What are the core eligibility rules that must be met before someone can qualify for Medicaid nursing home benefits?

Here is the general rules.  There are lots of qualifications.  For more information contact Matthew A. Linde today.

1. Citizenship. A Medicaid long-term care recipient must be a U.S. citizen or a "qualified alien".

2. Residence. The applicant must be a resident of Florida.  Residency requirements are usually fairly simple to meet: Physical presence in the state coupled with no current intent to move out of the state is a common test of residence.

3. Medical need. Before qualifying for long-term care assistance, the applicant must need long-term care. Generally, the applicant is scored on a test measuring functional disabilities; the applicant who is unable to complete at least several "activities of daily living" (ADLs) without assistance will usually qualify. Greater medical need will almost surely qualify the applicant under this test.

4. Resources. Except for coverage to those with "low-income" Medicaid under the Affordable Care Act the first of two financial requirements, resource eligibility, generally requires that the applicant have available resources worth less than $2,000 for a single applicant. The rules for married couples, and the exceptions and special rules applicable to both married and single applicants, are different in order to avoid "spousal impoverishment". For those with low-income Medicaid (eligible under Medicaid expansion, but not eligible otherwise as being disabled, etc.) there is no resource eligibility test.

5. Income.  For 2015 the applicaint cannot have more than $2,199.00 of countrable income.

Matthew A. Linde
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