The Basic Rules of qualifying for nursing home eligibility under the Florida Medicaid Institutional Care Program for a couple where one spouse requires institutional care and the other spouse remains in the community are as follows.
- The gross monthly income for the spouse in need of institutional care cannot exceed $2,313.00. If the gross monthly income for the spouse in need of institutional care exceeds $2,313.00 then a Qualified Income Trust will be required. In determining the gross monthly income, the spouse is allowed to retain a monthly personal needs allowance of $130.00.
- The non-exempt assets of the spouse in need of institutional care cannot exceed $2,000.00.
- Examples of non-exempt assets are checking accounts, savings accounts, brokerage accounts, certificates of deposit, stocks and bonds U.S. savings bonds, real estate that is non-homesteaded, life insurance with cash values exceeding $2,500.00, boats, loans, non-qualified annuities and IRAs where no RMD (required minimum distribution) is being taken.
- Examples of exempt assets are marital home (provided the home value does not exceed $585,000.00) motor vehicle, personal property, term life insurance, life insurance owned by the community spouse with a face value of less than $2,500.00, burial plans that are irrevocable in any amount, income producing property (the asset is exempt but the income from the property is included in the monthly income of the spouse in need of institutional care), IRA’s where RMD’s are being taken (the asset is exempt but the RMD income is included). Annuities purchased prior to 2007 that are required to make monthly payments and qualified annuities (the asset is exempt but the monthly payment is included as income).
- The spouse remaining in the community may retain up to $126,420.00 in non-exempt assets.
- There is no limit on the monthly gross income of the spouse remaining in the community
- If the gross income is less than $2,058.00, a portion of the gross monthly income of the spouse in need of institutional care may be diverted to the spouse remaining in the community up to $3,161.00 per month.
- The spouse remaining in the community is entitled to what is called excess shelter cost.
- The excess shelter cost is the amount by which the community spouse’s shelter costs exceeds $617.00 per month.
- The total amount of diverted gross income and excess shelter credit and utility allowance cannot exceed $3,090 per month.
- Shelter costs include rent or mortgage payment, homeowner’s insurance, condo maintenance fees.
- The spouse remaining in the community is also allowed a monthly utility allowance of $347.00 per month.
- The total amount of diverted gross income and excess shelter credit and utility allowance cannot exceed $3,161.00 per month.