Florida’s Medicaid program can cover long-term care costs — but the rules are complicated, the stakes are high, and timing matters more than most people realize.
Long-term care in Florida is expensive. A private room in a nursing facility commonly runs $10,000 or more per month. Assisted living with memory care isn’t far behind. For most families, that’s not a bill they can sustain indefinitely from savings.
Medicaid — the joint federal and state program — does cover nursing home care for people who qualify. But “qualifying” is more complicated than most people expect. And by the time families find out how it works, they’ve often already made decisions that make the process harder than it needed to be.
Here’s what we walk families through when they come to see us.
Medicaid has an asset limit — and a look-back period
To qualify for Florida Medicaid’s nursing home benefit, an applicant’s countable assets generally need to be below $2,000. Some assets are exempt: a primary residence (under certain conditions), one vehicle, personal property, a prepaid funeral policy. But checking accounts, savings accounts, investment accounts, a second property — those count.
Here’s the part that catches families off guard: Medicaid looks back five years at asset transfers. If assets were given away or transferred to family members within that five-year window, Medicaid can impose a penalty period — a stretch of time during which the applicant is ineligible for benefits. The penalty is calculated based on the amount transferred, and it can run for months or even years.
This is why “just put the money in my kids’ names” is almost never a good answer.
Spousal protections exist — but they have limits
When one spouse needs nursing home care and the other doesn’t, the rules get more nuanced. Florida Medicaid allows a “community spouse” to keep a portion of the couple’s assets — currently up to about $154,000 — plus the home and a monthly income allowance. But every couple’s situation is different, and maximizing what the community spouse can keep while still qualifying the nursing home spouse requires careful planning and documentation.
We work with couples in this situation regularly. The law allows more flexibility than most people realize — but only if you know how to use it.
Planning is possible, even late in the game
One of the biggest misconceptions we encounter is the idea that it’s too late to do anything once a family member is already in a facility or about to enter one. That’s often not true.
There are legal strategies — some involving specific types of trusts, others involving the restructuring of assets into exempt categories — that can be used even when care is imminent or already underway. The window is narrower, and the options are fewer, but planning almost always beats not planning.
The families who come to us earliest have the most options. But we’ve helped families who came to us with very little time still find meaningful ways to protect what they’d spent a lifetime building.
Why this matters for estate planning too
If Medicaid pays for long-term care and the person later passes away while receiving benefits, Florida has the right to seek reimbursement from the estate. This is called Medicaid estate recovery. It can affect the home, and it can affect what’s left for children and grandchildren.
Estate planning and Medicaid planning are more connected than most people realize. A comprehensive plan addresses both — not just what happens at death, but what happens if there’s a long period of care before death.
When to get started
The best time to think about long-term care planning is before you need it. Five years before you might need nursing home care gives you the most flexibility, because of the look-back period. But if you’re already in a crisis, reach out anyway.
Our office handles both elder law planning and estate planning, and we take a coordinated approach. If you’re not sure where to start, that’s exactly what a consultation is for.
Lighthouse Legal Group is an estate planning and elder law firm in Orlando, Florida. We can be reached at (407) 494-6701 or through lighthouselegalfirm.com.