Medicare Rehab Is Ending: The Legal Steps That Keep a Florida Medicaid Application From Stalling

For what Medicare and Medicaid each pay after rehab, see the companion guide from Senior Care Resources, Medicare Stops Paying When Rehab Ends. Who Pays for the Nursing Home Now?

Who has authority to act for your parent?

Legal authority is needed from the first step. A Medicaid application requires months of bank and investment statements, and most banks won't release a customer's private account information to a family member who can't show valid legal authority. The same authority is needed later to open a trust, move money, or change ownership of accounts. The usual source of that authority is a durable power of attorney.

Having a power of attorney is not always enough. Under Florida law, an agent can create a trust, make gifts, or change beneficiary designations only if your parent signed or initialed next to each of those specific powers in the document (§ 709.2202(1), Fla. Stat.). Many older or generic forms don't include them. Without the trust power, the agent cannot set up the Qualified Income Trust that Medicaid may require.

If your parent signed the power of attorney in another state, Florida generally honors it if it was valid where signed (§ 709.2106(3), Fla. Stat.). A bank or other institution may still ask for a lawyer's opinion that the document is valid, at your parent's expense, before accepting it. Out-of-state forms are also the ones most likely to be missing the specific powers Florida requires.

Ask an elder law attorney to read the power of attorney the week your parent enters rehab, not the week Medicare ends.

No usable power of attorney: guardianship

If your parent can still understand and sign, the fastest fix is a new Florida power of attorney with the right powers initialed. If your parent can no longer sign, a court has to appoint someone through a guardianship under Chapter 744, Florida Statutes.

Guardianship takes weeks to months. When something can't wait, such as a Medicaid deadline or a trust that must be funded this month, the court can appoint an emergency temporary guardian once an incapacity petition is filed. That authority lasts 90 days from appointment and can be extended for another 90 days if the emergency continues (§ 744.3031, Fla. Stat.).

The practical lesson is timing. A Medicaid application can be filed and kept moving while a guardianship is pending, but the steps that need a signature wait for the appointment.

Income over the limit: the Qualified Income Trust

In 2026, Florida's Institutional Care Program limits gross monthly income to $2,982 for a single applicant. A parent with a pension and Social Security can pass that number easily. Being over doesn't disqualify them. It means the excess must run through a Qualified Income Trust, sometimes called a Miller trust, which federal law authorizes for exactly this purpose (42 U.S.C. § 1396p(d)(4)(B)).

Three things families should know:

1. It has to be done right the first time. The trust must name the State of Florida as remainder beneficiary for Medicaid paid, and it must be signed by your parent or someone with authority to create a trust on their behalf. See the power of attorney section above.
2. It only works if it's funded every month. The excess income has to be deposited into the trust's bank account each month. A missed month can cost a month of eligibility.
3. It is legal work. The Florida Supreme Court approved an advisory opinion treating the preparation of a Qualified Income Trust as the practice of law, so a Medicaid application service cannot prepare one. Only an attorney can.

A spouse still at home

When one spouse enters a nursing home and the other stays home, federal spousal impoverishment rules protect the spouse at home from losing everything (42 U.S.C. § 1396r-5).

In 2026, the spouse at home can keep countable assets up to $162,660 (the Community Spouse Resource Allowance), plus the home, a car, and certain other exempt assets.

The spouse at home may also be entitled to part of the nursing home spouse's income each month if their own income is low. These numbers are where planning pays off. Which assets count, which spouse owns what, and how income is allocated can change the outcome significantly. Get advice before moving money between spouses or paying down debt.

Gifts and transfers: the five-year look-back

DCF reviews your parent's finances for the 60 months before the application (42 U.S.C. § 1396p(c)(1)(B)). Money or property given away for less than its value during that window can trigger a penalty: a period when Medicaid won't pay the nursing home, even though your parent otherwise qualifies.

Families trip on this in ordinary ways: checks to grandchildren, paying a child for help without a written agreement, adding a child to a deed, or "loans" with no paperwork. Not every transfer is penalized, and some can be cured or explained. Bring the last five years of bank statements to an elder law attorney before filing, so the problems surface on your schedule rather than DCF's.

If a family member is providing care and should be paid going forward, a written personal care agreement at fair market value, signed before the care is paid for, is the usual way to do that without creating a transfer. Drafting one is also legal work.

When DCF says no

DCF communicates through a written Notice of Case Action. A denial is not the end. Many denials come from a missing document or a missed verification deadline, and those can often be fixed by supplying what was missing or by reapplying.

When the denial is wrong on the rules, your parent has the right to a fair hearing. The request must be made within 90 days of the date on the notice (Fla. Admin. Code R. 65-2.046(1)). A hearing is a legal proceeding with evidence and testimony, and it is where having an elder law attorney matters most.

Next step

If your parent is in rehab now, call us while Medicare is still paying. We'll review the power of attorney, check income against the limit, look at the last five years of transfers, and tell you which of these problems you have and how long each will take to fix. Zacharia Frey PLLC has offices in Bonita Springs, Lakewood Ranch, and Pompano Beach. Call (239) 345-4545.

If you'd like help preparing and managing the Medicaid application itself, Senior Care Resources handles that work. Carl Zacharia owns Senior Care Resources, which is a separate company and not a law firm. You are free to use any application service, or none.