New Eligibility Rules For Medicaid Nursing Home Coverage Take Effect In Florida

Main Category: Medicare / Medicaid / SCHIP
Article Date: 14 Nov 2007 - 7:00 PDT

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New rules took effect in Florida on Nov. 1 that limit the equity interest seniors can have on their homes to qualify for Medicaid coverage of nursing home care, the South Florida Sun-Sentinel reports. The new rules require that applicants have home equity interest no greater than $500,000, rather than the $750,000 maximum allowed under the federal Deficit Reduction Act of 2005.

Calculations will be based on local fair market rates and will be apply only to unmarried applicants who do not have children younger than age 21 or children of any age who have disabilities and reside in an applicant's home, the Sun-Sentinel reports. A provision that extends from three to five years the length of time that seniors cannot make significant monetary contributions, such as paying college tuition for an adult child or placing a down payment on a home years ahead of the application for senior home care, will be phased in starting in 2010.

Alice Reiter Feld -- an elder-law attorney in Tamarac, Fla. -- said, "It's important that people know this change is finally here, and they need to be careful with their gifts," adding, "We will have this hybrid law for some time, and it will be very confusing ... and maybe cause people to be denied." According to the Sun-Sentinel, the rules could delay Medicaid eligibility for some seniors because a penalty period will begin when a denied application was submitted, instead of when a gift was made.

Federal legislators who supported the changes said they are meant to discourage wealthy seniors from applying for federal subsidies and qualifying for Medicaid by legally reorganizing their assets and properties. According to data from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured, just 13% of seniors moved their assets within four years of becoming eligible for Medicaid and the average transfer was $5,380. A Government Accountability Office report in March showed similar data, with 12% of seniors transferring an average of $2,278 four years prior to eligibility (Lade, South Florida Sun-Sentinel, 11/12).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.