Medicaid Planning and the 5-Year Look-Back: A Miami Checklist

For many Miami families, long-term nursing care is the single largest threat to a lifetime of savings. Florida Medicaid can help cover those costs, but its 5-year look-back rule trips up well-meaning people every day. Use the checklist below to think through your situation before you move a single dollar.

Understand What the Look-Back Actually Reviews

When you apply for Florida long-term care Medicaid (administered through the Department of Children and Families and managed care plans), the state reviews the 60 months of financial records before your application date. Gifts or below-market transfers made in that window can trigger a penalty period during which Medicaid will not pay for your care. The look-back does not apply to retroactive penalties forever; it is a fixed 60-month window counted backward from the application.

Inventory the Right Assets First

• List countable assets: bank accounts, brokerage accounts, cash-value life insurance, and second properties.
• Separate exempt assets: in Florida, your homestead, one vehicle, and certain prepaid funeral contracts are generally not counted.
• Note that Florida’s homestead protection under Article X, Section 4 of the state constitution is powerful, but Medicaid has its own equity limits and rules that differ from creditor protection.

Watch the Common Miami Mistakes

• Do not simply gift the house to your children to “protect it.” An uncompensated transfer can create a penalty and may strip away the homestead and capital-gains step-up benefits.
• Do not add a child to your bank account as a quick fix; this can be treated as a transfer and exposes the funds to that child’s creditors and divorces.
• Do not assume a will or a standard revocable trust shields assets for Medicaid. A Florida revocable trust under Chapter 736 keeps assets fully countable because you retain control.

Consider Florida-Specific Planning Tools

• Lady Bird (enhanced life estate) deeds are widely used in Florida to pass homestead at death without a completed gift during life, helping avoid probate while preserving homestead status.
• Personal services contracts and qualified income trusts (often called Miller trusts) can address Florida’s income cap for institutional Medicaid.
• Spousal protections allow a community spouse to keep a portion of assets and income under federal and Florida rules.

Build Your Timeline

Because the penalty is measured against transfers made within five years, earlier planning gives you more options. If a health crisis is already underway, crisis planning may still help, but the safest strategies usually involve planning well before care is needed. Keep clear records of every transaction, since the burden is on the applicant to explain transfers.

Coordinate With Your Whole Estate Plan

Medicaid planning should never happen in a vacuum. Confirm your durable power of attorney under Chapter 709, Florida Statutes, includes specific gifting and Medicaid-planning authority, because a generic form may not allow an agent to act. Review beneficiary designations and your will so that a single decision does not undo another part of your plan.

Florida’s Medicaid rules are detailed and change frequently, and the homestead and transfer rules interact in ways that are easy to get wrong. Before making any transfer, speak with a licensed Florida elder law or estate planning attorney who can review your specific Miami-Dade situation.