Navigating Long-Term Care in Florida

Florida participates in the long-term care partnership program. Owners of qualified LTC Insurance policies enjoy dollar-for-dollar asset protection from the future costs of extended health care. Plus, a wide variety of care providers offer services throughout the state.

While many qualified care providers are available when you need long-term health care services, the costs are rising due to the increasing demand for care services throughout Florida. 

The variety of quality care options available in Florida for those who require long-term health care services include:

• adult day care centers
• assisted living facilities
• continuing care retirement communities
• home health care providers
• memory care facilities
• rehabilitation facilities
• traditional nursing homes

Several insurance solutions are available to safeguard income and assets from the high costs and burdens of aging. Plus, all tax-qualified Long-Term Care Insurance policies in Florida have several consumer protections in addition to federal tax benefits.

Federal Partnership Program

Florida participates in the federal/state Long-Term Care Partnership Program authorized by the Deficit Reduction Act (DRA). Florida’s Long-Term Care Partnership Program is a partnership program between Medicaid and private long-term care insurers designed to encourage individuals to purchase private long-term care insurance.  Long-Term Care Partnership policies must be tax-qualified (a portion of premiums paid may be claimed as a tax deduction) under federal law; provide policyholders with inflation protection; and most importantly, provide dollar-for-dollar asset protection in the event the policyholder needs to apply for long-term care Medicaid assistance. For every dollar that a partnership policy pays out in benefits, a dollar of assets can be protected from Medicaid spend-down requirements.

The intent of the plan is to encourage people to make better plans for their future long-term care needs. A plan must meet state and federal requirements to be considered a partnership plan.

Policy Example

For example, if your partnership policy pays $300,000 in benefits the state will disregard an equal amount in the spend-down requirement for Medicaid. This would allow you to qualify for Medicaid long-term care benefits while retaining more of your assets than what Medicaid would typically allow. The state will not attempt to recover any money from the estate equal to the amount of benefits protected under your partnership long-term care policy.

Reciprocity

Most states have reciprocity with other states' long-term-care partnership programs including Florida. This means if you move from or to Florida your partnership asset protection follows you as well.

Medicaid

The Florida Medicaid program will pay for long-term health care if an individual has little or no income and assets. The Long-Term Care Medicaid spend down is $2,000. A spouse’s minimum asset allowance is $137,400. Your spouse’s minimum monthly income allowance is $3,435. * The home equity limit is $636,000.

For more information about the Medicaid program visit www.medicaid.gov

Florida Medicaid Estate Recovery Program

When a person applies for Medicaid in Florida and requires long-term services and supports, their estate will be subject to the Medicaid Estate Recovery Program, otherwise known as MERP.

Under the Florida Estate Recovery Program, the assets subject to recovery will include your home and other real estate, bank accounts, other financial assets, vehicles, cash, and even household goods. All deceased assets are subject to recovery, including holdings in most trusts.

The state may "look back" up to 60 months before application for Medicaid long-term care services to determine when income was reduced and resources were transferred.

In Florida, the primary residence with a home equity value of less than $636,000 is an exempt asset for Medicaid eligibility. A primary residence can be a single-family residence, a townhome, or even a mobile home if the applicant is an owner. Any additional parcels of real property in Florida or elsewhere, even a vacant lot, is a countable asset.

If there is no estate, recovery may be made against the spouse's estate. Recovery will not be made until after the individual's death and that of a surviving spouse, whichever is later.

Florida law requires the personal representative of an estate to notify all creditors, including Medicaid if the person received Medicaid long-term care benefits. Florida Statute 409.9101, called the "Medicaid Estate Recovery Act," contains the authority to collect this recovery.

Remember, Florida's Medicaid program will provide long-term care services only if you have little or no income and assets. However, the state will never require a living spouse to move out of their home. 

If a person had a qualified Partnership Long-Term Care Insurance policy, the total amount of benefits paid by the policy would be sheltered from asset recovery. 

State Resources for Aging and Long-Term Care in Florida

There are a variety of state resources available in Florida to help residents and their families with issues of aging and long-term health care. Many of these services benefit low-income families. 

• Florida Area Agencies on Aging AAA - 800-963-5337

The Department of Elder Affairs administers programs and services for elders across Florida through the eleven Area Agencies on Aging, known in the state as Aging and Disability Resource Centers (ADRCs). These ADRCs function as a single, coordinated system for information and access to services for all Floridians seeking long-term care resources. 

ADRCs deliver information and assistance about state and federal benefits and available local programs and services for older Floridians and their families. 

Find the closest ADRC by clicking here.

• Florida Long-Term Care Ombudsman - 888-831-0404

The Florida Long-Term Care Ombudsman program promotes and protects the residents of long-term care facilities and ensures their rights under federal and state law are protected.

In the state of Florida, a long-term care ombudsman is a trained volunteer who helps to improve the quality of care and quality of life for residents of long-term care facilities such as nursing homes, assisted living facilities, and adult family care homes.

The state says that almost 60% of long-term care residents in Florida do not receive visits from family members and friends. They are isolated and have no voice. The Florida Long-Term Care Ombudsman's office helps protect all long-term care facility residents regarding their individual rights, health, safety, and welfare. 

• Community Care for the Elderly (CCE) Program - 800-963-5337

The Community Care for the Elderly (CCE) Program provides community-based services organized in a continuum of care to help functionally impaired elders live in the least restrictive yet most cost-effective environment suitable to their needs.

CCE services numerous services, including adult day care, companionship services, counseling, home nursing, and legal assistance. Eligible individuals must be 60 years or older and functionally impaired. 

• Respite for Elders Living in Everyday Families (RELIEF) 850-414-2374

The RELIEF Program offers family members and loved ones providing constant care for a loved one with Alzheimer's and other dementia with the needed break or 'respite' from their caregiving role. Respite care reduces the stress and physical demands of being a caregiver.

• Veterans Affairs Long-Term Care 877-222-8387

Eligible Veterans can receive long-term care services if they're signed up for VA health care and meet the eligibility requirements that include service-related care and income requirements. Services include nursing and medical care, physical therapy, help with daily living activities, and pain management. 

Rate Stability Rules

In addition, Florida consumers enjoy additional peace-of-mind as the state has adopted Long-Term Care Insurance Rate Stability Rules.  These rules, developed the National Association of Insurance Commissioners, makes it much harder for an insurance company to get an approved rate increase.

Products Approved in Florida

A variety of products are approved in Florida for Long-Term Care planning. These include traditional plans including partnership certified policies and asset-based “hybrid” plans.

Tax Incentives

There are no current state tax incentives available as there is no state income tax; federal tax incentives do apply.

Reverse Mortgages in Florida

Reverse mortgages are available in Florida. A reverse mortgage is a type of home equity loan where the borrower does not have to make payments.

This type of mortgage can increase monthly income, eliminate mortgage payments, and even fund Long-Term Care Insurance. However, there are many rules in Florida on these products, and you should seek the help of a qualified and licensed mortgage broker. 

Several qualifications must be met before anyone can be approved for a Reverse Mortgage in Florida. For a single individual, they must be at least age 62 or older. For a married couple, at least one spouse needs to be age 62 or older. The home must be the principal residence. 

You must also have a home paid in full or have substantial equity in your home without any tax liens. 

Learn more about reverse mortgages by clicking here.

_{*The federal government sets a new minimum and maximum amounts each year, but states can set their own minimum requirements at any level between the federal limits. This information is based on the best available sources.}