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What is Medicaid? What does Medicaid Cover?

What is Medicaid? What does Medicaid Cover?
Medicaid Planning
Jason Neufeld
March 24, 2020

Medicaid is a partnership between the Federal Government and The State of Florida to provide a variety of different benefits for those who qualify. Medicaid is many things, not one single program; it is an umbrella term for a variety of programs. Most people are familiar with Medicaid as a safety net provider of health insurance for the poor. This is, by far, Medicaid’s most well-known program.

However, Medicaid has other less-well-known programs. These Medicaid programs include:

Medicaid for Emergency Medical Assistance (EMA) for Non-Citizens: The EMA program will cover certain serious emergency medical conditions for those who would qualify for Medicaid but for their citizenship status.

Medicaid for Pregnant Woman: Loosened requirements are available for pre-natal care for pregnant woman who are in need.

Temporary Cash Assistance (TCA): The TCA program is available for those caring for children under 18 years old who fall below a specified income level. Once one qualifies for TCA, they are automatically eligible for Medicaid health insurance.

Medicaid for Former Foster Care Children: available until age 26 if they had Medicaid when they aged out of foster care.

Medicaid for Children: Caretakers and parents can apply for Medicaid on behalf of the children they care for who are under 21 years old and live with the Medicaid applicant.

SSI-Related Medicaid: Low Income Individuals (who qualify for SSI) either 65 years old and older OR disabled are automatically qualified for Medicaid health insurance. There isn’t a need to file an ACCESS application unless long-term care services are needed.

Medical Needy Program: This is for those who do not meet the strict Medicaid requirements to be eligible, but still need assistance paying for outstanding medical bills. This is also known as "share of cost" Medicaid in Florida.

Florida Medicaid Programs For Elderly or Disabled Americans

Our elder law attorneys work with older US citizens, in Florida, who are looking to for long-term care benefits at home (need help paying for home health care or live-in assistance with activities of daily living); or need help paying for Assisted Living Facility (ALF) bills; or require skilled nursing / rehab / nursing home care. The below Medicaid long term care programs are what we help people qualify for (usually after protecting their income and assets which currently exceed Medicaid eligibility requirements) or assist with the application process.

Medicaid Institutional Care Program (ICP): If the applicant desires Medicaid to pay for institutionalized care, such as nursing home care, must apply to the ICP Medicaid program in Florida and meet certain income and asset requirements. This is a less-well known program and can be a huge benefit for the elderly finding themselves facing exorbitant long term care expenses. Talk to your Medicaid planning attorney to discuss what steps are necessary for medicaid qualification.

Florida Medicaid Waiver LTC Programs: the Medicaid Waiver programs have a waitlist, but are designed to provide in-home or services (or assistance paying an Medicaid approved ALF bill) to hold off the need for institutionalize care such as a nursing home. Your medicaid planning lawyer should be familiar with these programs as well. Medicaid Waiver programs are also referred to as home and community based services Medicaid or the State Managed Medicaid Long Term Care program.

Medicare Savings Program: This program assists those currently receiving Medicare with paying their Medicare premiums (and sometimes copays and deductibles) depending on their income level. Medicare Savings Programs, such as QMB - Qualified Medicare Beneficiary - eligibility criteria are only slightly looser than Medicaid Waiver or ICP eligibility. Because of this, when someone comes to us looking to become eligible for a Medicare Savings Program, our elder care lawyers will explain why it often makes more sense to seek Florida Medicaid Waiver benefits as well.

Additional information on the variety of Florida Medicaid programs can be found at this link.

Elder Law Attorney Resources

Read more about How to Apply for Medicaid here.

Other Medicaid Programs For the Elderly.

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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