The institutional Medicaid program in Florida is the Florida Medicaid Institutional Care Program ("ICP"). Medicaid provides free or low-cost health coverage to eligible or needy persons.
Program Contact
(866) 762-2237
Additional Info:
Managing Agency:
The Medicaid agency's name in Florida is the Florida Department of Children and Families (“DCF").
Eligibility
To be eligible for Florida Medicaid, you must be a resident of the state of Florida, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be one of the following:
To qualify, you must have an annual household income (before taxes) that is below certain amounts, depending on household size.
To learn more about Florida Medicaid, please go to the Florida Medicaid website.
Medicaid has eleven area offices that serve Medicaid providers and recipients. To find your local office, please visit the Recipient Information page.
More detailed information on who is potentially eligible for Medicaid is available at the Medicaid Eligible Reports page.
Available Asset Description:
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Checking accounts;
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Savings accounts;
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Brokerage accounts;
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Certificates of deposit;
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Stocks and bonds;
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Savings bonds;
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Primary residence if applicant does NOT intend to return home (note that if equity is greater than $688,000.00, then applicant does not qualify for Medicaid);
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Limited partnerships;
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Cash value of life insurance, above the $2,500.00 limit;
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Vehicles other than the one excluded vehicle;
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Boats, unless it is your primary residence;
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Recreational vehicles, unless it is your primary residence or your only vehicle;
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Loans payable to applicant;
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Deferred annuities and some immediate annuities, depending on how they are structured and the date purchased; and
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Retirement funds that are not making regular periodic automatic distributions.
Excluded Asset Description:
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Primary residence if applicant intends to return home (note that if equity is greater than $688,000.00, then applicant does not qualify for Medicaid);
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Primary residence, regardless of equity, if spouse, child under age 21, or blind or disabled child of any age lives there;
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Other real property if rented or listed for sale at fair market value;
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One vehicle, regardless of age or value;
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Life insurance with no cash value;
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Life insurance with cash value, up to $2,500.00;
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Irrevocable burial contracts;
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Funds designated for burial expenses, up to $2,500.00;
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One burial plot per family member; and
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Retirement funds of the applicant, if in payout status.
Retirement Accounts
Retirement funds of the applicant: Retirement funds are work-related annuities and plans for providing income when employment ends (for example, retirement plans administered by an employer or union, disability, or pension). Other examples are funds held in an individual retirement account (IRA) and plans for self-employed individuals, sometimes referred to as Keogh plans. Retirement funds must be treated as an asset or as income, unless they are considered unavailable. If an individual is eligible to receive regular payments from a retirement fund, the payments are considered unearned income, and the fund is not considered a countable asset to the individual. (If the individual is eligible to receive payments but elects not to, he is ineligible due to failure to file for other benefits to which he is entitled.) If the individual is not eligible to receive payments from the retirement fund, the value of the funds currently available is considered a countable asset. Any penalty imposed due to early withdrawal can be deducted when computing the value of the retirement fund, but any taxes due are not deductible. A retirement fund is not an asset if an individual must terminate employment in order to obtain any payment. Retirement funds that are unavailable due to legal restrictions are not counted.
Retirement funds of spouses: At the time of application, if the community spouse receives payments from their retirement funds, the funds are not considered an asset when computing the couple's total countable assets. The payment is considered unearned income to the community spouse when computing the community spouse income allowance. At the time of application, if the community spouse does not receive payments from a retirement fund he owns, but he has the option of withdrawing a lump sum, the total value of the funds must be considered an asset when computing the couple's total assets and the community spouse's asset eligibility. Early withdrawal penalties are excluded from the value of the funds, but any imposed taxes cannot be deducted.
Annuities
The purchase of an annuity on or after 11/01/2007, and within the look-back period, by an individual (or his representative) will be considered a transfer of assets for less than fair compensation unless the annuity meets all of the following requirements:
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Names the Florida Agency for Health Care Administration (AHCA), as the primary beneficiary, for the total amount of medical assistance paid on behalf of the individual, except for when the individual has a spouse or minor or disabled adult child. In this case, the state shall be named as secondary beneficiary after the spouse and/or the minor or disabled child. Note: If the spouse or minor/disabled child disposes of their primary remainder beneficiary interest for less than fair market value (for example, transferred their interest to someone who does not meet the criteria), AHCA must be named primary beneficiary, or the individual will be subject to a transfer of asset penalty;
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Is irrevocable and non-assignable;
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Makes payments (that include both principal and interest) to the individual in equal amounts during the term of the annuity, with no balloon or deferred payments; and
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Is actuarially sound based on the actuarial tables used by the Social Security Administration, (refer to Appendix A-14).
If the annuity meets all of the above criteria, funds in the annuity are excluded as a resource and the periodic payments are counted as income in the eligibility determination and patient responsibility. If all of the requirements above are not met, the total amount of funds transferred into the annuity is considered a transfer without fair compensation, except when the annuity is revocable or assignable. When the annuity is revocable, count as an asset the amount the purchaser would receive from the annuity issuer if the annuity is cancelled. When the annuity is assignable, count as an asset the amount the annuity can be sold for on the secondary market.
Planning Strategies include:
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Gifting Plus Annuity;
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Gifting Plus Promissory Note;
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Gifting Plus Partial Return;
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Purchase Income Producing Real Estate;
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Purchase Annuity for Community Spouse;
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Make Exempt Transfer (any asset);
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Make Exempt Transfer to Sole benefit trust;
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Make Exempt Transfer to a Pooled Trust;
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Make Exempt Transfer to a Self-Settled Special Needs Trust;
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Make Exempt transfer of home;
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Transfer Home, Retain Life Estate Interest;
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Lady Bird Deed;
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Purchase Life Estate in Home of Another;
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Lump Sum Personal Service Contract;
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Purchase Prepaid Funeral Services Contract;
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Create a Burial Savings Account;
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Purchase an Exempt Automobile;
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Make Exempt Renovations to the Home;
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Transferring assets to an irrevocable trust (Medicaid Asset Protection Trust®);
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Purchase fractional interest in real estate; and
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Spousal refusal.
