Florida Nursing Home Medicaid Income

If they are a penny over—$2,313.01—then they do not qualify for Medicaid income-wise. This presents a big issue for a lot of Medicaid applicants as a $2,313 is quite a low bar for qualifying for Medicaid.

The first question that needs to be answered is:

What is income?

The Florida Medicaid Access manual defines income as the following:

Income includes both earned and unearned income. What in the world is unearned income? Well, earned income would be a salary, wages, commission, or profit from a business—basically any income where you perform services to earn the income.

Unearned income is when you do not perform any services to earn the income. Unearned income includes retirement payments, annuities, pensions, dividends, royalties, social security income (SSA), social security disability (SSD), and supplemental security income (SSI).

Does Florida Medicaid Care About Gross or Net Income?

A common mistake when calculating a Medicaid applicant’s income is that the gross income is not totaled. Most people look at the income received in the Medicaid applicant’s bank account each month and assume that is the gross income.

Unfortunately, income received in the Medicaid applicant’s bank account is usually the net income—meaning that some tax was withheld or a premium was paid before the monthly income was deposited into the bank account.

Medicaid only cares about the gross income of an applicant. Most pensions, IRA required minimum distributions, and social security payments have some form of withholding or payment for health benefits. This means that when you calculate a Medicaid applicant’s income, you must make sure to use the gross income when calculating whether the applicant qualifies or not.

They call a local competent elder law attorney and realize that social security automatically deducts $135.50 per month for Medicaid Part B premiums. Joe’s actual income for Medicaid purposes is $2,335.50 per month, which means that Joe is not eligible for Medicaid unless he does some additional planning for his income.

Here are some common deductions that are withheld from gross income that are considered income to the applicant:

1. Premiums for health insurance or hospitalization,
2. Premiums for life insurance;
3. Federal and state income taxes;
4. Optional deductions;
5. Child support

Do Gifts Count as Florida Medicaid Income?

What about the gift that you give your father for his birthday? This can’t be considered income, right? As crazy as it sounds irregular gifts such as birthday gifts can count as income. The rule is that the gift cannot be in excess of $60 in any calendar quarter, and the gift cannot be anticipated.

Other Florida Medicaid Income Questions

Here are some common income questions we see that didn’t justify creating a whole new section to answer:

Question: How do you determine income when the bank account is owned jointly between a Medicaid applicant and a spouse or a child?

A: If the income is deposited in the name of the non-Medicaid applicant account holder, then the income is not considered income for the Medicaid applicant.

Question: Does the spouse’s monthly income who stays in the community (known as the community spouse) affect the Medicaid applicant spouse’s income?

A: No. The community spouse’s income does not affect the Medicaid applicant spouse’s income calculation for Medicaid eligibility. The community spouse’s income will affect the amount of spousal diversion.

Question: What About Payments to Joint Owners?

Question: Are VA benefits considered income?

A: Yes. VA benefits are generally counted as income for the Medicaid applicant except for payments made for Aid and Attendance, housebound allowance, and unreimbursed medical expenses.