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STATE PROFILE • Last updated: April 24, 2026

Florida Medicaid & Elder Care

Florida's senior Medicaid landscape centers on the Statewide Medicaid Managed Care Long-Term Care Program, offering home and community-based services and assisted living support, often requiring a Qualified Income Trust for those over income limits.

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Medicaid Report Card

Overall State Performance Index

F Grade
ELIGIBILITY ACCESSIBILITY STRONG
WAIVER AVAILABILITY MODERATE
QUALITY OF CARE CRITICAL

Based on CMS Nursing Home Compare + state Medicaid agency data

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Florida Monthly Costs

NURSING HOME (SEMI-PRIVATE) $10,652 State Avg / Month
ASSISTED LIVING $4,000 State Avg / Month
ADULT DAY HEALTH CARE $1,760 State Avg / Month

Florida's assisted living costs are generally lower than the national average, with a projected median of $5,484 monthly in 2026 compared to the national median of $6,129. However, nursing home costs in Florida can be higher than the national median, while home care services may be lower.

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Waiver Programs

Statewide Medicaid Managed Care Long-Term Care Program

Also called: Medicaid Waiver, Nursing Home Diversion Program

The SMMC LTC Program provides home and community-based services, assisted living, and nursing home assistance to functionally impaired seniors and disabled adults at risk of nursing home placement. Services are delivered through managed care organizations, helping individuals remain in their homes or assisted living facilities.

  • check_circle Adult Companion Care
  • check_circle Adult Day Health Care
  • check_circle Assistive Care
  • check_circle Assisted Living Facility Services
  • check_circle Attendant Nursing Care
  • check_circle Behavioral Management
  • check_circle Caregiver Training
  • check_circle Case Management
  • check_circle Home Accessibility Adaptation
  • check_circle Home Delivered Meals
  • check_circle Homemaker
  • check_circle Hospice
  • check_circle Intermittent and Skilled Nursing
  • check_circle Medical Equipment & Supplies
  • check_circle Medication Administration
  • check_circle Medication Management
  • check_circle Nutritional Assessment/Risk Reduction
  • check_circle Nursing Facility Care
  • check_circle Occupational Therapy
  • check_circle Personal Care
  • check_circle Personal Emergency Response System (PERS)
  • check_circle Respite Care
  • check_circle Physical Therapy
  • check_circle Respiratory Therapy
  • check_circle Speech Therapy
  • check_circle Transportation to LTC Services

insights Program Snapshot

Functional criterion
Nursing Home Level of Care
Administered by
Agency for Health Care Administration (AHCA), Department of Children and Families (DCF), Department of Elder Affairs (DOEA)
Self-direction
Yes, for some services, including hiring family members
Population served
Seniors (65+) and disabled adults (18+)

2026 Eligibility Requirements

Criteria Individual Limit Married (Both Applying)
Monthly Income $2,982 $5,964
Asset Limit $2,000 $3,000
Home Equity Limit $752,000
Level of Care Nursing Home Level of Care (NHLOC)
Florida is an income cap state, requiring a Qualified Income Trust (Miller Trust) if income exceeds the monthly limit for long-term care services.
home_work

Estate Recovery Warning

Florida MERP: Aggressive
info The state may place a lien on the home for care costs after the recipient's death.
info Recovery is delayed while a surviving spouse, minor child, or blind/disabled child resides in the home.
info Recovery applies to Medicaid services received by individuals aged 55 and older.
info Florida's recovery is limited to probatable assets only.
info An exemption is possible if recovery would cause undue hardship for qualified heirs.

Florida's Medicaid Estate Recovery Program is federally mandated to recoup costs for services provided to recipients aged 55 and older from their probate estate after death. Recovery is delayed if a surviving spouse or dependent child resides in the home, and it is limited to probatable assets.

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Spend-Down & Asset Protection

Medically Needy Pathway Miller Trust Required Income Cap State

PROTECTED ASSETS

Primary home up to $752,000 equity (no limit if spouse, minor, or disabled child resides there) One vehicle (any value) Personal belongings Burial plots Life insurance (under $2,500 face value) IRAs in payout status

COMMON PITFALLS

  • warning Look-back Period: Gifts or asset transfers for less than fair market value within 60 months trigger heavy penalties.
  • warning Excess Income: Failing to establish a Miller Trust if monthly income exceeds the cap for long-term care Medicaid.
  • warning Joint Accounts: The full balance of joint bank accounts is often counted as the applicant's asset.
Community Spouse Resource Allowance (CSRA): $162,660

First Steps for Families

1

Locate your ADRC

Contact your local Florida Aging and Disability Resource Center.

2

Gather 5 years of records

Bank statements, deeds, asset transfers for the Medicaid look-back period.

3

Financial assessment

Consult a Medicaid planner if assets exceed $2,000.

View Full Application Process ↓
Florida state capitol

Resource Contact

Florida Agency for Health Care Administration

call (800) 963-5337
Official site open_in_new

How to Apply for Florida Long-Term Care Medicaid

1
Contact ADRC for Screening

Contact your local Aging and Disability Resource Center (ADRC) or the Elder Helpline (1-800-963-5337) for an initial over-the-phone screening to determine priority and waitlist placement.

2
Submit Medical Certification

Submit Form 5000-3008, the Medical Certification for Medicaid Long-Term Care Services.

3
Apply for Financial Eligibility

Submit a Medicaid application through the Department of Children and Families (DCF) ACCESS Florida for financial eligibility determination.

4
Complete CARES Assessment

Undergo a 701B Assessment with the Department of Elder Affairs' CARES Program to determine the functional level of care needed.

5
Select Managed Care Plan

If approved, select a Long-Term Care Managed Care Plan from the available options in your region.

Documents You'll Need

Financial Verification

  • 60 months of bank statements
  • Stock/bond certificates
  • Retirement account information
  • Proof of all income sources

Income Verification

  • Social Security award letters
  • Pension stubs
  • VA benefit statements
  • Other income documentation

Medical/Identity

  • Social Security card
  • Medicare card
  • Doctor's clinical assessments (Form 5000-3008)
  • CARES assessment results
  • Proof of age

Property/Residency

  • Home deed
  • Vehicle registration
  • Proof of Florida residency
  • Utility bills
timer Federal Deadline: 45 Days
update Typical Florida Processing: 90 Days

Frequently Asked Questions About Florida Medicaid

Does Florida Medicaid pay for assisted living?

Florida's Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program can help cover care services in an assisted living facility, but it does not cover room and board costs. Availability of these benefits can be limited, and there is often a lengthy waitlist for community-based services.

What is the Florida Medicaid income limit for seniors in 2026?

For long-term care Medicaid in Florida, the individual income limit for seniors in 2026 is $2,982 per month. Florida is an 'income cap' state, meaning individuals whose income exceeds this amount may still qualify by establishing a Qualified Income Trust, also known as a Miller Trust.

How long is the HCBS waiver waitlist in Florida?

Florida's Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program, which replaced former Home and Community-Based Services (HCBS) waivers, has a lengthy waitlist for community-based services. While specific numbers are not published, wait times can extend for years, with priority given to the sickest applicants.

Will Medicaid take my parent's house in Florida?

Florida's Medicaid Estate Recovery Program (MERP) may seek reimbursement from a deceased recipient's probate estate for care costs after age 55. However, the primary residence is generally protected from recovery if a surviving spouse, minor child, or disabled child lives there. MERP is limited to assets that pass through probate.

Can I be paid to care for my parent through Florida Medicaid?

Yes, through the consumer-directed option within Florida's Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program, eligible family members, including adult children and spouses, can be hired and compensated as caregivers. This option allows participants to choose and manage their care providers for certain services like personal care and homemaker services.

Medicaid vs Medicare for long-term care in Florida?

Medicare primarily covers short-term, skilled medical care and generally does not pay for long-term custodial care in assisted living or nursing homes. Florida Medicaid, specifically the SMMC LTC program, covers a broad range of long-term care services, including nursing home care and home and community-based services, for eligible low-income seniors.

TOPICAL GUIDES — HOW MEDICAID WORKS

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Last updated: April 24, 2026. Sources: Florida Agency for Health Care Administration, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.