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January 2024 Florida LTC Medicaid Income Cap Increase

January 2024 Florida LTC Medicaid Income Cap Increase
Medicaid Planning
Jason Neufeld
January 3, 2024

As of January 1, 2024, the Florida Long Term Care Medicaid Programs' (i.e. Institutional Care Program or Home and Community Based Services / Medicaid Waiver) Income Cap has increased to: $2,829.00/month. 

What is the Florida Medicaid Income Cap in 2024?

Different Medicaid programs in Florida have different income and asset thresholds. For this article, I am only discussing the Florida Income Cap for Long-Term Care Medicaid Programs: ICP, which helps to pay for nursing home costs; and Medicaid Waiver, which helps to pay for home-health care or Assisted Living Facility costs.

The Medicaid Waiver (a/k/a Home and Community Based Services) and ICP program have the same income and asset thresholds. The income threshold changes every January 1st.

As of January 1, 2024, the LTC Medicaid Income Cap in Florida is: $2,829.00 per month.

All sources of income are added up together (i.e. Social Security, IRA / 401k / 403b distributions, annuity payments, pensions, rental income, etc...). If all gross sources of income combined exceeds the income cap in any calendar month, then without additional action, the individual is not eligible for Medicaid to help pay for help at home or in a long-term care facility.

What Happens if Income Exceeds $2,829.00 Per Month? 

If a Medicaid applicant (or existing Medicaid recipient)'s income ever exceeds the income cap in any calendar month, the excess amount needs to be transferred into one of two places: 

  1. Qualified Income Trust ("QIT") - also known as a "Miller Trust"; or
  2. Pooled Special Needs Trust ("PSNT")

Once excess gross income has been appropriately calculated and transferred into a QIT, funds can come out of the trust (the same day if you want) to pay for any health or medical related expense for the individual wanting, or already receiving, Medicaid LTC benefits.

If using a Pooled Trust, in lieu of a Miller Trust, the trust funds can be spent on anything the Medicaid recipient needs or wants (medical or non-medical).

  • As an aside, only excess income should ever go in a Qualified Income Trust (never assets); while Pooled Special Needs Trusts can receive income, or assets, or both.

How Might a Medicaid Recipient's Income Increase?

Your income changes every year (at the very least your social security check has increased).

Beyond social security retirement income, some people have increased RMDs that must flow out of their IRA or other qualified retirement account.

Other Medicaid recipients may have inherited a new form of income (e.g. spouse passes away and now surviving spouse receives their pension as one example; or a parent passes away leaving an inherited IRA).

Still others, usually in a long-term care facility, may want to rent out their home now that they are no longer occupying it to take advantage of the extra rental income (which, if planned for properly is allowed by Florida Medicaid).

For Those Who Already Have a Miller Trust in Florida

You want to take another look at all of your income, from all sources, to determine the proper amount to transfer into your Miller Trust (or Pooled Trust) each and every calendar month in 2024.

  • Note: you can always over fund your Qualified Income Trust (meaning, you can transfer more income than what is legally required every month) -- but transferring even a penny too little can jeopardize Medicaid Waiver or ICP benefits.

For those in a skilled-nursing facility, all income less the personal needs allowance (currently $160.00) is going to make its way to the nursing home anyway (generally, we are not as concerned about overfunding a QIT in a nursing home setting).

But, for those at home or in an ALF, you generally want to avoid significantly overfunding the income trust.

This video provides a practical guide on how to use your Miller Trust / Qualified Income Trust.

For Those on Medicaid Who Do Not Have a Qualified Income Trust

If a Florida Medicaid recipient's income has increased, resulting in gross income that exceeds $2,829.00 (from all income sources combined), it would be wise to reach out to establish a QIT or PSNT immediately.

If you are concerned about a change in income or whether or not you need a QIT / Miller Trust, please feel free to reach out.

If you are interested in learning more about how we legally and ethically protect income and assets to help Floridians qualify for Medicaid long-term care services (without having to sell your house, without having to wait five years, and without having to go broke first), please schedule a consultation.

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References: Florida Medicaid | Benefits.gov

Jason Neufeld

Jason Neufeld is the Founder and Managing Partner of Elder Needs Law, a Florida estate planning and elder law firm he created in 2017. With more than 15 years of experience practicing law, he represents clients in a wide range of legal matters, including Medicaid planning, estate planning, elder law, probate, Medicare, and life insurance.

Jason received his Juris Doctor from the University of Miami — School of Law and is a member of the Florida Bar and the Broward County Bar Association. He has received numerous accolades for his work, including being named a Rising Star and Super Lawyer by Super Lawyers and among the Florida Legal Elite by Florida Trend in 2024.

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