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Florida is an income cap state. This means that to be eligible for Medicaid long-term care benefits, the Medicaid Institutional Care Program (ICP), the applicant must be under the income limit. If the applicant’s income is greater than the “Income Cap” the applicant is not eligible. So to remedy this problem an applicant must establish and properly fund an Irrevocable Income Trust through which the portion of income that exceeds the “Income Cap” must travel on its way to the Nursing Home as part of the Patient Responsibility for Medicaid (ICP). Yes, the same amount of income goes to the nursing home as patient responsibility if there were no income cap. So, there is no real difference except this legal instrument that is required by law to be prepared by an attorney and must be formally executed, notarized and provided to a bank with Trust Certifications to prove to the Department of Children and Families the bank has approved and establish this “Income Trust” and that a relatively small amount of income has been funneled through to the nursing home in order to be in compliance.
This happens every month.
What's The Difference?
Non-income cap states allow applicants to have unlimited income because it simply reduces the amount the government reimburses the Nursing Home. Whereas income cap states require the amount to be no higher than their limit ( currently $2,250 in Florida ) at the time of application. What is ironic here is both states ultimately require the same amount of CO-PAYMENT and both states enjoy the reduced amount the government reimburses the Nursing Home. Florida law says all of an applicants income is required to be paid to the Nursing Home for CO-PAYMENT minus a personal expense allowance and allowable deductions.
So the net result is the same amount of CO-PAYMENT goes to the Nursing Home in both states except in the income cap state an ATTORNEY must be involved to prepare the legal document (Miller Trust) for eligibility. That is why it is important that you get an Advisor that knows the Florida Medicaid Eligibility rules and regulations and together with an attorney from our exclusive network, (this keeps your cost much lower) we can help you put in place the money saving tactics and strategies that will enable your family member to be eligible for Florida’s Medicaid Nursing Home Program. We are the go-to team for Florida Medicaid Eligibility-Florida Nursing Home Medicaid. Florida Medicaid Long Term Care Eligibility.
Statewide Medicaid Managed Care (SMMC) Longterm Care (LTC) program
The Florida Medicaid program has a program through which Medicaid recipients may receive long-term care services. This program is called the Statewide Medicaid Managed Care Long-term Care Program. The Long-term Care program has two types of health plans: Health Maintenance Organizations (HMOs) & Provider Service Networks (PSNs)
Individuals are required to be enrolled in the Long-term Care program if they are:
Services and meet the following criteria:
Individuals who are enrolled in the following programs are NOT required to enroll, although they may enroll if they choose to:
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