If you’re thinking about long-term care, even “just in case”, the most important step is talking with an elder law attorney before a crisis happens.
Medicaid planning is highly time-sensitive. One mistake, made too late, can cost your family tens of thousands of dollars and limit your care options. A paid Medicaid planning consultation allows us to review your assets, timeline, and goals and help you understand what strategies are available right now.
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Below, we’ve outlined the key Medicaid eligibility rules and planning considerations so you can better understand why early, personalized planning matters.
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Thinking about a future where you might need long-term care can feel uncomfortable, even pessimistic. But planning for Medicaid isn’t about expecting the worst. It’s about protecting everything you’ve worked for and ensuring you have choices when and if you need care.
Because of Medicaid’s five-year look-back period, the ideal time to plan is years before you think you’ll need care. The earlier you start, the more options you have and the more you can preserve. But even if you’re starting late, there are still strategies available—the key is working with an experienced elder law attorney who can maximize whatever timeline you have.
Let’s walk through what you need to know about Medicaid eligibility and why starting now can protect both your assets and your access to quality care.
Why Plan Now Instead of Later?
The single most important reason to plan early is Medicaid’s 60-month look-back period.
When you apply for Medicaid, the state reviews every financial transaction you’ve made in the past 60 months (five years). If you gave away assets or transferred them for less than fair market value during this time, you’ll face a penalty period where you can’t receive Medicaid benefits, even though you need care.
Here’s what that means in practice: If you transfer your house to your children today and need nursing home care three years from now, Medicaid will discover that transfer and penalize you. You’ll be ineligible for benefits for a period of time, and your family will have to pay for your care out-of-pocket during that penalty period. At $8,000-$12,000 per month for nursing home care in Florida, those penalties add up fast.
The Real Cost of Waiting
The penalty period equals the value of what you gave away divided by $10,438 (Florida’s 2025 penalty divisor—the average monthly cost of nursing home care).
Example: You give your daughter $100,000 to help with her mortgage:
- $100,000 ÷ $10,438 = 9.5 months of ineligibility
- You’d need to pay for care out-of-pocket for nearly 10 months
- That’s roughly $95,000-$120,000 your family would need to cover
This is why timing matters. The further in advance you plan, the more strategies become available to you.
Medicaid Essentials: What You Need to Know
Medicare vs. Medicaid: Understanding the Difference
Many people assume Medicare will cover their long-term care needs. Unfortunately, that’s not the case.
Medicare coverage for long-term care is extremely limited:
- Requires a 3-day hospital stay first
- Days 1-20: Zero co-pay
- Days 21-100: You pay $210.50 per day (2025)
- Days 101+: You pay everything
After just over three months, you’re on your own. At $8,000-$12,000 per month for nursing home care in Florida, those costs add up fast.
Medicaid provides comprehensive coverage for long-term care, including nursing home care, in-home care services, physician services, and prescription drugs. But you must meet strict financial requirements to qualify.
Basic Qualification Requirements
To qualify for Medicaid long-term care services in Florida, you must meet both requirements:
- Physical Eligibility: You must need assistance with activities of daily living (ADLs) such as eating, bathing, dressing, transferring, using the bathroom, and walking.
- Financial Eligibility: Your income and assets must fall within Medicaid’s limits:
- Income limit for 2025: $2,901 per month
- Asset limit for a single person: $2,000 in countable resources
However, many assets are exempt and don’t count toward this limit, including your home (up to $730,000 in equity), your vehicle, personal property, life insurance policies under $2,500, and prepaid burial arrangements.
Why Strategic Planning Makes All the Difference
Understanding these basic rules is one thing, knowing how to navigate them to protect your family’s financial security is entirely another.
The goal isn’t just to qualify for Medicaid; it’s to qualify while preserving as much as legally possible for your spouse, your heirs, and your own peace of mind. This is where working with an experienced elder law attorney becomes invaluable.
How Strategic Planning Protects Your Assets
Maximize exempt assets: An attorney can help you identify your exempt assets and strategies on converting countable assets into exempt ones such as prepaying funeral expenses, making home improvements, setting up a caregiver agreement or putting those assets into a pooled trust. This reduces what counts against your $2,000 limit while improving your quality of life.
Time transfers appropriately: Certain transfers are penalty-free (such as transfers to a spouse) , and others can be structured strategically if you have enough planning time. The key is understanding which is which and when to act. A misstep here can cost you tens of thousands of dollars in penalties.
Protect your spouse: If you’re married, the rules change significantly. There are special protections that can preserve over $150,000 in assets for the healthy spouse—but these protections must be structured correctly. The strategies for married couples are completely different than those for single individuals.
Structure income properly: If your income exceeds Medicaid’s limits, tools like Qualified Income Trusts can make you eligible while still providing for your needs. But these must be set up and managed correctly.
Plan for your estate: Florida may try to recover Medicaid costs from your estate after you pass. Proper planning so that your assets avoid probate can minimize or eliminate this recovery, preserving your home and other assets for your heirs.
Why DIY Planning Usually Backfires
Many people try to handle Medicaid planning themselves, often based on advice from well-meaning friends or internet research. The most common costly mistakes include:
- Transferring the house to children: This triggers penalties if done within five years of needing care AND creates major tax consequences for your children when they eventually sell.
- Withdrawing large amounts of cash: Without proper documentation, Medicaid assumes you gave it away, triggering penalties.
- Making gifts without understanding penalties: Even small regular gifts to grandchildren can add up to significant penalty periods.
- Waiting until a crisis: By the time you need care, many protective strategies are no longer available.
- Assuming you must spend everything: There are legal strategies to preserve assets—you just need to know what they are and when to use them.
Each of these mistakes can cost tens of thousands of dollars or delay care when you need it most. The rules are complex, they change annually, and Florida has specific requirements that differ from other states.
Every Situation Requires a Custom Strategy
Your planning strategy depends on multiple factors that make your situation unique:
- Your marital status: The rules and strategies for married couples are significantly different than for single individuals.
- Your asset types: Real estate, business interests, and retirement accounts all require different approaches.
- Your timeline: How much time you have before you might need care affects which strategies are available to you.
- Your family situation: Who will be your caregiver, whether you have children, and your relationships all influence the best approach.
- Your care preferences: Where you want to receive care and what quality of life you want to maintain matters.
- Your estate goals: What you want to preserve for your family affects which strategies make sense.
This is why a personalized plan is essential. What works for your neighbor or friend may not be the right strategy for you—in fact, it could be exactly the wrong approach for your circumstances.
The Value of Planning Early
The earlier you plan, the more options are available. With five years of planning time, strategies that would trigger penalties in a crisis situation become perfectly legal and effective. Your attorney can help you understand which strategies fit your timeline and goals and create a roadmap that protects your assets while ensuring you’ll qualify for care when you need it.
Your Next Steps: Creating Your Personal Plan
Planning for potential long-term care needs isn’t pessimistic; it’s empowering. You’re taking control of your future, protecting what you’ve worked for, and ensuring you’ll have access to quality care if you need it.
The difference between pre-planning and crisis planning can literally be hundreds of thousands of dollars in preserved assets and significantly less stress on you and your family.
Don’t wait until you’re in crisis mode. The best time to plan was five years ago. The second-best time is today.
Contact Orlando Law Group today to schedule your Medicaid planning consultation. We’ll help you understand your options, protect your assets, and create a plan that gives you peace of mind about your future.
Information current as of 2025. Medicaid rules and financial limits change annually. This article is for educational purposes only and does not constitute legal advice. For guidance specific to your situation, consult with an experienced elder law attorney.