How does Florida Medicaid work?
Florida's long-term care Medicaid program, primarily the Statewide Medicaid Managed Care (SMMC) Long-Term Care (LTC) Program, administered by the Agency for Health Care Administration (AHCA), offers key benefits for eligible seniors (65+) and adults with disabilities needing nursing facility level of care. This includes limitations in Activities of Daily Living (ADLs: bathing, dressing, toileting, eating, mobility) and/or cognitive impairments.
Key Benefits
- Home and Community-Based Services (HCBS) — Allows recipients to receive care at home, in assisted living facilities, adult family care homes, or the home of a loved one, rather than in a nursing home. This promotes independence and delays or prevents institutionalization.
- Nursing Facility Coverage — Pays for care in Medicaid-certified nursing homes, including room and board (unlike HCBS, which covers services or cost of care but not room/board in community settings).
- Personalized Care Management — Each enrollee gets a dedicated case manager to develop a customized plan of care, coordinating services with family, providers, and the recipient.
- Wide Range of Covered Services — Based on medical necessity, including:
- Adult day health care (supervision, meals, therapies)
- Assistance with activities of daily living (bathing, dressing, eating, mobility)
- Emergency Alert Device
- Home modifications (e.g., ramps, accessibility adaptations)
- Home-delivered meals
- Homemaker companion services (housekeeping, laundry)
- Medical equipment and supplies
- Medication management
- Respite care (temporary relief for caregivers)
- Therapies (physical, occupational, speech, respiratory)
- Transportation to services
- Hospice care
- Behavioral management and caregiver training
2026 Eligibility Standards
Income
$2982/mo (single applicant)
Assets
$2000 total (single applicant)
$3000 total (married applicants)
Community Spouse (not applying)
$162,660
