Florida Medicaid planning is the legal work of reshaping a person’s income and assets so they can qualify for the Statewide Medicaid Managed Care Long-Term Care program without spending every dollar they saved. For 2026, a single applicant needs countable assets at or below $2,000 and gross monthly income at or below $2,982. Most Florida seniors sit above one line or both, and the strategies below — Qualified Income Trusts, Lady Bird deeds, personal services contracts, and spousal protections — are how families close that gap legally, provided the planning starts before a health crisis forces a rushed application.
The 2026 Eligibility Limits
The income ceiling is 300 percent of the federal SSI benefit rate. With the 2026 SSI rate at $994 per month, the cap works out to $2,982.1Social Security Administration. SSI Federal Payment Amounts for 2026 Every dollar of gross income counts: Social Security, pensions, annuity distributions, investment income. One dollar over the cap means ineligibility unless a Qualified Income Trust is in place.
The asset limit for a single applicant is $2,000 in countable resources. For married couples where one spouse needs care and the other stays home, the rules split. The community spouse can retain up to $162,660 in 2026 under the Community Spouse Resource Allowance. The applicant spouse still has to bring their own countable assets down to $2,000. The community spouse also has income protection through the Minimum Monthly Maintenance Needs Allowance, which in 2025 ranged from $2,555 to $3,948 per month and adjusts upward for 2026.
What Counts and What Doesn’t
Countable assets include bank accounts, CDs, stocks, bonds, mutual funds, life insurance cash value above certain thresholds, and any real estate beyond the primary home. Joint bank accounts are fully countable if the applicant can withdraw from them.2Florida Department of Children and Families. 1640.0000 SSI-Related Medicaid Asset Eligibility
The primary residence is the largest exempt asset. Florida excludes the home from the calculation regardless of market value, as long as the applicant intends to return to it or a spouse or dependent relative continues to live there.2Florida Department of Children and Families. 1640.0000 SSI-Related Medicaid Asset Eligibility Federal law imposes a home equity ceiling though. Equity above $713,000 (the base federal threshold, adjusted annually) makes the applicant ineligible regardless of the homestead exemption, with states permitted to elect a higher cap up to roughly $1,071,000.3Office of the Law Revision Counsel. 42 USC 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets Florida homeowners in high-value coastal markets get caught on this one.
Life insurance has its own rule. If the combined face value of all policies on one person is $2,500 or less, none of the cash surrender value counts. Once total face value crosses $2,500, the cash surrender value of every policy becomes countable.2Florida Department of Children and Families. 1640.0000 SSI-Related Medicaid Asset Eligibility Term life and burial insurance carry no cash value and stay out of both calculations.
The 60-Month Look-Back Period
Florida reviews every financial transaction from the 60 months before the application date. Assets given away or sold below fair market value during that window are presumed to be transfers made to qualify for benefits, and the state imposes a penalty period of ineligibility.4Legal Information Institute. Florida Administrative Code 65A-1.712 – SSI-Related Medicaid The 60-month window applies to transfers made on or after January 1, 2010.3Office of the Law Revision Counsel. 42 USC 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets
The math: the state divides the total uncompensated value of all transfers by the average monthly private-pay nursing home rate in Florida. The most recently published divisor is $10,438 per month. A $104,380 gift to a grandchild inside the look-back window produces roughly 10 months of ineligibility. The penalty does not start on the date of the gift. It starts on the later of the date the applicant would otherwise qualify for Medicaid or the first day of the month the transfer happened.4Legal Information Institute. Florida Administrative Code 65A-1.712 – SSI-Related Medicaid There is no cap on the length of the penalty. A large enough transfer can produce years of ineligibility that begin only once the applicant is otherwise out of money.
This is why planning belongs on the calendar well before care is needed. Families who transferred a vacation home or helped a child with a down payment three years ago often discover the consequence only when they file.
Qualified Income Trust for Excess Income
If gross monthly income exceeds $2,982, a Qualified Income Trust (also called a Miller Trust) is not optional. It is the only route to eligibility. The trust is an irrevocable account that receives the portion of income above the cap each month, and once that excess is deposited, the state disregards it for eligibility purposes.4Legal Information Institute. Florida Administrative Code 65A-1.712 – SSI-Related Medicaid The applicant, a spouse, a guardian, or an agent under a valid durable power of attorney can establish it.
The money is not sheltered from care costs. For a single applicant, the funds deposited into the trust flow out to the nursing facility as part of the patient responsibility (the Medicaid co-pay). For a married applicant, some of the trust income may be diverted to the community spouse under the MMMNA rules. Any funds left in the trust when the recipient dies are paid back to the state. The trust must be funded every month coverage is needed. Miss a month and eligibility lapses for that month.
Lady Bird Deed for the Home
The enhanced life estate deed, commonly called a Lady Bird deed, lets the owner keep full control of the home during life — the right to sell it, mortgage it, or revoke the deed — while naming a beneficiary who takes the property automatically at death without probate. Because the owner keeps the power to change the beneficiary at any time, the Department of Children and Families does not treat the arrangement as a completed transfer, so it does not trigger a look-back penalty.
The deed also handles a second problem. Florida’s Medicaid estate recovery program reaches only probate assets, and a Lady Bird deed moves the property outside probate by operation of law. Without this deed or a similar non-probate mechanism, a home that was exempt during the applicant’s lifetime can become the target of a state recovery claim after death.
Personal Services Contract for Family Caregivers
A personal services contract, sometimes called a caregiver agreement, lets an applicant pay a family member for future caregiving services. The lump-sum payment converts countable cash into an exempt expenditure, as long as the contract reflects fair market value for the anticipated work. DCF reviews the terms, pay rate, and hours during the application.
The payment is calculated by multiplying a reasonable hourly rate by expected weekly hours, then by the applicant’s remaining life expectancy under DCF actuarial tables. A parent with a 6.62-year life expectancy receiving 10 hours per week of care at $35 per hour could support a contract of roughly $120,000. The contract cannot be retroactive. Payments for care already provided count as gifts and get penalized. DCF rejects arrangements that read as disguised gifts, so the paperwork needs precision.
Spousal Protections and Spousal Refusal
Two federal protections apply automatically for married couples: the Community Spouse Resource Allowance (up to $162,660 in 2026) and the Minimum Monthly Maintenance Needs Allowance, which lets the at-home spouse keep an adequate share of the couple’s monthly income, sometimes drawing from the institutionalized spouse’s income to get there.
Florida also recognizes a more aggressive move called spousal refusal. The community spouse formally refuses to make their separate assets available for the institutionalized spouse’s care. Florida abolished the common law doctrine of necessaries in 1995, so spouses have no legal obligation to support each other financially for Medicaid purposes. The applicant spouse assigns support rights to the state, which in theory gives the government a path to pursue the refusing spouse for reimbursement, though enforcement has historically been limited.
There is a real trade-off. DCF takes the position that a community spouse who refuses to share assets also gives up the right to receive the MMMNA income supplement from the Medicaid spouse. If the community spouse’s independent income is low, losing the supplement can hurt more than the asset protection helps. Spousal refusal works best when the community spouse can cover living expenses on their own.
Power of Attorney: The Precondition Most Families Miss
Most of these strategies depend on someone acting on the applicant’s behalf, especially when cognitive decline is already present. Florida Statutes section 709.2202 requires that a power of attorney authorize certain acts through a separate signature or initial next to each specific power listed. An agent can create trusts, make gifts, change beneficiary designations, or modify survivorship rights only if the principal individually signed or initialed each of those enumerated powers.5Florida Statutes. Florida Code 709.2202 – Authority That Requires Separate Signed Enumeration
A generic, boilerplate power of attorney almost never contains those separate authorizations. Without initialed authority to create inter vivos trusts and make gifts, an agent cannot set up a Miller Trust or execute a personal services contract for a parent who has lost capacity. Families often discover the document is inadequate at the exact moment the parent can no longer sign a new one. Reviewing and updating the power of attorney belongs on the front end of any planning conversation.
Estate Recovery After the Recipient Dies
Qualifying is not the end. Florida’s Medicaid Estate Recovery Act creates a debt equal to the total medical services paid on behalf of a recipient who was 55 or older when the benefits were provided.6Florida Statutes. Florida Code 409.9101 – Recovery for Payments Made on Behalf of Medicaid-Eligible Persons After death, the Agency for Health Care Administration files a claim in probate.
The reach is limited to probate assets. Property that passes outside probate through a Lady Bird deed, a trust, joint ownership with right of survivorship, or a beneficiary designation is not subject to the claim. Assets protected under Florida’s constitution, including protected homestead property, are also shielded. The state will not enforce the debt against a recipient survived by a spouse, a child under 21, or a child who is blind or permanently disabled.6Florida Statutes. Florida Code 409.9101 – Recovery for Payments Made on Behalf of Medicaid-Eligible Persons
Heirs outside those protected categories can request a hardship waiver. Qualifying generally requires having lived in the recipient’s home for at least 12 months before death, owning no other residence, and showing that recovery would deprive the heir of basic necessities. Losing an expected inheritance is not hardship. Benefits paid before the recipient turned 55 create no recoverable debt at all.
Documentation, Filing, and Appeals
DCF requires five years of financial records. Gather consecutive bank statements for every account held by the applicant or spouse across the full 60-month window, real estate deeds, life insurance policies with face and cash surrender values, Social Security award letters, and pension statements showing gross monthly amounts before deductions. If a Qualified Income Trust is needed, identify a trustee and open a dedicated bank account for it before filing. Any personal services contract and the payment documentation go in with the application. Missing records are the most common reason applications stall, and DCF will not process the file until the record is complete. If a bank account was closed years ago, request the statements early.
Applications go through the Florida ACCESS portal or by mail to a regional DCF office. The state must decide within 45 days for a standard application, extending to 90 days when a disability determination is involved.7MyACCESS. Medicaid Details Financial eligibility is only half the review — a separate medical determination through the CARES program has to confirm the applicant needs a nursing-home level of care, and both reviews run in parallel.8Elder Affairs Florida. Comprehensive Assessment and Review for Long-Term Care Services (CARES) Program For home and community-based services (as opposed to nursing home placement), a frailty-based waitlist adds another wait even after eligibility is confirmed.9Agency for Health Care Administration. SMMC LTC Program Waitlist Release
A denial or termination can be appealed through a fair hearing, but the request must reach the Agency for Health Care Administration within 90 days of the date on the Notice of Case Action.10Agency for Health Care Administration. 59G-1.100 Medicaid Fair Hearings Filing before existing benefits end can keep coverage in place during the appeal. Common grounds for reversal include DCF treating an exempt resource as countable, miscalculating a look-back penalty, or failing to account for a properly funded Qualified Income Trust. Miss the 90-day window and the denial is final.