As a Certified Senior Advisor specializing in Medicaid representation in Florida, my business, Isenhour Senior Services, has been operating for over 25 years. We assist our clients in navigating the waters of the Florida Medicaid system for seniors in our community. We are a local business with the ability to represent anyone in the State of Florida having long term care needs. Each day, our staff members go breathless attempting to explain the differences between the various long term care Medicaid programs offered here in Florida. In this article, I will attempt to cover as many aspects of these programs as possible and assist you through this maze of confusion.
Long Term Care Programs:
1. ICP - Institutional Care Program (Nursing Home Medicaid) – This program is the one that most of the inquiries to our office are calling about. ICP is for nursing home residents who need assistance in paying the high cost associated with this level of care. The private pay cost of this type of care can range anywhere from $9,000 to over $15,000 per month. This program is for those who possess a need of assistance with at least 3 activities of daily living (bathing, dressing, toileting, transferring, feeding oneself) or are a hospice patient in addition to residing in a skilled nursing facility.
2. Hospice - For individuals with a life expectancy of 6 months or less. While Hospice services are primarily covered by Medicare, if a person resides in a nursing facility and are applying for Medicaid, hospice would assist in managing the care even in the nursing facility.
3. HCBS - Home and Community Based Services (Waiver programs)
A. Pace - Program of All-inclusive Care for the Elderly - This is a medical program that assists people who are living independently. The individual is expected to use the medical professionals that Pace contracts with, and recipient would attend their health center at least one day per week to see doctors there. Transportation is provided in addition to many other benefits. This program provides supportive services in order to allow the applicant to maintain their independence and the goal is to avoid placement for as long as possible. Hope Pace is a pilot program and not available in all counties. For more information, in SW FL call Hope Pace - phone number is 239-985-6400.
B. Medicaid Waiver for care at home, daycare or in an Assisted Living Facility-These programs are funded and have a waiting list which is managed by a state agency called the Area Agency on Aging. Each person who calls to be added to the waiting list is given a phone assessment appointment to be called by the agency at a later date and asked a series of questions. The phone assessment takes about 45 minutes and afterward the recipient is given a priority score based on physical need for care and is placed on the list based on their priority score. Those with the most need for assistance with activities of daily living are given a higher priority score than others with less need for physical help. The goal is to avoid nursing home placement, so those at a higher risk of possible nursing home placement are moved to a higher position than those that are more independent. They will usually ask financial questions as well during the phone assessment. Phone number for Area Agency on Aging is 239-652-6900.
Qualification and Procedure:
All long-term care Medicaid programs have the same income and asset limitations. The applications are submitted using an online portal through the Department of Children and Families (DCF). You may also fax in a paper application to the department, however submitting online gives access to information much more efficiently than waiting for notifications to come via U.S. Mail. Since you would be using the online portal, you may log in whenever you would like to check on your case and the online portal allows changes to be reported more easily, documents to be uploaded easily and notices may be viewed upon generation. This application process is comprehensive in terms of all financial aspects of the applicant’s situation in order for the caseworker to determine eligibility.
The Medicaid applicant income limit is currently (2022) $2,523 per month and increases each year commensurate with Social Security cost of living adjustments. The individual’s gross income is what is counted which is the amount prior to any deductions such as Medicare or other health insurance premiums, tax withholding, union dues, life insurance premiums, etc. If the applicant’s gross countable income exceeds the limitation, the individual would need to obtain the assistance of an elder law attorney to provide a remedy. Isenhour Senior Services is not a law firm, however we would be able to offer a list of competent attorneys to contact for the purpose of legal needs as they arise.
Allowable assets may include Florida homestead with a maximum value of $636,000 for a single individual and unlimited value if a spouse or minor child is living in the home; other income-producing real estate that is producing fair market value income (net income after calculated expenses is counted as income); additional property that is listed for sale at fair market value; vehicle of any value; IRAs if there is an income distribution in place; Irrevocable funeral arrangements of any value; An additional $2,500 in other burial funds which can be in the form of savings, life insurance cash value, or other assets that the value can be verified; and up to $2,000 in other liquid or non-liquid assets.
For nursing home Medicaid applicants where there is a spouse living in the community, the community spouse’s resource limit is $137,400 in addition to the previously mentioned items. If both spouses are in the same facility seeking Medicaid benefits, together they are limited to $3,000, rather than the larger community spouse resource limit. For nursing home applicants, there is usually a dollar amount that is to be paid from their income called a patient responsibility. The patient responsibility is paid to the nursing home and Medicaid pays the remaining balance of the charges. The applicant is allowed to keep $130 for personal needs and enough to cover any medical premiums such as dental or health insurance, hearing aid leases, etc..
When there is a community spouse living at home or in a private pay assisted living facility and their ill spouse is applying for nursing home Medicaid, their information is also included in the application for benefits and the community spouse may possess the ability to retain some of the applicant's income in order to meet their shelter expenses in the community. Currently the State of Florida allows the community spouse to retain a minimum of $2,289 from both spouse's income sources in order to meet their needs in the community. If the spouse has excess shelter costs, such as assisted living expenses, mortgage, rent or other high shelter expenses, the community spouse is allowed to retain more of the applicant's income, with a maximum total income allowance of $3,435 per month. This amount includes both spouse’s gross monthly income and these amounts usually raise each year as well. If the community spouse needs even more than this amount to cover their expenses in the community, they may wish to seek legal advice for a court order for spousal support.
For the Assisted Living Medicaid Waiver program, once the applicant’s name has come up on the Area Agency on Aging’s waiting list and the application is submitted and approved (usually a 60-day time period), then benefits begin the following month. The Medicaid recipient would then need to choose a managed care provider, so the individual would need to inquire with the facility in which they are residing as to their preferred Medicaid managed care provider. That provider would contribute up to somewhere between $1100 and $1500 per month toward the charges after the recipient has contributed their income minus allowances. The contribution amount is determined by the managed care provider and the facility in accordance with the contract that has previously been agreed upon between facility and managed care provider. The rest of the ALF’s charges would still need to be covered so that the facility still receives full payment. If the recipient’s income is not sufficient to cover the remaining charges and the family cannot cover the shortfall, the recipient may need to enter a nursing home if they qualify physically for that level of care, since nursing home Medicaid only expects the applicant to pay in less than their monthly income as their patient responsibility. This same Medicaid Waiver program can assist with homecare hours, daycare, and other services which would help them to remain in their home if that is a safe decision.
For all long-term care programs other than Hospice, there is a physical level of care evaluation that is completed by the Department of Elder Affairs which would determine if the individual meets the physical need of the program for which they are applying. This evaluation is requested by sending a 3008 form that has been completed and signed by the individual’s physician along with additional medical records including medication list to the Department of Elder Affairs. An assessor would then make arrangements for an evaluation to be performed wherever the individual is residing. The final report is then provided to the Department of Children and Families, and added to the financial documentation already sent in by the applicant and then the DCF caseworker is able to open the benefits for which the applicant had applied if all qualifications have been met.
If the individual had applied for nursing home Medicaid, the effective date of the Medicaid approval would be the 1st of the month that the application was submitted, providing the individual was eligible beginning in that month. The waiver programs are forward-moving programs in that benefit begins the 1st of the following month after approval is granted and enrollment in a Medicaid managed care plan has been completed. The plan that is chosen would provide a case manager who would contact the recipient and/or family to discuss the applicant’s needs and plan of care. The case manager would also remain involved in the client’s ongoing care needs.
In order to continue ongoing benefits, the applicant must submit a renewal of benefits each year with the Department of Children and Families and is also responsible for reporting any changes that occur along the way, such as changes in living arrangements, income, expenses, assets, etc. The physical level of care evaluation does not need to be repeated each year - only the financial piece.
So, as you can see, navigating these confusing waters of Florida’s Medicaid long term care system is forever in need of explanation. What I have provided here is a plethora of information to comprehend and we are here for you to help you through this maze. Call us at 239-542-7366.
With stores putting out holiday decorations well before Halloween, it is hard to avoid the hype surrounding the holiday season.For most people, it is an anticipated time of year with traditions, memories and family gatherings. But for older residents, these same reasons may result in the blues, making the holidays a challenging time. Sometimes beloved traditions and family gatherings become out of reach as we age and may be isolated from friends and families. Holidays may remind us of the passing of time, who is missing in our lives and who is not nearby. The loss of holiday traditions and gatherings often changes the way we feel about the holidays. Sometimes reminiscing on traditions that have gone can fuel feelings of loneliness.An AARP study found that 31% of respondents felt lonely during the holiday season. Additionally, another 41% worried about a family member or friend feeling lonesome. Whats more, more than 12 million Americans over age 65 live alone, according to the American Psychological Association. As children grow up and move away, neighborhoods change, and friends pass, the opportunities for close connections sometimes become limited. Financial constraints and loss of independence and mobility can change looking forward to the holidays to dreading them. To help avoid the holiday blues, here are some steps you can take to restore holiday joy. Find new ways to connect, such as video chat and email. Write letters, cards and call. You do not have to wait for family members to reach out. Take initiative. Connecting with others is one of the best ways to relieve loneliness. It is heathy to feel sadness about missing family and friends. It is important to acknowledge your feelings. Volunteer and help others. If you are able, you can help with daily tasks that may seem overwhelming or share a meal. If you are feeling lonely, maybe your neighbor is, too. Being available for someone else is good medicine. Be kind to yourself. Continue your wellness routines and healthy habits. Rethink how you do things this season. Joy is not limited to the last two months of the year! Every day can be treated as a holiday! Consider trying a new activity or hobby or teach someone something you are good at. Limit screen time. A constant diet of bad news creates anxiety. Resolve to make the best of the holidays but adjust your expectations and adopt realistic goals. While the holidays may look different over time, they can still be meaningful. The most important thing to make someone feel special this season is to simply spend time with them. If you cannot participate in person, FaceTime or Zoom also work.Here are other ways you can help others (and yourself) find joy in the holidays and help banish the holiday blues: Share your traditions with others and enjoy theirs. Reflect about past holidays as you unpack cherished decorations. Listen to the stories of others and ask about special pieces. Make a conscious effort to be available for those who might be feeling isolated. Plan a regular call or visit or reach out with a video call or old-fashioned letter. For anyone who might be struggling with holiday loneliness, provide a comfortable space for them to talk. Save judgments or problem solving and simply have a genuine conversation. As you plan your celebrations, look for ways to be inclusive. Extending an invitation may not be enough to make others feel included. Being with a crowd of strangers who have little in common can still feel very lonely. Being recognized and honored goes a long way in combating loneliness. Be open to asking about and including favorite memories such as treasured decorations, traditional treats and meaningful music. Religious organizations often offer extra social and/or spiritual support. Just talking with someone can go a long way. Bring or send familiar treats that represent holiday customs for elders to enjoy and share. Often, holiday blues are temporary. However, if symptoms last for more than two weeks, they can indicate clinical anxiety or depression. According to the National Institute of Mental Health (NIMH), socially isolated older adults are at higher risk for depression.It may be time to seek help if you or someone you love is experiencing any of these common symptoms of depression: Feeling so down you cannot shake it off Too little or too much sleep, or interruptions through the night Changes in appetite; eating more or less than usual Difficulty concentrating Lack of interest in the things that typically make you happy Irritability Lack of interest in socializing or engaging with others. Plan to look for and spread cheer this season, but if the holiday blues linger well beyond the season, discuss your symptoms with your primary care provider.ABOUT THE AUTHOR Courtney L. Whitt, Ph.D. is Director of Behavioral Health at Healthcare Network, which offers behavioral health services as a routine part of comprehensive care and traditional counseling services. Healthcare Network provides quality primary care services for children and adults in locations throughout Collier County. To learn more or make an appointment, please call 239.658.3000 or visit HealthcareSWFL.org.
When your friend is grieving, you want to do everything you can to be there for them and support them during this difficult time. But you may wonder are you overstepping? What if you say the wrong thing? Its common to second guess ourselves when we have the best intentions for supporting a friend after a loss.Grief is something we all experience at some point, but without some guidance, it can be difficult to know how to best support someone when theyve lost a loved one, said Erin Smith of The Terraces at Bonita Springs, a senior living community in Bonita Springs, FloridaWere starting a group for widows in our community called The Terraces Vita Nova Social Club. This will be a space where people in our local community who have lost their significant other have an opportunity to connect and socialize through new friendships, Erin continued.Vita Nova gives members the opportunity to talk about their experiences, their challenges, and enjoy the shared support of the people around them. The group will also focus on moving forward and finding joy in the next chapter of their lives through engaging gatherings and new friendships.Vita Nova aims to provide ladies with a space where they feel encouraged to venture away from isolated homes to spend an afternoon with others who have gone through a similar experience.As a friend, keep these simple ways in mind so that you can be there for a grieving friend.1. Reach Out to Your FriendReach out with a phone call or a text message to express your condolences. This small action lets them know youre there for them and will support them through this difficult time. Remember to keep reaching out, even after the initial wave of loss has settled.2. ListenYou may be with your friend when they feel like they want to vent about their emotions or talk about their loved one. A study examining grief support showed that allowing the grieving person to discuss their loved one and not rush them through their feelings felt emotionally supported.One key thing to remember is to not advise or interrupt your friend. Simply listening and letting them get anything they want off their chest can be a huge help to their grieving process.3. Validate Their FeelingsWhen your friend is discussing how theyre feeling, its important to validate them. While grief is a process, its not always a straightforward process. Your friend may have had a good couple of weeks, only to feel their grief all over again. Being there to validate their feelings and that its okay for them not to be okay can provide them with comfort and assurance.4. Show UpShowing up is one of the best ways to support your grieving friend.You cook a meal, drop it off to them, and its ready to go in the oven.You stop by with groceries.You take their dog for a walk or mow the lawn.Often, when you say, Let me know if I can do anything for you, your friend may not feel comfortable reaching out and asking. By showing up with a plan, you can alleviate some of the most difficult parts of going through the grieving process keeping up with everything else.Use the phrase Id love it if youd allow me to to increase the odds of them accepting your assistance without shame.5. Help Your Friend Find SupportWhile there are many ways you can support your friend, they may benefit from other types of support as well. A support group for people who have experienced loss, like your friend, can help them connect with others and hear from others who are further along in the grieving process. They may not be ready for quite some time, but gently remind them that they may find comfort in like-minded individuals.6. Plan an ActivityWhen your friend is going through the grieving process, some days or times of the week may be particularly difficult. For example, the demands of the workweek and running a house may keep your friend occupied Monday through Friday, but they struggle with Saturdays.Taking them out for coffee, to walk around a farmers market, or to their favorite restaurant can give them something to look forward to and get through the more difficult days.7. Keep in TouchMany people may be in touch with your friend immediately following their loss. However, when life starts to get back to normal, those people may stop reaching out. Keeping in touch with your friend will show them that youre there for them and available to give them support during the grieving process.Get Support at The Terraces at Bonita SpringsNavigating the loss of a loved one isnt something you should have to face alone. Fortunately, at The Terraces at Bonita Springs, youll have friends and associates to hold your hand and help. Give us a call at 239-949-7848 to learn more about our groups dedicated to those who have experienced the loss of a significant partner.
We all make mistakes in many areas of life. These mistakes are usually fairly harmless we took a wrong turn while driving, used the wrong ingredients in a recipe and so on. But sometimes, our mistakes can be costly especially those connected to investing.Here are some of the most common investment mistakes: Too much buying and selling Some people find it exciting to constantly buy and sell investments in the pursuit of big gains. Yet, frequent trading can work against you in a couple of ways. First, it can be expensive if youre always buying and selling investments, you could rack up taxes, fees and commissions. Perhaps even more important, though, excessive purchases and sales can make it difficult to follow a unified, cohesive investment strategy. Such a strategy requires, among other things, careful construction and management of an investment portfolio thats appropriate for your goals, risk tolerance and time horizon. Heavy trading can disrupt this strategy. Failing to diversify If you only owned one type of asset, such as growth-oriented stocks, your portfolio could take a hit when the financial markets go through a downturn. But not all investments will respond the same way to the same forces for example, stocks and bonds can move in different directions at any given time. And thats why its usually a good idea to own a mix of investments, which can include domestic and foreign stocks, bonds, certificates of deposit (CDs) and government securities. Keep in mind, though, that while diversification can help reduce the impact of market volatility, it cant guarantee profits or protect against losses in a declining market. Trying to time the market Buy low and sell high might be the original piece of investment advice, but its pretty hard to follow because no one can really predict when an investment will reach low or high points. Also, trying to time the market in this way can lead to bad decisions, such as selling investments whose price has dropped, even if these same investments still have good business fundamentals and strong prospects. Not understanding what youre investing in If you dont know the nature of investments when you buy them, you could set yourself up for unpleasant surprises. For example, some companies, by the very nature of their business and the type of industry theyre in, may consistently pay dividends to their investors even though their stock prices may only show relatively modest price gains over time. If you bought shares of this stock, thinking it had the potential to achieve quite substantial appreciation, you might end up disappointed. Making the wrong comparisons Youre no doubt familiar with some of the most well-known investment benchmarks the S&P 500, Dow Jones Industrial Average and the Nasdaq Composite. But it might be counterproductive to compare your results against these indexes. If you have a diversified portfolio, youll own an array of investments that wont fit into any single index or benchmark, so you wont get an apples-to-apples comparison. Youre better off comparing your portfolios performance against the only benchmark that really matters the progress you need to make to help achieve your goals.Investing will always have its challenges but you can help make it easier on yourself by staying away from as many mistakes as possible.Chad Choate III, AAMS828 3rd Avenue WestBradenton, FL firstname.lastname@example.orgThis article was written by Edward Jones for use by your local Edward Jones Financial Advisor.Edward Jones, Member SIPC
Our office helps nursing home patients and assisted living residents as well as people in their own homes apply for Medicaid benefits. We stand by our work by offering a money-back guarantee our fee returned to you if you are not approved for Medicaid due to an error on our part.Our office focuses specifically on Medicaid representation with over 20 years of experience in this field. Our knowledge and ability and 100% approval rating on nearly 90 cases a year speaks for itself as well as a close working relationship with Florida government social service specialists. *Our office prides itself on its integrity, approachability, and one on one personal service with references available at the highest level upon request.* We also continue in the role of Authorized Representative for the Medicaid recipient's lifetime, performing yearly reviews in order to continue benefits, as well as processing notification of changes along the way. The Medicaid recipient or their family will never have to deal with the Department of Children and Families.Our office specializes in helping nursing home patients and assisted living residents as well as people in their own homes apply for and get approved for Medicaid benefits.Discovery Organize Application Submission Upload & Approval Commitment to you as long as neededYearly Review