCard, American Express and Discover credit cards.


Meet Our Attorneys
John F. Tolson Jr.
John has been helping clients for over four decades to resolve their complicated legal issues. John received his Juris Doctor from the University of Florida Law School in 1972. He went on to establish Tolson & Associates, P.A., in 1993, where he focuses on providing thorough and effective legal representation in the areas of estate planning, probate, tax law and real estate.
April R. Scott
April Scott received her bachelor's degree in Economics from the University of Florida in 2006 (B.A, cum laude), and her law degree from Florida State University in 2013 (J.D., Magna Cum Laude) as well as a master's degree in urban planning (M.S.P.).
W. Ashton Scott
William Ashton Scott ("Ashton") received his bachelor's degree in the field of Physics from St. John Fisher College in Rochester, New York in 2007. He was admitted to the United States Patent Bar in 2009 and worked as a patent prosecutor for four years prior to and during law school. He received his law degree from Florida State University in 2013.
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