I'll Never Financially Qualify for Medicaid - Will I?

To be very bold, the answer is yes, you will.

Long Term Care Medicaid operates on 2 simple rules regarding finances.

1)            You must be under $2,829 of GROSS COUNTABLE Income (in 2024).

2)            You must be under $2,000 of GROSS COUNTABLE Assets (in 2024) as a single person or $154,140 for a couple.

The key word is COUNTABLE. 

Countable INCOME 

There is only one way to reduce COUNTABLE income and that is to establish what is called a Qualified Income Trust which artificially reduces COUNTABLE income by the amount of income you deposit in the trust. For example, if gross countable income is $3,192 and you deposit $500 of income into the QIT account then Medicaid only counts $2,692 ($3192 - $500 = $2,692) which is $200 below the limit of $2,892. Therefore, qualification is allowed despite what was previously considered excessive income. 

Countable ASSETS 

There are many ways to convert countable assets into NON-COUNTABLE assets, and/or expend them using qualified expenditures, and/or transfer them using qualified transfers. In fact, there are more than 30 ways of rearranging excess countable assets and an almost endless combination of ways. The possibilities are so numerous it is simply not feasible to provide the information here. Suffice it to say that even multi-millionaires can qualify for Long Term Care Medicaid. 

What is the HCBS Waiver Program (Home Health Care or Assisted Living)? 

The HCBS Waiver Program, short for Home and Community Based Services Waiver Program, is designed for individuals needing financial assistance for home health care, adult day care, or an assisted living facility.

When applying for Medicaid assistance for traditional skilled nursing, the patient needs only to file the application, whereas a patient seeking financial assistance for in-home care, or an assisted living must undergo a more complicated process. 

Process for In-Home Health Care and Assisted Living 

An individual seeking Medicaid assistance for in-home care or an assisted living facility must schedule a screening call with the geographically appropriate Aging and Disability Resource Center for placement on the waitlist. The waitlist utilizes a needs-based ranking, with scores from 1-5. A ranking of 1 indicates a "low" need, while a 5 indicates a "high" need. The higher the need, the more likely an individual is to be placed on the waitlist AND ALSO called off the waitlist quickly. Once the patient is called off the waitlist, he or she may then apply for Medicaid. 

Upon approval for Medicaid, he or she must then enroll in a managed care program and long-term care program. Medicaid benefits will only begin the first day of the month following the month in which Medicaid eligibility is approved, and the patient is enrolled in both a managed care program, as well as a long-term care program. 

How to Bypass the Waitlist for HCBS Waiver Services 

It is possible to bypass the waitlist if, a patient:

1) Is in a skilled nursing facility.

2) Has already been approved for long-term care Medicaid.

3) Is enrolled in a managed care program and wishes to discharge home or to an assisted living facility.

4) The Medicaid long-term care recipient is evaluated by the managed care company to determine their ability to transition home or to an assisted living facility. If determined that the applicant is eligible to transition, he or she may do so without undergoing the waitlist process.

Medicaid eligibility will follow the recipient to any new long-term care arrangements where care is needed. Form 2515 must be filed by the managed care company.

How Platinum Benefit Services Can Help 

It should be clear that this process is complex. While an applicant can attempt this process alone or can have the appropriate Aging and Disability Resource Center attempt to navigate it on behalf of the family, Platinum's HCBS Success Escalation Service provides a meaningful difference with a substantial increase in the likelihood of success. 

An applicant/legal representative in crisis can easily become overwhelmed when attempting to navigate the intricacies of the waitlist process. Further, Florida's Aging and Disability Resource Centers are notorious for mismanaging the process. 

Using Platinum Benefit Services is a game changer. When working with Platinum and enrolling in our HCBS Success Escalation Program, Platinum will provide you with the information, training, and services necessary to maximize the chances you or your loved one is placed on the waitlist with a high ranking AND ALSO selected off the list quickly. The fee for the program is just $500 and is worth every penny! 

If you choose to hire platinum to process the medicaid application in advance of contacting the ADRC the $500 fee is waived. 

Free Instructions For Getting On The HCBS Waitlist 

By accessing the site below, Platinum will provide FREE OF CHARGE to you, a video that explains the HCBS Waiver program and how you can get on the waitlist without assistance and FREE. 

https://waitlist.platbenservices.com/waitlist

At the end of the video, if you choose to get help, the video will explain how you can enroll in Platinum's HCBS Success Escalation Program, as well as, a video that explains how to "ace the test" when answering interview/screening questions. This second video will teach you how to answer the questions honestly, in a way that maximizes the likelihood of being placed on the waitlist, with a high ranking. Platinum even provides a list of the questions that will be asked!

Platinum's HCBS Success Escalation Program

Our automated system will enroll you with the proper ADRC, which starts the benefit approval process. Platinum will confirm with the appropriate ADRC that the patient's name has been submitted and that a screening call has been scheduled. Platinum will then check in once a week with the ADRC to track the status of the patient's selection from the waitlist. Further, we will also follow up to confirm that you are aware the call is scheduled, and we will confirm the date and time. 

Once the potential applicant is called off the waitlist, a form 1823 will be provided to you that needs to be completed by your doctor and provided to the ADRC along with supporting documentation. The 1823 must be properly completed and signed by your doctor or a nurse practitioner. Platinum will track this form as it is passed 4 times, to 3 government agencies, and confirm proper distribution and receipt. 

You will then have the option to hire Platinum to complete the Medicaid application process on your behalf While you can file on your own, or have the ADRC file for you, there are potential problems beyond belief Dealing with The Department of Children and Families (Medicaid) has become the epitome of a bureaucratic nightmare. 

Platinum Success for Families 

Over more than 26 years Platinum has obtained 14,000+ Medicaid approvals in the State of Florida alone. We'll help you obtain approval as well. If you decide to go it on your own, no hard feelings, we truly wish you the very best! 

Qualifying financially, regardless of assets or income is the easy part! What's hard is being selected off the waitlist and then navigating DCF during the application process. 

Let's get you enrolled in the "HCBS Success Escalation Program" by contacting Platinum at 1-800-582-1934, pressing O and say, "I would like to sign up for the Success Escalation Program". We look forward to working with you!

Call us at 1-800-582-1934 or go to https://waitlist.platbenservices.com/waitlist

ASK FOR :

Hilary Hayes, CSA Certified Senior Advisor 

Serving Collier, Lee, Charlotte Glades, Hendry & Monroe

Nothing in this document or other information, in whatever format provided by Platinum Benefit Services, Inc, is legal advice. If legal advice is needed, please contact a competent and properly licensed attorney. If you would like a referral to an attorney, please contact our office at 1-800-582-1934