Florida Medicaid long-term care

How does Florida Medicaid pay for long-term care?

Through the Statewide Medicaid Managed Care Long-Term Care program (SMMC LTC): an eligible person enrolls in a managed care plan, and that plan pays for nursing home care or for home and community-based services, including services provided in assisted living facilities and adult family care homes.

Medical care (doctors, hospitals, prescriptions) is handled separately through Medicare for most older adults, with Medicaid filling gaps. The long-term care plan covers the help with daily living that Medicare does not.

What are the 2026 income and asset limits?

DCF's April 2026 standards set the long-term care income limit at $2,982 a month for one person, which is 300 percent of the $994 SSI benefit rate, and the countable asset limit at $2,000; when both spouses apply, the limits are $5,964 and $3,000.

Source: Florida DCF transmittal I-26-02-0003 (Feb. 24, 2026), Appendix A-7, SSI-Related Medicaid Financial Eligibility Standards, April 2026.

A home, one car, personal belongings and certain burial funds are generally not counted. Income above the cap does not end eligibility if a qualified income trust is set up.

Is there a waiting list for Medicaid home and community-based services?

Usually, yes: someone not yet enrolled is screened by ElderSource, the Aging and Disability Resource Center for Volusia and Flagler, and placed on a statewide wait list ranked by priority, then released as funding allows; a person already living in a nursing home and applying for nursing home Medicaid does not go on that list.

Call ElderSource at 1-888-242-4464 to start the screening early, even before money runs short, because time on the list matters. Florida Medicaid choice counseling (1-877-711-3662) helps with picking a plan once enrolled.

Does Florida Medicaid pay for assisted living?

Partly: an SMMC LTC plan pays for assisted living services such as personal care and medication help in ALFs that contract with the plan, but not for room and board, which the resident covers from income while keeping a personal needs allowance equal to room and board plus 20 percent of the federal poverty level ($266 for one person in 2026).

52 local ALFs list Medicaid services on their AHCA profiles: 21 name the assisted living waiver and 33 name assistive care services. Ask each facility which plans it contracts with and whether it keeps any Medicaid beds open; the answer changes often.

How much income does a nursing home resident on Medicaid keep?

A personal needs allowance of $160 a month under DCF's 2026 standards; most of the rest of the resident's income goes to the nursing home as patient responsibility, with allowances for a spouse at home.

The application goes to DCF through ACCESS Florida. Missing paperwork is the most common reason for delay, so gather five years of bank statements before applying.