Medicaid Planning for Long Term Care - Elder Law

Medicaid Planning for Long Term Care - Elder Law

If you or your loved one needs long-term care in a skilled nursing facility (SNF), you may be wondering how to pay for it. The average cost of a SNF in the Panhandle of Florida is about $10,000 per month, which can quickly deplete your savings and assets. Fortunately, there are several options to help you cover the cost of long-term care, such as: 


·        Medicare: This is a federal health insurance program for people who are 65 or older, disabled, or have certain diseases. Medicare covers up to 100 days of SNF care per benefit period, but only if you meet certain criteria. For the first 20 days, Medicare pays the full cost. For the next 80 days, you have to pay a co-payment of $185.50 per day (in 2024). After 100 days, Medicare stops paying and you have to pay the full cost out of pocket or use another source of payment. 


·        Long-term care insurance: This is a type of private insurance that covers some or all of the cost of long-term care services, such as SNF care. The amount and duration of coverage depend on the policy you choose and the premiums you pay. However, most policies have a cap that is reached within the first 24-36 months, and often only cover a portion of the daily expense. 


·        Private pay: This means using your own cash or assets to pay for SNF care. This option may be suitable for people who have enough savings or income to afford the high cost of long-term care. However, most people do not have enough resources to private pay for more than a few months or years. 


·        Medicaid: This is a federal and state program that pays for health care services for people with low income and assets. Medicaid is the largest payer of long-term care in the United States, covering more than 80% of SNF residents when you remove rehab patients from the consideration. Unlike Medicare, Medicaid does not have a time limit for SNF care if you meet eligibility requirements. 

How to Qualify for Medicaid for SNF Care

Medicaid is often confused with Medicare, but they are very different programs. To qualify for Medicaid for SNF care, you have to meet the following requirements: 


·        Medical necessity: You (the person needing Medicaid) will have to need a level of care that can only be provided in a SNF, as determined by a medical professional.  


·        Income limit: Your gross monthly income (before taxes and deductions) has to be less than $2,829 (in 2024). If your income is higher, you can still qualify by using a Qualified Income Trust (QIT), which is a special type of trust that allows you to divert some of your income to pay for your medical expenses and other needs. 



·        Asset limit: Your total countable assets (such as cash, bank accounts, stocks, bonds, etc.) must be less than $2,000 (in 2024). However, some assets are not counted, such as your home (valued less than $713,000), your car, your personal property, your funeral plan, certain income producing properties, and certain retirement accounts. 

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