Qualifying for Medicaid ICP Benefits

Meeting the Asset Limit Test, the Income Limit Test & the Benefits of a Qualified Income Trust

There are many types of Medicaid programs in Florida.  Medicaid ICP benefits for nursing home residents are administered through the Florida Department of Children and Families.  There are three eligibility tests that must be passed to obtain Medicaid ICP benefits.


  1. Medical Necessity for Skilled Care
  2. Income Test (we can still get you qualified if over income limits)
  3. Asset Test (we can still get you qualified if over asset limits)


 Eligibility Requirements Include:


  • Must be 65 or older or disabled as determined by Social Security criteria
  • Must be a U.S. citizen or qualified noncitizen
  • Must be a Florida resident
  • Must have a Social Security number or apply for one
  • Must be determined to be in need of nursing facility services
  • Must be placed in a nursing home that participates in the Medicaid program

Asset Limit Test


Determine Which Assets Count Towards Your Asset Limits

To Qualify for Medicaid ICP benefits, certain assets count towards your asset limits and other are exempt. The limits are as follows:


  • $2,000 for an individual
  • $117,240 for a married couple (one spouse residing in the community)
  • $3,000 for a couple who are both in the nursing home
  • If the individual or a couple has income at or below 88% of the Federal Poverty Level (FPL) the asset limit is $5,000 for an individual and $6,000 for a couple who are both in the nursing home


Some Types of Assets That Do Count


These assets count towards your asset limits:

  • Real property, other than home
  • Bank accounts, Certificates of Deposit (CDs), money market funds
  • Stocks, bonds
  • Trusts
  • Life insurance cash value if the face value of the policies owned on any insured individual totals more than $2,500 ($1,500 for SSI recipients)

 

Transfers of Income and Assets


Transfers of income or assets may affect eligibility. 

 

Some Types of Assets That Do Not Count


  • Home, if the individual or dependent lives there, or if the individual is absent but intends to return
  • One vehicle
  • Revocable burial funds up to $2,500 (or $1,500 for SSI recipients)
  • Irrevocable pre-paid burial contracts
  • Life insurance, if the total face value of all policies owned by the individual for any one insured does not exceed $2,500 ($1,500 for SSI recipients)

 


Income Limit Test


Florida’s “Income Cap”


Florida has an “Income Cap”. If the individual’s income exceeds the cap, the application will be denied.


  • The income limit for ICP for 2014 is $2,163
  • Only total gross monthly income that belongs to the nursing home applicant is considered in determining eligibility for ICP.
  • Some types of income include, but are not limited to:
  • Social Security
  • Veterans Administration Benefits
  • Pensions
  • Income from mortgages
  • Contributions

 


Qualified Income Trust


How to Qualify Despite Having Too Much Income


Individuals with income over the Medicare ICP income limit may still be eligible if they set up a “qualified income trust” and deposit sufficient funds every month into the “qualified income trust” account so their income outside the trust is less than the income limit.


To qualify, the “qualified income trust” must:


  1. Be irrevocable;
  2. Be comprised of income only; and,
  3. Designate that the state will receive any funds remaining in the trust upon the death

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