Current Florida Medicaid eligibility amounts for long‑term care (Institutional Care Program or HCBS Waiver) as of mid‑2025:
🧾 Asset Limits & Community Spouse Resource Allowance (CSRA)
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Community Spouse Resource Allowance: up to $157,920 in total assets the non‑applicant spouse may retain while the applicant applies for Medicaid myflfamilies.com+12medicaidlongtermcare.org+12medicaidplanningassistance.org+12
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Individual applicant asset limit: $2,000; Couple applying together: $3,000 virtuallawoffice.com
💰 Income Limits – Applicant & Spousal Allowance
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Applicant income cap: $2,901/month (gross); if exceeded, a Qualified Income Trust (e.g. Miller Trust) or Pooled Trust is required seniorplanning.com+3elderneedslaw.com+3dhclaw.com+3
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Community spouse own income: unlimited and not counted dhclaw.com+2medicaidplanningassistance.org+2dhclaw.com+2
🏠 Monthly Maintenance Needs Allowance (MMMNA)
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Minimum MMMNA: $2,555/month (effective January 2025) medicaidlongtermcare.org+9elderneedslaw.com+9virtuallawoffice.com+9
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Maximum MMMNA: $3,948/month (effective January 1, 2025) medicaidplanningassistance.org+6medicaidplanningassistance.org+6hkhelderlaw.com+6
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Excess shelter allowance: $766/month; plus a Standard Utility Allowance (approx. $370/month) may permit diversion above the minimum up to the maximum MMMNA dhclaw.com+6elderneedslaw.com+6elderneedslaw.com+6
⚖️ Penalty Divisor for Look‑Back Transfers
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Penalty divisor (used to calculate ineligibility period for improper transfers): $10,438 per month (effective January 2024 into 2025) elderneedslaw.com+2dhclaw.com+2hkhelderlaw.com+2
🗂 Summary Table
| Category | Current Florida Amount (2025‑early) |
|---|---|
| Community Spouse Resource Allowance (CSRA) | $157,920 |
| Asset Limit – single applicant | $2,000 |
| Asset Limit – married couple applying together | $3,000 |
| Applicant Gross Income Cap | $2,901/month |
| Community Spouse Income (not counted) | Unlimited |
| Minimum MMMNA | $2,555/month |
| Maximum MMMNA | $3,948/month |
| Excess Shelter Standard | $766/month |
| Utility Allowance (SUA) | ~$370/month |
| Penalty Divisor | $10,438/month |
✅ Planning Notes (still applicable)
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Applicants with income above $2,901 must use a Qualified Income Trust (QIT) to qualify.
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Income diversion to the community spouse is calculated based on their own income and shelter costs (housing + utility allowance), up to the maximum MMMNA.
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The care‑level requirement (e.g., skilled needs) determined by the Department of Elder Affairs remains the same.
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Proposed strategies involving gifting, testamentary trust planning, or Special Needs Trusts remain critical to protect both spouses A comprehensive, tailored strategy for your specific numbers is advisable if needed.
🧾 Hypothetical Medicaid Planning Case – 2025
📍 Background
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Husband (John, age 82): Needs skilled nursing care and is applying for Medicaid (Institutional Care Program).
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Wife (Mary, age 79): Lives at home (community spouse).
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They jointly own $175,000 in countable assets.
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John’s gross monthly income: $3,100
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Mary’s gross monthly income: $900
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Mary pays $1,000 in rent and $400 in utility bills monthly.
✅ Step-by-Step Medicaid Eligibility Review
1. Asset Test
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Florida allows the community spouse (Mary) to keep up to $157,920 of the couple’s total assets.
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John (the applicant) may retain only $2,000.
🧮 Calculation:
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Total assets: $175,000
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Subtract Mary’s CSRA allowance: $157,920
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Subtract John’s limit: $2,000
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Excess Assets: $15,080 must be spent down legally before John qualifies.
✅ They can spend this excess on exempt items: home repairs, funeral plans, a newer vehicle, or paying off debt.
2. Income Test
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Medicaid Income Cap: $2,901/month (2025)
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John’s income is $3,100, which exceeds the cap.
✅ John will need a Qualified Income Trust (QIT). He can deposit any amount above the cap (e.g., $199/month) into the QIT each month to qualify.
3. Spousal Income Allowance (MMMNA)
Mary may receive part of John’s income if her own income is low.
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Minimum Monthly Maintenance Needs Allowance (MMMNA): $2,555
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Mary’s own income: $900
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She can receive an income diversion of:
$2,555 – $900 = $1,655/month
➕ Shelter Allowance Bonus:
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Mary’s shelter cost: $1,000 rent + $400 utilities = $1,400
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Standard shelter allowance: $766
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Excess shelter: $1,400 – $766 = $634
So, additional diversion permitted (but total capped at $3,948):
$2,555 base + $634 = $3,189
💰 Mary can be allocated up to $3,189 of John’s monthly income (depending on his total income). Since John earns $3,100/month, virtually all of it could be diverted to Mary.
4. Medicaid Penalty for Gifts
If the couple had gifted $50,000 to children in the last 5 years:
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Penalty Divisor = $10,438/month
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$50,000 ÷ $10,438 = ~4.79 months penalty
⛔ John would be ineligible for ~4.8 months unless funds are returned or planning is done (e.g., caregiver agreements or promissory notes).
💡 Summary
| Test | Result |
|---|---|
| Asset Limit | $15,080 |
| Income Cap | Exceeded → QIT needed |
| Spouse Income Need | $3,189/month can be diverted to Mary |
| Gifting Penalty | ~4.8 months of ineligibility |
👨⚖️ Notes
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A testamentary special needs trust should be included in Mary’s will in case she predeceases John, to avoid disqualifying his benefits.
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Early Medicaid planning (ideally 5+ years in advance) allows for more flexible asset protection strategies like irrevocable trusts.
We at Burzynski Elder Law have been practicing law in Naples since 1988. We are committed to providing our clients with excellent elder law services delivered with compassion. Please be sure to contact us today! Please call the office at 239 434-8557 to set up your initial consultation to schedule an initial assessment.