Long-term care in Florida runs roughly $10,000–$12,000 a month, and Medicare doesn't cover it beyond short-term rehab. For most families, Medicaid is what ultimately pays — but its rules are strict, and the myths ("you have to spend everything," "you'll lose the house") cause families to give away protections they were legally entitled to keep. With planning, you can qualify for Medicaid and preserve a meaningful share of a lifetime's savings. Here's how the Florida rules actually work.
The Two Tests: Assets and Income
Florida's Institutional Care Program (ICP) Medicaid has both an asset test and an income test:
| Test | 2025 figure (single applicant) | If you're over |
|---|---|---|
| Countable assets | $2,000 | Exempt assets + legal planning bring countable assets down |
| Gross monthly income | ~$2,901 (income cap) | Use a Qualified Income Trust (Miller Trust) |
These figures adjust periodically; confirm the current year's numbers when you apply.
What's Exempt (You Keep These)
The $2,000 limit applies only to countable assets. Many things don't count:
- Homestead — your primary residence, subject to an equity limit (about $730,000 for 2025), and with no equity limit if a spouse or dependent lives there.
- One vehicle of any value.
- Personal belongings and household goods.
- An irrevocable prepaid funeral/burial contract.
- Certain term life insurance and a limited amount of whole-life cash value.
The Married-Couple Protections (Spousal Impoverishment)
When one spouse needs care and the other stays home (the "community spouse"), Florida applies spousal impoverishment rules so the at-home spouse isn't left destitute:
- Community Spouse Resource Allowance (CSRA) — the at-home spouse may keep a substantial share of the couple's assets (up to roughly $157,920 for 2025), separate from the applicant's $2,000.
- Minimum Monthly Maintenance Needs Allowance (MMMNA) — some of the ill spouse's income can be diverted to the community spouse to bring them up to a protected income floor.
The 5-Year Lookback (Why Timing Is Everything)
When you apply, Florida reviews the prior 60 months of finances. Any gift or transfer for less than fair value during that window creates a penalty period of Medicaid ineligibility — calculated by dividing what you gave away by the state's average monthly cost of care. Giving the house to the kids "to protect it" right before applying is the classic, costly mistake: it can disqualify you for months or years.
The Legal Tools That Protect Assets
Medicaid Asset Protection Trust (MAPT)
An irrevocable trust that holds assets so they no longer count for Medicaid, while still passing to your heirs — and often preserving a step-up in basis at death. Because funding it starts the 5-year clock, a MAPT works best when set up well before care is needed. This is the cornerstone of proactive planning.
Qualified Income Trust (Miller Trust)
Florida is an income-cap state. If your income exceeds the limit, you don't have to "spend down" income — you route the excess through a Qualified Income Trust each month, which makes an over-income applicant eligible. It must be drafted and funded correctly, every month.
Legal spend-down and conversions
Countable assets can often be lawfully converted into exempt ones — paying off the mortgage, home repairs, a newer car, an irrevocable funeral, or a Medicaid-compliant annuity for a community spouse. These are legitimate, planned steps, not gifts.
Homestead & estate-recovery planning
Florida's homestead is protected during life, but after death the state may seek estate recovery against the probate estate. A lady bird (enhanced life estate) deed can pass the home outside probate, helping shield it from recovery while keeping the homestead exemptions intact during life.
Frequently Asked Questions
Related Reading
- Florida Medicaid Planning: The 5-Year Lookback Explained
- Florida Nursing Home Costs & Who Pays
- Florida Guardianship · Lady Bird Deeds
Protect Your Family Before the Nursing Home Does
Truestead Law builds Florida Medicaid plans — asset-protection trusts, income trusts, spousal allowances, and crisis planning — so a lifetime of savings isn't lost to the cost of care. The earlier we plan, the more we protect.
Florida Elder Law & Medicaid Practice →This article is for general informational purposes and does not constitute legal advice. Medicaid figures and rules change and are highly fact-specific. Consult a licensed Florida elder-law attorney regarding your situation. Arthur Simpson, Esq. is licensed to practice law in the State of Florida. Attorney advertising.