One of the most surprising parts about getting health care as an older adult in Florida is the process of trying to qualify for Medicaid. Medicaid is the only way to get long-term coverage for skilled nursing facilities and other forms of care, but to qualify, people need to spend down all of their assets.
Medicare is an insurance program designed for the poor. While its coverage can be very good for certain key types of care, it is not easy for most people to become eligible for Medicare. The rules for qualification vary based on the state, but there are limits to income and assets that a person can have, and if they have too much wealth, they need to spend down until they are under the limit. Not all assets count– for example, the primary home is often exempt.
The process of spending down assets is strictly monitored. The assets cannot be given away or sold for less than their market value, and Medicaid officers will look back several years to check on each transaction and make sure it is valid. Any asset transfer or sale, or an attempt to hide assets, will be met with penalties, such as a delay before you can qualify for Medicaid. Medicaid is very tough with people who attempt to bend the rules and the agency will not allow people to qualify until they have resolved all outstanding issues.
Spending down all assets might seem like a strict rule, but it is often necessary because paying out of pocket for this level of care is even more expensive.