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Long Term Care Payments Counted as Income

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.

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