He’s 81, Moving From Georgia To Florida, And Asked What Florida’s Medicaid Rules Are. Three Of Them Will Decide Whether He Qualifies

The post He’s 81, Moving From Georgia to Florida, and Asked What Florida’s Medicaid Rules Are. Three of Them Will Decide Whether He Qualifies appeared first on 24/7 Wall St..

We got an email from a reader who is 81, recently widowed and planning to build a house in Florida, but he’s a little confused about Medicaid coverage for nursing home and assisted living bills. Florida runs its nursing home coverage through the Institutional Care Program. To qualify, you have to pass three separate tests: an income test, an asset test, and a review of everything you gave away in the 60 months before you apply. Fail any one of them and Florida turns you down.

First, I’m sorry about your wife. Second, there’s a distinction that trips up almost everyone. Your federal health insurance, Medicare, pays for short rehab stays after a hospital visit. It doesn’t pay for long-term custodial care. Medicaid is a joint federal-state program, and it picks up that bill once you qualify. The nursing home side of Medicaid also uses far stricter rules than the Medicaid health coverage most people picture.

Test 1: Florida’s $2,982 Monthly Income Cap

Florida is an income-cap state. In 2026, a single applicant’s gross monthly income can’t top $2,982. That cap equals 300% of the federal SSI benefit rate, which the Social Security Administration set at $994 a month for 2026. Gross means before your Medicare premium comes out.

The average retired worker receives an estimated $2,071 a month from Social Security in 2026, so it’s usually a pension that drives a widower over the line. Go over by even a dollar and Florida requires a Qualified Income Trust, often called a Miller trust. Your excess income flows into a dedicated account each month and then goes toward that bill. It’s paperwork, but it works.

States handle this differently. Some use a hard cap with a trust workaround, as Florida does. Others let applicants “spend down” their extra income on medical bills.

Test 2: $2,000 in Assets and a $752,000 Home Equity Cap

In 2026, a single Florida applicant can keep $2,000 in countable assets. That matches the SSI resource limit the Social Security Administration lists for 2026, also $2,000. Countable assets include checking and savings accounts, CDs, stocks and most investment accounts.

Your home gets an exemption, but only up to a cap. The 2026 federal minimum home equity limit in CMS’s 2026 SSI and Spousal Impoverishment Standards is $752,000, and Florida applies that $752,000 figure. This is where your new house comes in. Cash sitting in a bank counts against you. Put that same money into a home you live in and it generally stops counting, as long as your equity stays under the cap.

Test 3: Florida’s 60-Month Look-Back on Gifts

Federal law, Section 1917(c) of the Social Security Act (42 U.S.C. § 1396p), governs asset transfers, and Florida reviews every transfer you made in the 60 months before you apply. Cash gifts to your children count. So does selling property to a relative for less than it’s worth, or paying a family member for care without a written agreement. Any of these can trigger a penalty period when Medicaid won’t pay.

To set the penalty, Florida divides the amount you transferred by a factor the state updates periodically. The Florida Department of Children and Families (DCF) releases the current figure through ACCESS Florida, so check it there before you rely on any number.

Your Georgia house matters here. When you sell it, the proceeds turn into countable cash the day the sale closes. Spending them on your Florida build is a purchase at fair value. Giving a portion to the kids starts the look-back period on that money.

Your Georgia Medicaid Planning Stays in Georgia

This is the part you might not have thought about. Medicaid runs on federal money, but each state manages it. Under federal regulation 42 CFR § 435.403, a state “must provide Medicaid to eligible residents of the State”, so Florida assesses you from scratch, under Florida’s rules. You get no credit for anything you set up in Georgia: an eligibility review, an income trust created under Georgia law, a Georgia attorney’s sign-off. Florida’s look-back still covers every account you held, no matter which state it sat in.

The numbers also move on different schedules. Federal standards reset each January, while Florida’s own figures can change every July. A plan built on last year’s chart can fail this year’s test.

Lock Down Florida’s Three Tests Before You Sign a Builder’s Contract

Before you sign with a builder, sit down with a Florida elder law attorney and run your real numbers through all three Florida tests: your gross income, your countable assets, and every transfer from the past 60 months.

The house is your biggest and least reversible decision. If your income comes in above $2,982, you’ll know a Florida Qualified Income Trust is coming. If the build would drives your equity past $752,000, you can scale the plans down while they’re still on paper. And if you’re thinking of helping the kids with the sale proceeds, you’ll know exactly what it costs before the money leaves your account.

Moving at 81 takes nerve. Moving with your Florida numbers already run means no surprises later, when it would be too late to fix them.

The post He’s 81, Moving From Georgia to Florida, and Asked What Florida’s Medicaid Rules Are. Three of Them Will Decide Whether He Qualifies appeared first on 24/7 Wall St..