Florida Medicaid Glossary
Plain-English definitions of the terms a Florida family hears during a nursing home or assisted living Medicaid application.
Florida Medicaid uses its own vocabulary for long-term care eligibility, and most of it will not be familiar even to someone who has managed a parent's finances for years. The eleven terms below are the ones that come up most in a Florida nursing home or assisted living Medicaid application — what counts as an asset, what a spouse at home is allowed to keep, and what a Qualified Income Trust actually does. For the current dollar figures behind several of these terms, see the Florida Medicaid limits guide.
Five-Year Look-Back
When someone applies for Medicaid long-term care, Medicaid reviews all financial transactions from the previous five years. Any asset transferred for less than fair market value during that period may result in a penalty period of Medicaid ineligibility.
Community Spouse
The healthier of the two spouses who is not in a nursing facility and is residing at home or elsewhere.
Countable Assets
Those assets owned by the applicant or spouse that count and must be totaled to determine if the applicant is at or under the allowed asset level. If owned jointly, the entire amount counts — not one half — even if owned jointly with a child or someone else.
Non-Countable Assets
Assets owned by the applicant and/or spouse that do not count towards the amount of assets the applicant can have to be eligible for Medicaid.
PNA (Personal Needs Allowance)
The amount of the applicant's monthly income that he or she can keep each month to pay for personal needs.
CSRA (Community Spouse Resource Allowance)
The amount of countable assets the Community Spouse can keep when the other spouse applies for Medicaid nursing home benefits.
MMNA (Monthly Maintenance Needs Allowance)
The calculated amount of income the Community Spouse needs to pay his or her monthly bills. If the Community Spouse's actual income is less than this amount, some of the income of the nursing home spouse is diverted to the Community Spouse. If his or her income is greater than this amount, none of the nursing home spouse's income is diverted.
PAR (Protect Additional Resources)
When the available income of the nursing home spouse and the income of the Community Spouse are insufficient to bring the Community Spouse to his or her MMNA, PAR allows the Community Spouse to retain additional resources beyond the standard CSRA. The calculation determines the monthly income shortfall and the actuarial life expectancy of the Community Spouse; the amount needed to purchase an annuity to cover that shortfall for the Community Spouse's remaining life expectancy can be added to the resources the Community Spouse may keep. A fair hearing is typically required.
Patient Liability
The amount of income each month that is due and payable to the nursing home. Caution is warranted — each month that goes by, that obligation to the nursing home exists. Far too often, families spend the income on home maintenance and other things that are not permissible. Guidance by an experienced elder law attorney is strongly urged.
IBR / IBF (Irrevocable Burial Reserve / Fund)
A fund used to pay for the burial and funeral of the applicant. It must be irrevocable and held in a special account — typically a prepaid funeral life insurance policy purchased from the funeral home. A regular life insurance policy or CD cannot be "earmarked" for this purpose; the contract itself must be irrevocable or, if a life insurance policy, the funeral home must be the primary beneficiary.
Income Cap
The gross monthly income limit for Florida Medicaid ICP. If the applicant's gross monthly income is greater than this amount, a properly drafted Qualified Income Trust (QIT) must be in place AND funded every single month. If the income is at or below this amount, no QIT is needed.
QIT (Qualified Income Trust)
Also called a Miller Trust or Income-Only Trust. Required for any Florida Medicaid applicant whose gross monthly income exceeds the income cap. The trust must be irrevocable, name the State of Florida as primary remainder beneficiary, and be funded every month with the applicant's excess income — every missed month is a missed month of Medicaid eligibility with no retroactive fix.
These definitions are general. How a term applies to one family's specific accounts, trusts, or property is a question worth asking an elder law attorney before an application is filed — a misclassified asset or an unfunded QIT is one of the most common reasons a Florida Medicaid application is delayed or denied. See the fifteen application pitfalls for the mistakes we see most, or return to the Resources hub.
Frequently asked questions
What is the Medicaid Five-Year Look-Back?
When someone applies for Medicaid long-term care, Medicaid reviews all financial transactions from the previous five years. Any asset transferred for less than fair market value during that period may result in a penalty period of Medicaid ineligibility.
What is a Community Spouse in Medicaid?
The Community Spouse is the healthier of the two spouses who is not in a nursing facility and is residing at home or elsewhere.
What are Countable Assets for Medicaid?
Countable assets are those owned by the applicant or spouse that count toward the allowed asset level for Medicaid eligibility. If owned jointly, the entire amount counts — not one half — even if owned jointly with a child or someone else.
What is a CSRA (Community Spouse Resource Allowance)?
The Community Spouse Resource Allowance (CSRA) is the amount of countable assets the Community Spouse can keep when the other spouse applies for Medicaid nursing home benefits.
What is a MMNA (Monthly Maintenance Needs Allowance)?
The Monthly Maintenance Needs Allowance (MMNA) is the calculated amount of income the Community Spouse needs to pay for monthly bills. If their actual income is less than this amount, some income from the nursing home spouse may be diverted to the Community Spouse.
What is a Qualified Income Trust (QIT / Miller Trust)?
A Qualified Income Trust, also known as a Miller Trust, is an irrevocable trust used to help individuals qualify for Medicaid long-term care benefits when their income exceeds the state income cap. Only the applicant's income may be deposited, and the state Medicaid agency must be named as the remainder beneficiary.
What is Patient Liability for Medicaid?
Patient Liability is the amount of income each month that is due and payable to the nursing home. Each month that goes by, that obligation exists. Guidance by an experienced elder law attorney is strongly urged.
What is an Irrevocable Burial Reserve (IBR)?
An Irrevocable Burial Reserve (IBR) or Irrevocable Burial Fund (IBF) is a fund used to pay for the burial and funeral of the Medicaid applicant. It must be irrevocable and in a special account, or typically a prepaid funeral life insurance policy purchased from the funeral home.