ALL definitions are in the context of Medicaid eligibility!
Allowable Transfers – The transfer of an asset or income that does not create a period of ineligibility
Annuity – A financial product issued by an insurance company with many different features that can be counted as an asset or converted to an income
Application Processing – The application process includes the gathering of information, the arranging of assets and income at the direction of an attorney, the packaging of all supporting documentation, the filling in of the application, the submission of the application, the managing of communications with the Department of Children and Families (DCF), the attendance and representation at a Fair Hearing if needed, and the obtaining of a properly completed and issued Notice of Case Action with the word approved.
Asset Protection Strategies – Various actions that can be taken to rearrange assets in a way that will allow a Medicaid applicant to qualify for benefits without spending excess assets on nursing home care.
Assets Essential for Self-Support – a category of assets that are non-countable because they are used to create income necessary for self support.
Assignment – The act of conveying ownership of an asset or income to another.
Assignment of Rights – The act of conveying one person or entities rights to another.
Business Assets– Assets owned by or used in a business necessary for generating income.
CARES– Comprehensive Assessment and Review for Elderly Services (CARES) is a division of the Florida Department of Elder Services that evaluates the medical records and the individual to determine if their health condition requires a nursing home level of care.
CELA – A Certified Elder Law Attorney is a member of the Bar in the appropriate state and has passed a test in addition to the Bar Exam that focuses on issues commonly related to the elderly.
Countable Assets – Assets that are used in the calculation of assets to determine eligibility for Medicaid benefits.
Countable Income – Income that is used in determining Patient Responsibility, Spousal Diversion, and Qualified Income Trust funding.
CSRA – Community Spouse Resource Allowance is the amount of Countable Assets Medicaid allows the spouse not in the nursing home to keep without creating ineligibility for the nursing home patient.
Custodial Care – The level of care most commonly provided in a long term nursing home setting and paid for by Medicaid.
DCF – The Department of Children and Families is the agency responsible for determining Medicaid eligibility among other things.
Department of Elder Affairs – A department in the State of Florida responsible for many aspects of protecting the elderly.
Designated Representative – A person designated by the applicant, the applicant’s legal representative, or in some instances self-designated to act on behalf of the applicant with the Department of Children and Families.
Designation of Burial– A form that allows an applicant and/or applicant spouse to designate up to $2,500 of almost any type of asset to final expense related items and therefore remove the $2,500 value from the countable asset category for determining eligibility.
DMRT – Disability Medical Review Team is a state group responsible for determining disability in applicants who have not yet had a decision rendered on a disability application with the Social Security Administration
DRA– The Deficit Reduction Act was passed in 2005and created multiple changes in the state Medicaid programs.
Excess Housing Allowance – An amount for additional expenses for housing related items that total an amount in excess of the standard allowance for housing related expenses.
Excess Spousal Diversion–An allowance for the community spouse that is above and beyond the Minimum Monthly Maintenance Needs Allowance due to excess housing costs or an order from a Fair Hearing decision or a court order.
Exempt Assets – Assets that are not included in the calculation for determining Medicaid eligibility and are not subject to estate recovery by the State after the applicant passes.
Fair Hearing – An administrative hearing conducted by the Office of Hearings to determine the outcome of any dispute between an applicant and DCF.
Financial Information Release – A standard state form that must be signed by all applicants and applicant spouses that authorizes the state to access financial information electronically, verbally, or in writing to assist in determining eligibility for benefits.
For The Sole Benefit Of – A designation for assets that have been transferred from the applicant to another person but are designated as only available to benefit the applicant who transferred them.
Gross Income – The income of a person before any deductions (i.e. taxes, insurance, union dues, etc.)
Home Equity – The amount of value in a home after deducting all encumbrances (i.e. mortgages, back taxes, other liens)
Homestead – Medicaid considers any place that is owned and lived in by the applicant as the homestead (i.e. traditional home, motorhome, travel trailer, cabin cruiser, mobile home, etc.)
IAVS– The Income and Asset Verification System is an electronic system that DCF uses to access financial information on an electronic basis to determine if all assets and income of the applicant have been disclosed.
Income Trust – A legal document used to establish a bank account that receives income that exceeds the maximum applicant income limit and thereby artificially lower the income to within acceptable limits.
Ineligibility Period – The amount of time an applicant is ineligible for benefits because of a non-allowable transfer of assets or income (gift) calculated by dividing the gift by the penalty divisor (average cost of a nursing home).
Informed Consent – A standard state form that authorizes the state to evaluate the applicant to determine the need for long term care.
Irrevocable Prepaid Funeral – A prepaid funeral plan that has been irrevocably assigned so that it cannot be cashed in or sold.
Lady Bird Deed – A deed that is also known as a Beneficiary Deed, an Enhanced Life Estate Deed, a Pay On Death Deed, and has specific wording that allows the described property to pass to heirs named in the deed without being subject to the probate process.
Life Expectancy – The amount of time a person is expected to live based upon the Social Security Life Expectancy Tables.
Look-back Period – The amount of time DCF looks back from the time of application to see if any non-allowable transfer of assets or income have occurred.
Medicaid Managed Care – An quasi privatization arrangement between the state and private insurance companies whereby the insurance companies manage the care of the applicant in exchange for a set amount of money.
Medicaid Pending – A description of the status of an application for Medicaid benefits that has not yet resulted in a decision.
MMMNA– The Minimum Monthly Maintenance Needs Allowance is the federally determined total amount of income the community spouse is allowed to obtain by diverting the applicant’s income to themselves.
Net Income – The amount of income received after reductions at the income source for taxes, insurance, union dues, etc.
NOCA – The Notice of Case Action is how DCF notifies the applicant or Designated Representative of needed information or of an eligibility determination and is provided in a letter format.
Non-Attorney – A person who has not passed an appropriate Bar Exam or for other reasons is not a member of the state Bar and is therefore not licensed to practice law in the state.
Non-Countable Assets - Assets that are not used in the calculation of assets to determine eligibility for Medicaid benefits.
Online Application – An application for Medicaid benefits that can be completed through a web browser on the world wide web.
Paper Application – An application that can be completed in paper format and submitted to DCF by mailing or faxing.
Penalty Divisor – The state determined amount representing the average private pay nursing home rate in the state.
PNA – A Personal Needs Allowance is a state determined amount within federal guidelines that an applicant is allowed to keep for personal needs such as haircuts, in sundries, and other basic wants or needs.
Pooled Trust – A Trust that is managed by a non-profit organization for the benefit of a person with disabilities over the age of 65 of which the amounts deposited into the account do not create a penalty period and do not count as an asset for determining eligibility.
Public Records Search – A generally electronic process of accessing public records to determine if all real estate and vehicles have been disclosed to DCF.
Rental Property – Real estate from which the owner receives income and if the income is equal to or exceeds “fair market rent” then the real estate is considered non-countable for Medicaid qualification purposes.
Return of Gift – A process for removing a penalty period created by a transfer for less than fair market value (gift) by returning the gifted asset or an asset of equal or greater value.
Skilled Care – The highest level of long term care which usually includes rehabilitative therapy.
Spousal Diversion – The amount of money transferred from the applicant to the community spouse to increase the community spouse’s income to the MMMNA plus any excess shelter/housing allowance.
TEFRA Lien - (Tax Equity and Fiscal Responsibility Act) liens or pre-death liens occur when the recipient is permanently institutionalized. Post-death liens are placed against the estate of a deceased Medicaid recipient.
Transfers for Less Than Fair Value – The amount of money or asset value transferred from the applicant or applicant spouse to another for which money or an asset of equal value was not received.
UPL – The Unlicensed Practice of Law is a serious offense and can be criminally prosecuted in most states even though the definition is ambiguous but can generally be said to include the advice regarding, recommendation or analysis of Personal Services Contracts or Qualified Income Trusts, or the initial determination of the appropriate strategies for asset protection, or the application of specific facts and circumstance to state of federal law by a person not licensed by the State Bar Association.
VA– The Veteran’s Administration is a Federal Agency tasked with providing for the authorized needs of veterans.
Veteran’s Benefits – The benefits a veteran and/or a veteran’s dependents are qualified to receive which includes a wide range of direct financial benefits, as well as, a wide range of services.
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