Page 15 - Medicaid New Client Welcome Guide

GLOSSARY

Assets: Certain holdings, cash, or property with a value that must be evaluated during the eligibility determination (also referred to as
resources)

CARES: Comprehensive Assessment and Review for Long-Term Care Services (CARES) is a unit within the Department of Elder Affairs
responsible for completing an assessment of individuals applying for nursing home Medicaid or Medicaid Waiver
DCF: Department of Children and Families is the state agency that determines eligibility for Medicaid

Gift: Something given voluntarily without payment in return
ICP Medicaid: Institutional Care Program Medicaid

Income: Monies received by individuals
Level of Care (LOC): An assessment completed by CARES to determine the level of nursing care that an individual requires.
Long-Term Care: Maintenance care or care expected to last for a continuous period of time

Look-Back Period: A period of time meant to prevent Medicaid applicants from giving away assets or selling them under fair market
value in an attempt to meet Medicaid's asset limit. In Florida, the look-back period is five years prior to the date of Medicaid application
Medicaid: A state-administered federal program of medical assistance that is available to specific individuals based on financial and

medical needs as defined in the policy
Medicare: A federal insurance program that covers hospitalization, medical care, and drugs for aged and disabled individuals who

have a sufficient work history
Medicare Coinsurance: The amount Medicare determines an individual owes the facility for days on which Medicare makes a partial
payment, typically days 21-100 of skilled care

Patient Responsibility: The amount of income DCF determines an individual must pay towards their cost of care
Personal Needs Allowance (PNA): The portion of an individual's income that is protected and reserved to cover their personal needs

while they are residing in an institution. As of now, the maximum amount of income that can be allocated for the PNA is $130 per
month.
Private Pay: Payment for care in a nursing home without insurance or government help

Posthumous Benefit: A determination of eligibility after an individual dies for a benefit period prior to the time of their death
Recertification: Also known as an annual review, a recertification is required to determine continued Medicaid eligibility
SMMC LTC Plan: Also known as, Statewide Medicaid Managed Care Long-term Care Program, this program requires Medicaid

recipients to enroll into a medical plan for long-term care services in a nursing home, assisted living, or at home.

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