What You Need To Know About Medicaid!

March 13, 2025

Medicaid is a federal and state-funded program that provides health insurance coverage to low-income individuals and families. It is designed to help people who might not otherwise be able to afford healthcare, including certain groups like children, pregnant women, seniors, and individuals with disabilities. Medicaid programs are managed by each state, so the specific benefits, eligibility requirements, and application process can vary depending on where you live.


Key Things You Need to Know About Medicaid:


Eligibility for Medicaid: Medicaid eligibility is typically based on factors such as income, household size, and specific circumstances. In general, eligibility is determined by:


    -  Income: Medicaid is designed for low-income individuals, and eligibility is often based on 

       the Federal Poverty Level (FPL). If your income is below a certain threshold, you may 

       qualify.

   -  Age and Health Status: Some groups are automatically eligible, such as:

      Children

      Pregnant women

      Seniors (65 or older)

      People with disabilities

   -  Family and Household Size: Medicaid eligibility also considers the size of your household 

      and your family members’ income.

   -  Expanded Medicaid: Under the Affordable Care Act (ACA), many states expanded 

      Medicaid to cover individuals with incomes up to 138% of the FPL. Some states have     

      opted not to expand Medicaid.


Benefits Covered by Medicaid: Medicaid provides a comprehensive range of health   

   services. While states are required to cover certain mandatory benefits, they also have the 

   option to cover additional optional benefits. Common services covered by Medicaid 

   include:

 

   - Doctor visits

   - Hospital services

   - Prescription drugs

   - Laboratory tests and X-rays

   - Emergency services

   - Mental health services

   - Rehabilitative services (like physical therapy)

   - Dental and vision care (in some states)

   - Maternity and newborn care

   - Home and community-based services (for people with disabilities or the elderly)

   - Preventive care: Vaccines, screenings, and wellness visits.


How Medicaid Works


   State-specific Programs: Medicaid is jointly funded by the federal government and states, 

   but each state administers its own program with different rules. This means coverage and 

   benefits can vary by state.


   Managed Care: In many states, Medicaid operates under a managed care system, where 

   beneficiaries get their care through private health plans that are contracted by the state.


   Fee-for-Service: Some states still operate Medicaid on a fee-for-service basis, where 

   providers are paid for each service they deliver.


How to Apply for Medicaid


Online or In-Person: You can apply for Medicaid online through your state’s Medicaid website, by phone, or in person at your local Medicaid office. Some states also have mobile apps to help with the application process.


Application Process: During the application process, you'll need to provide information about your income, household size, and any other relevant details (like disability or pregnancy status). The state will determine your eligibility and notify you whether you qualify for Medicaid or other assistance programs like CHIP (Children’s Health Insurance Program).


Special Enrollment Periods: Medicaid enrollment is open year-round, unlike other health insurance programs like those under the Affordable Care Act (ACA), which have open enrollment periods.


Medicaid for Children (CHIP)


Medicaid has a Children’s Health Insurance Program (CHIP) that provides coverage for children in families who earn too much to qualify for Medicaid but cannot afford private insurance. CHIP covers many of the same services as Medicaid and is available in every state.


Medicaid for Pregnant Women


In many states, pregnant women with low income can qualify for Medicaid, regardless of their immigration status. Medicaid helps cover prenatal care, labor, delivery, and postpartum care, including health services for the baby.


Income and Asset Limits


Medicaid uses both income and assets to determine eligibility. Each state may have different income and asset limits, and some states may allow a spend-down for people with income just above the threshold. This means you may be able to deduct certain medical expenses to qualify.


Medicaid and Medicare


If you're eligible for both Medicaid and Medicare (the federal health insurance program for those 65+ or with disabilities), you're considered dual-eligible. Medicaid can help cover costs that Medicare doesn't, such as premiums, co-pays, and certain services not covered by Medicare (like long-term care).


Cost and Coverage


No Premiums: Most Medicaid recipients don’t have to pay premiums for coverage, although some states may charge a small premium for certain services or individuals with higher incomes.


Out-of-pocket Costs: Depending on your state, you may be required to pay small copayments for services, but they are generally low compared to other insurance plans.


Additional Coverage: Medicaid often covers essential services that may not be available with private insurance, like long-term care (nursing homes or in-home care).


Medicaid for Long-Term Care


Medicaid is the largest payer of long-term care services in the U.S., including nursing home care and home-based services for elderly individuals or those with disabilities. However, qualifying for long-term care benefits typically requires individuals to meet certain asset and income limits.


Changing Medicaid Eligibility


Eligibility for Medicaid can change due to changes in income, family status, or health condition. It’s important to update your information with the Medicaid office if there are any significant changes. Some states have yearly renewal processes to ensure people still meet the eligibility criteria.


Important Considerations: 


Not All Providers Accept Medicaid: Some healthcare providers do not accept Medicaid, so it’s important to make sure your doctors or hospitals participate in the program.


State-Specific Variations: As Medicaid is run by each state, the benefits, eligibility, and application process can vary. Be sure to consult your state’s Medicaid website or office for specific details.


Sounds like a lot, right? Would you like to know more about Medicaid or how to apply? Contact Rhodes Law, P.A. at (321) 610-4542 and speak with Ruth C. Rhodes. She advises clients regarding how to qualify, obtain and maintain Medicaid benefits!


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When is Legal Guardianship Needed and Necessary?

June 1, 2026
Legal guardianship becomes necessary when an individual is unable to make safe, informed decisions about their personal, medical, educational, or financial affairs and no less restrictive alternative is available. Guardianship is intended to protect vulnerable individuals while ensuring their needs are met, but because it can limit a person's legal rights, courts generally view it as a measure of last resort. What Is Legal Guardianship? Legal guardianship is a court-appointed arrangement that gives one person (the guardian) the authority to make decisions on behalf of another person (the ward). Depending on the circumstances, the guardian may be responsible for healthcare decisions, living arrangements, education, finances, or other aspects of the ward's well-being. Situations Where Guardianship May Be Necessary 1. An Aging Adult with Cognitive Decline One of the most common reasons for guardianship is when an older adult develops conditions such as dementia or Alzheimer's disease and can no longer safely manage daily activities, medical care, or financial matters. Guardianship may be needed if the individual: Forgets to take medications Is vulnerable to financial exploitation Cannot understand important decisions Is unable to provide for their own safety 2. A Person with a Developmental Disability Some adults with developmental disabilities may require ongoing assistance with decision-making. While many individuals can live independently with support, guardianship may be appropriate when a person lacks the capacity to make critical life decisions and no less restrictive alternative is sufficient. 3. Serious Mental Illness or Cognitive Impairment Individuals experiencing severe mental illness, traumatic brain injuries, or other cognitive impairments may be unable to consistently make informed decisions regarding their health, safety, or finances. In these situations, guardianship may provide legal authority for a trusted individual to step in and assist. 4. A Minor Without Available Parents Guardianship is often necessary when a child's parents are deceased, incapacitated, incarcerated, deployed, or otherwise unable to provide care. A legal guardian can then: Make educational decisions Consent to medical treatment Provide housing and daily care Act in the child's best interests 5. Emergency Situations Courts may appoint temporary or emergency guardians when immediate intervention is necessary to protect an individual from harm. Examples include: Urgent medical decisions Risk of financial abuse Unsafe living conditions Sudden incapacity following an accident or illness When Guardianship May Not Be Necessary Courts generally prefer less restrictive alternatives whenever possible. Guardianship may not be necessary if the individual has already established legal tools such as: Durable powers of attorney Healthcare powers of attorney Advance healthcare directives Revocable living trusts Supported decision-making agreements These arrangements often allow assistance without removing significant legal rights. How Courts Determine Whether Guardianship Is Needed Before appointing a guardian, courts typically examine: Medical evaluations and expert opinions The individual's ability to understand decisions The person's functional limitations Available alternatives to guardianship The extent of assistance required The court's goal is to protect the individual while preserving as much independence as possible. 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Conclusion Legal guardianship is typically necessary when a person cannot adequately care for themselves or make informed decisions, and no less restrictive legal option can provide the needed protection. Whether the situation involves an aging parent, an adult with a disability, or a child without parental care, guardianship can offer an important legal framework for ensuring safety, stability, and proper decision-making. Because guardianship affects fundamental rights, it should be pursued thoughtfully and only when truly necessary. At Rhodes Law, P.A., we believe in proactive planning whenever possible. We encourage clients to establish advance directives, such as powers of attorney and healthcare surrogates, to help avoid the need for guardianship proceedings and ensure their wishes are honored in the future. Please contact Rhodes Law, P.A. to schedule your free estate planning consultation so we can advocate for you in the event of incapacity!

Protecting Your Legacy in the Space Coast: 5 Critical Updates for Your Out-of-State Estate Plan

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Navigating the Nuances of Florida Homestead Law - Perhaps the most significant shock for many professionals moving to Brevard County is the complexity of Florida Homestead Law. This is a proprietary legal concept unique to Florida that provides three distinct benefits: asset protection from creditors, property tax exemptions, and strict restraints on how you can devise (leave) your primary residence in a Will or Trust. If you have a spouse or minor children, Florida law may limit your ability to leave your home to anyone else—even if your out-of-state Trust says otherwise. Failure to align your estate plan with Florida’s Constitutional requirements regarding homestead property can lead to your home being tied up in probate, or worse, being distributed in a way that contradicts your actual wishes. A Melbourne, FL elder law attorney or estate practitioner can help you structure your Trust to ensure it harmonizes with these protections rather than conflicting with them. 2. Qualifying Your Personal Representative - In many states, you can name almost any trusted individual to serve as the Executor or Personal Representative of your estate. Florida, however, is significantly more restrictive. Under Florida statutes, a Personal Representative must be either a Florida resident OR a blood relative (or certain other close relatives). If you moved from the Midwest and named a lifelong friend from your hometown as your Executor, and that friend is not a resident of Florida and not related to you by blood, the Florida probate court will disqualify them from serving. This frequently results in the court appointing someone you did not choose to manage your private affairs. Updating your plan ensures your chosen representative meets local statutory requirements. 3. The Shift in Durable Power of Attorney Standards - Florida’s laws regarding Powers of Attorney underwent a massive overhaul in 2011. 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Pros and Cons of Revocable Living Trusts in Melbourne, Florida

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Estate planning is an essential step for protecting your assets and ensuring your wishes are carried out—but not every strategy fits every situation. In places like Melbourne, Florida, where many residents own property, retire, or maintain multi-generational assets, revocable living trusts have become an increasingly popular tool. But are they the right choice for you? Understanding the advantages and limitations is key before making a decision. What Is a Revocable Living Trust? A revocable living trust is a legal arrangement created during your lifetime that holds your assets and outlines how they should be managed if you become incapacitated or after your death. The key feature is flexibility—you can modify or revoke the trust at any time while you’re alive. The Pros of a Revocable Living Trust Avoiding Probate in Florida One of the biggest advantages is avoiding probate—the court-supervised process of distributing assets after death. Probate in Florida can be time-consuming and costly, especially for larger estates. Assets held in a trust bypass this process, allowing for faster and smoother distribution. Privacy Protection Unlike wills, which become public record during probate, trusts remain private. This means your assets, beneficiaries, and distribution plans stay confidential. Planning for Incapacity A revocable living trust allows you to name a successor trustee who can manage your finances if you become incapacitated. This can help avoid court-appointed guardianship and ensure continuity in managing your affairs. Flexibility and Control You retain full control over your assets and can update or revoke the trust at any time. This makes it ideal for individuals whose financial or family situations may change over time. Helpful for Complex Estates If you own property in multiple states or have a more complex financial situation, a trust can simplify asset management and avoid multiple probate proceedings. The Cons of a Revocable Living Trust Upfront Costs and Effort Setting up a trust typically costs more than drafting a simple will and requires additional work, such as retitling assets into the trust. This process can be time-consuming and sometimes overlooked. No Tax Advantages A common misconception is that revocable trusts reduce taxes. In reality, they do not provide income or estate tax benefits—you are still taxed as the owner of the assets. No Protection from Creditors Because you maintain control of the assets, they are not shielded from creditors or lawsuits. If asset protection is your goal, other strategies may be more appropriate. Requires Proper Funding A trust only works if assets are properly transferred into it. If you forget to retitle accounts or property, those assets may still go through probate—defeating one of the main benefits. Not Always Necessary For individuals with simple estates, beneficiary designations or joint ownership may already avoid probate without the added complexity of a trust. Considerations for Melbourne, Florida Residents Florida has its own unique estate planning considerations. Homestead laws, retirement assets, and the state’s large retiree population can all influence whether a trust makes sense. For some residents, tools like enhanced life estate deeds (“Lady Bird deeds”) or properly structured beneficiary accounts may provide simpler alternatives. However, for those with significant assets, privacy concerns, or a desire to streamline estate administration, a revocable living trust can be a powerful solution. Final Thoughts A revocable living trust offers clear benefits—privacy, probate avoidance, and flexibility—but it’s not a one-size-fits-all solution. The right choice depends on your financial situation, family dynamics, and long-term goals. If you’re considering a trust in Melbourne, Florida, consulting with an experienced estate planning attorney like Ruth Rhodes at Rhodes Law, P.A. , can help ensure your plan is properly structured—and that your assets are fully protected for the future. Call us today at 321-610-4542 to schedule your consultation!