A Florida appeals court finds that long-term care insurance payments that do not reimburse actual medical expenses must be counted as income when determining Medicaid eligibility. Rosenshein v. Florida Department of Children (Fla. Ct. App., 3rd Dist., No. 3D07-989, Oct. 24, 2007).
Nursing home resident Sara Rosenshein received Medicaid benefits. She also received a monthly payment from a long-term care insurance policy. When the state discovered the insurance policy, it informed her that she was no longer eligible for Medicaid benefits because her income exceeded the monthly income limit.
Ms. Rosenshein appealed, arguing long-term care insurance payments are exempt unearned income for the purposes of determining Medicaid eligibility. The hearing officer found that she was ineligible for Medicaid, and she appealed.
The Florida Court of Appeal affirms, holding that long-term care insurance payments must be counted when determining Medicaid eligibility. According to the court, because the long-term care payment is a flat-rate payment, not a reimbursement for actual medical expenses, it is not exempt unearned income.
