Understanding Florida Medicaid Eligibility for Seniors: Why You Might Be Denied

Income Limits in Florida Medicaid

For a single individual in Florida, the gross monthly income limit to qualify for Long Term Care Medicaid is $2,901. For a couple receiving $2,000 combined from Social Security, this falls below the threshold, assuming no other income like pensions exists. Social Security counts as income, and additional funds must also stay under this limit to avoid disqualification.

The Critical Asset Limit

Florida Medicaid limits assets to $2,000 per individual at any point during the month. This includes cash, stocks, bonds, mutual funds, and cash surrender values of insurance policies if not handled correctly. Retirement accounts can also count if not managed properly. Exceptions include an irrevocable life insurance policy for burial and a non-interest-bearing burial fund up to $2,500.

Common Reasons for Denial

Denials often result from incomplete applications, missing information, or data not in the required format. The denial letter explains the reason, such as an asset overage or paperwork issues.

What to Do If Denied

Review the denial letter carefully. If unclear, an elder law attorney can analyze it and suggest fixes. Providing additional information within 30 days can sometimes reverse the decision. Attorneys help when facilities lack motivation or the process is complex.

Planning to Qualify

If assets exceed $2,000, spend down on medically necessary items or bills. Set up an irrevocable life insurance policy or burial fund to protect eligibility. An elder law expert can ensure compliance with Florida’s rules.

Why This Matters for You

For seniors on $2,000 a month, understanding these rules is key. Denial might stem from asset or application errors, but guidance can lead to successful reapplication.

How to Resolve your Florida LTC Medicaid Denial

Ready to resolve and start receiving Long-Term Care Medicaid? If you’re in Florida and facing challenges with Medicaid approval, don’t hesitate to reach out to us at atCause Law Office, the non-stuffy attorneys. Our team can review your denial letter and guide you through the next steps.