“Just Say No” to Get Medicaid Benefits for Your Spouse in Florida

For lower income individuals without insurance or the means to pay for medical care, even a simple health concern could turn into a major emergency. To cover their needs and prevent vulnerable people from going without treatment because of financial constraints, the federal government established the Medicaid program in 1965. Those who qualify under Florida rules on Medicaid eligibility can obtain financial assistance to pay for essential services.

The maximum level for Medicaid eligibility is set quite low, making it out of reach for many elderly individuals. However, you might be able to take advantage of a unique law in Florida known as the spousal refusal or “Just say no” approach. The strategy is an unusual one that you should discuss with a Pasco County, FL elder law attorney, but an overview may be informative.

Overview of the Spousal Refusal Provision: The starting point for understanding the rule is reviewing the basics of Medicaid eligibility. To qualify for long-term care, home and community based services, and other support, the applicant’s assets and income must both fall under a certain threshold. When the applicant is married:

• Only his or her income is considered; and,
• Half the value of assets is taken into account, since property is presumed to be jointly owned.

For many married couples, these two factors will take them over the amount for Medicaid eligibility; this is where “just say no” steps in. The regulations allow the non-applicant spouse to refuse to contribute toward the care of his or her spouse AND to refuse to make them available to the applicant. Because the applicant spouse effectively owns less, it is possible to qualify for Medicaid. 

How to Take Advantage of the Spousal Refusal Rule: This description of spousal refusal may seem straightforward, but putting it into effect in your own real-life situation is much more complicated. There are three essential tasks, if you and your lawyer determine that this strategy may be suitable for your situation.

1. Transfer title from the applicant to the non-applicant spouse, sometimes referred to as the community spouse.
2. The community spouse prepares a notice of spousal refusal and submits it to Medicaid. When reviewing the application, officials treat the applicant as a single person. Assets that were previously transferred to the non-applicant spouse are not included in the assessment.
3. The applicant must also fill out a spousal refusal form when submitting the Medicaid application. Note that the process does entitle the government to sue the non-applicant for refusal to support, though it is rare that officials proceed with a lawsuit.
   

Contact a Florida Elder Law Attorney for Assistance 

From this description, you can see that the spousal refusal Medicaid law can be beneficial – yet extremely complicated. You need a knowledgeable lawyer to advise you and assist with making the proper arrangements. To learn how our team can help, please call 352-567-0055 or go online to reach a Dade City elder law attorney at The Law Office of Laurie R. Chane. We can schedule a consultation to review your circumstances at our offices.