What is Medicaid planning, and when should we start?

Medicaid planning is the process of legally structuring your finances so that you or your loved one can qualify for Medicaid benefits to help cover the cost of long-term care without spending down everything the family has worked for. The best time to start is before care is needed, when the widest range of strategies is available. But even in a crisis, when a loved one is already in a facility or about to enter one, an experienced elder law attorney can often take steps to help protect the family's financial well-being.

Does Medicaid cover assisted living, or only nursing homes?

In Florida, Medicaid can help cover care in both assisted living and nursing home facilities, but is a needs-based program. For questions about your specific situation, give us a call at 727-343-8959.

What is the difference between Medicare and Medicaid?

One of the most common questions families have is understanding the difference between Medicare and Medicaid. They sound similar, but they work very differently, and the distinction matters most when long-term care is needed. Many families assume Medicare will cover a parent's nursing home stay, only to learn later that the coverage has ended. Understanding the difference between Medicare and Medicaid early can give your family more time to plan and explore available options.

What happens if Medicaid is approved? Is the process over?

Medicaid approval is an important milestone; however, maintaining eligibility is ongoing. Medicaid recipients must continue to meet program eligibility requirements as the State requires annual recertification for continued benefits. Changes in income, assets, or other circumstances, such as receiving an inheritance or selling property, can affect eligibility can impact eligibility if improperly handled or reported. HKH Elder Law offers a Continuing Care Program to help families who want ongoing support to maintain eligibility and respond to Medicaid requests after approval.

What areas of Florida does HKH Elder Law serve?

HKH Elder Law operates primarily in the Tampa Bay area, but offers Medicaid planning and application services throughout the entire state of Florida. While our office is based in St. Petersburg, we are equipped to assist families throughout the state.

What is Medicaid?

Medicaid is a joint state and federal program designed to help eligible individuals have access to health care, including long-term care. The Agency for Health Care Administration is responsible for Florida's Medicaid program. Applications are submitted through the Department of Children and Families, the agency responsible for determining applicants' eligibility.

For many families, Medicaid becomes important when a loved one needs long-term care in a nursing home, an assisted living facility, or at home. The cost of care is often more than an individual or family can afford. Medicaid can assist elderly and disabled individuals with the cost of care in a nursing home or assisted living facility. Furthermore, Medicaid can also assist with the cost of care at home.

Medicaid is a needs-based program, which means individuals must meet certain eligibility criteria. The Medicaid application process can be daunting, and qualifying often requires very careful planning. Seeking the assistance of an elder law attorney to assist you in this area is extremely important.

If you're considering whether Medicaid is right for you or your family's situation, or if you’re wondering what to do next, we’re here to help. For more than 20 years, the attorneys at HKH Elder Law have helped Florida families navigate Medicaid planning and eligibility. We'll explain your options, guide you through the process, and help you and your family move forward with confidence.

Schedule a Consultation

Florida Long-Term Care Medicaid Asset & Income Criteria for 2026

Criteria

2026 Limit

Asset Limit [single applicant]

$2,000

Asset Limit [community spouse]

$162,660

Income Limit [applicant – gross amount]

$2,982/month

Income Limit [spouse – gross amount]

No Limit

Personal Needs Allowance [applicant]

$160/month

Minimum Spousal Income Diversion

$2,705/month

Maximum Spousal Income Diversion

$4,067/month

Community Spouse Excess Shelter Allowance

$812/month

Homestead – Exempt Value

$752,000

Transfer of Asset Penalty Divisor

$10,645

Unique Considerations in Florida Medicaid

In addition to federal Medicaid law, Florida has its own set of rules, regulations, and interpretations. Here are a few of the state-specific factors that can potentially affect families:

Florida is an income-capped state

Florida is an income-capped state, meaning there is a hard limit on how much income an applicant can have and still qualify for long-term care Medicaid. If an individual is over the limit, there are solutions, including establishing a Qualified Income Trust, which can be put in place to help obtain eligibility.

The five-year lookback

In addition, there is an asset limit for Medicaid eligibility in Florida. Another factor to consider is the potential penalty that may result from the improper transfer or gifting of assets.

When reviewing Medicaid applications, the state applies a five-year lookback. Any gifts or asset transfers made during that window can result in a penalty period of ineligibility. It's not too late to plan. There are strategies available to protect assets and help qualify for Medicaid.

Homestead property and the community spouse

Florida has protections for the homestead. The homestead is typically considered a non-countable resource up to a set amount. There are also protections in Florida for the community spouse (the spouse who remains). The details entirely depend on the family's full financial picture. An experienced elder law attorney can help determine the best course of action for your specific situation.

Eligibility standards, including income and asset limits are reviewed and updated annually by the state.

Working with an attorney who specializes in this area of law can be beneficial for families attempting to navigate this complex area.

Interested in learning more? Check out these additional resources.

Medicaid

9/16/2026

11:00 am

Understanding Florida Medicaid - Medicaid for Long-Term Care

Presented By:

Jonathan Kinsella

Attorney Jonathan Kinsella walks through common Medicaid questions, including eligibility, planning, and how to prepare for the application process.

Presented by:

Considering HKH for your Medicaid needs?

We want you to feel supported and informed every step of the way. Below are a few resources to help you along the way.

Are you concerned about long-term care?

9/16/2026

11:00 am