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Medicaid Programs

Posted by Gene D. Lipscher | Nov 30, 2018 | 0 Comments

There are two government programs under Medicaid that provide assistance to persons over the age of 65, who are Florida residents and meet the financial qualifications. The programs are the Managed Care Diversion Program and the Institutional Care Program.

  1. Diversion Medicaid

Diversion Medicaid is a government program available which can significantly defray the costs of long-term care at home or in an assisted living facility.

A.  Description of Program

The Diversion Program was conceived as a way to keep persons out of nursing homes for as long as possible. The government recognized that (1) nobody wants to be in a nursing home until it is medically necessary (and even then, nobody wants to be in a nursing home) and (2) it is less expensive for the government to pay for individuals to remain in their homes, with assistance, or to be placed in assisted living facilities, than to pay for nursing home care. As such, the government decided to try the idea of “diverting” individuals away from nursing homes for as long as possible by providing funding for services at home or in assisted living facilities.

The government has contracted with insurance companies to help administer the program. These insurance companies, in turn, contract with different care providers in the community. If and when you become eligible for Diversion program benefits, you will be able to select from one of these provider groups, and receive assistance in making your selection.

B.  Eligibility

To qualify, a person must: (1) be age 65 or older; (2) be a resident of Florida; (3) medically need the benefits; and (4) meet the financial qualifications. Currently, Medicaid allows an individual to have $2,000 in countable assets and, in 2018, $2,225 in monthly income.

2.  ICP Medicaid

A.  Description of Program

ICP stands for Institutional Care Program Medicaid. ICP covers the cost of nursing home care. Once a person meets eligibility requirements, ICP will cover the cost of the nursing home (excluding private room and other extras), minus the applicant's monthly income. As a nursing home typically costs anywhere between $8,000 and $12,000 per month, if not more, the benefits associated with the ICP program are substantial.

ICP benefits become available once an person's medical needs require nursing home care. The purpose of this firm's long term care planning is to ready an applicant for financial eligibility for this program. By meeting all of the eligibility criteria for ICP (nursing home) Medicaid, we will, along the way, happen to qualify for assisted living and home care benefits as needed. However, because Medicaid's assisted living and home care benefits are not as great as the nursing home benefits, many people choose to forego home care and assisted living benefits knowing that they can have nursing home care coverage for the future.

B.  Eligibility

In order to qualify for ICP Medicaid benefits, a person must: (1) be age 65 or older; (2) be a resident of Florida; (3) Medically need the benefits; and (4) qualify financially.

As stated above, currently, Medicaid allows an individual to have $2,000 in countable assets and in 2018, $2,225 in monthly income.

About the Author

Gene D. Lipscher

Gene D. Lipscher, P.A. has represented business clients that serve in a variety of industries, such as: Business & Commercial Litigation Business Transactions Business Formations Contract Disputes & Litigation Construction Litigation Collections Real Estate Litigation Maritime Litigatio...

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