Public benefits myths are as commonplace as walkers and motorized scooters in Florida. With a higher-than-average number of senior citizens living in Florida, current access to services and housing is complicated – and we haven’t seen the worst of it yet. An aging plan is more important than ever and understanding the public benefits available can make a big difference in whether or not you can afford the care you need.
Public benefits for seniors in Florida cover a wide range of services, discounts, and subsidies available from the state for eligible individuals. From waivers to food assistance to housing voucher programs, public benefits are available for those who apply and are approved. While there are government benefits available for seniors over 65 who are choosing to stay at home, what programs are available for those who need the care and oversight of a senior living facility?
Public Benefits for Senior Living
Medicaid
VA Aid & Attendance
The most important point to remember about public benefits for senior living is to never assume you won’t qualify. Financial planning with an experienced Elder Law Attorney who is knowledgeable in public benefits can save you time and stress when applying for benefits. Having someone who understands the asset and income requirements as well as the process for application is invaluable.
3 Public Benefits Myths
1. Benefits are automatic when the senior runs out of money.
2. The individual has too much money, so they won’t be eligible.
3. Anyone can apply at any time, so advanced planning is not necessary.
Myth 1. Benefits are automatic when the senior runs out of money.
Fact 1. Public benefits are not funded without an eligible individual making application.
A common misconception about public benefits is that they instantly become available when a senior runs out of money. Whether living at home or in a senior living facility, an individual must make application for the benefits, be determined to be eligible, and then wait for funding approval. It is a process that takes time. In some cases, a very long time.
With Medicaid in Florida, an individual must meet certain income and asset criteria for their application to be considered. If your income or assets exceed the limits for Medicaid, it is best to consult with an Elder Law Attorney who is seasoned in Public Benefits. For example, they can help determine if a Qualified Income Trust should be established for income above the limit to assist with eligibility.
Veteran’s Aid & Attendance benefits also require an application and approval process. There are certain criteria that must be met before you may be entitled to vital pension benefits to help cover expenses.
4 Considerations for Aid & Attendance Benefit
Dates of Service
Medical Need
Income for VA Purposes (IVAP)
Net Worth
If you got lost at IVAP, a consultation with a VA-accredited attorney is the first step in your benefits journey. An accredited attorney is recognized by the VA as an individual of good character and knowledgeable about VA laws and procedures. These designated individuals are authorized to assist in the preparation, presentation, and prosecution of VA benefits claims.
Beware, unaccredited individuals who prepare, present, or prosecute VA benefits claims, or hold themselves out as being authorized to do so, are in violation of Federal law.
Myth 2. The individual has too much money, so they won’t be eligible.
Fact 2. Don’t wait until you are down to the last penny to apply.
Medicaid planning is just that – a plan. While you may have cash in the bank now, when your medical and care needs exceed your income, you will exhaust your funds. In a situation where a well spouse can remain at home while the other spouse receives care in a senior living facility, it is important to have a plan that does not leave the well spouse impoverished. If you or a loved one is facing admission to a nursing facility and the possibility of paying privately, that can be financially devastating – it’s time to call an attorney.
Veteran’s Aid & Attendance can be a difference maker for those with medical expenses. If you are living at home, paying for help with Activities of Daily Living (ADLs) such as dressing, bathing, toileting, or transferring can be an Unreimbursed Medical Expense for the purposes of your application. If those services are received in a care facility or adult day program, you may qualify as well.
The key is in preparation. Neither of these benefits operates like a light switch – the funding is not immediate or without application. Waiting until you have depleted your savings or other cash reserves will limit your options.
What Happens if I Run Out of Money in a Care Facility?
In an assisted living facility in Florida, a resident can be evicted for non-payment. It may seem grim and unfortunate, but if the resident and their family did not take steps to apply for public benefits, the facility can terminate their residency agreement. If they have applied for public benefits but haven’t received funding yet, the family and/or resident are still responsible for paying the facility bill until funding is received.
With Medicaid, the facility will receive money when the resident is funded. Veteran’s benefits are awarded to the veteran or their beneficiary retroactively to the date of application. In this case, the family or veteran can reimburse themselves for some of the out-of-pocket expenses, including rent at an assisted living facility.
In either case, it is important to note that neither Medicaid in Florida nor VA Aid & Attendance covers the total expense of a care facility. In assisted living, Medicaid pays a contracted amount towards the care of the resident (currently between $900 and $1600 per month), and the resident or family is responsible for the balance (often called “shared cost”) of the monthly fee. In skilled nursing or nursing homes, Medicaid pays the balance after the contribution from the resident, including social security, pensions, and VA Aid & Attendance, if applicable.
Myth 3. Anyone can apply at any time, so advanced planning is not necessary.
Fact 3. Public benefits require advanced planning. Period.
One of the common misconceptions about public benefits is that you can apply anytime. One specific case in which this does not hold true is in the event an individual becomes incapacitated, or unable to make their own decisions. If they have not designated a Power of Attorney with specific powers required for making an application for public benefits in Florida, they may be unable to apply without the appointment of a guardian to do so on their behalf.
While the Medicaid application process can take up to three months or longer, getting approved and ultimately funded can take many months due to waitlists. An elder law attorney specializing in public benefits follows the application from start to finish, providing updates to the CARES team as needed to move their client through the waitlist. A knowledgeable attorney also works with their client to alleviate expenses in the interim, including application for Qualified Medicare Benefits.
VA Aid & Attendance is just one of the many programs eligible veterans and their families can include in their aging plan. Veterans’ funeral benefits and other support services are available with advanced planning. Your VA-accredited attorney is well-versed in the benefits available and when to apply for them. Lawyers that specialize in VA benefits are committed to having their veteran clients receive all the benefits they are eligible for throughout their lifetime.
Are There Benefits with Using an Attorney?
Absolutely. Your attorney is only interested in what is best for you. The fees you will pay for legal assistance in obtaining these benefits will be far less than the money lost while you tried to figure out each system. Having an Elder Law Attorney assist you with applying for public benefits affords you peace of mind.
There are plenty of “helpful people” who will offer to provide guidance in the application process for public benefits. Besides being unlawful in the case of VA Aid & Attendance, it is unlikely that unlicensed, non-accredited individuals carry malpractice or other liability insurance to cover your losses should they make a mistake on your application. There should be a remedy when things go wrong, but with a licensed attorney, mistakes are far less likely.
Their unwavering commitment to helping clients discover helpful benefits is just one reason Elder Law Attorneys are one of the Resources We Love. Learn more about these legal eagles and how they can help you apply for public benefits and more in the Legal and Financial Section of our Blog.
