Medicaid Long-Term Care Guide in Florida
Long-term care eligibility, benefits, and how to apply through the Agency for Healthcare Administration (AHCA).
What makes Florida Medicaid different
Medicaid in Florida is sometimes called the Statewide Medicaid Managed Care (SMMC) program. The managed care program for long-term care services for the elderly and disabled is called the Long-term Care (LTC) program. All other health care services outside of long-term care are provided via the Managed Medical Assistance (MMA) program. While Medicaid is jointly funded by the state and federal government, it is administered by the state.
Administered by the Agency for Healthcare Administration (AHCA).
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who is eligible will receive assistance. Benefits are provided in Medicaid-certified nursing homes.
Level of care: Nursing Home
Medicaid Waiver / Home and Community Based Services (HCBS)
Not an entitlement; the number of persons who can receive these services is limited and waiting lists may exist. Intended to delay nursing home admissions, long-term care benefits are provided at home, adult day care, in adult foster care homes, and in assisted living residences via a managed care system.
Level of care: Nursing Home
Regular Medicaid / Medicaid for Aged and Disabled (MEDS-AD)
An entitlement; all persons who are eligible will receive services. While Regular Medicaid is not Long-Term Care Medicaid, limited long-term care services, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 Florida Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waiver / Home and Community Based Services†
Regular Medicaid / Medicaid for Aged and Disabled (MEDS-AD)‡
*All of a recipient's monthly income, minus a monthly Personal Needs Allowance of $160, Medicare premiums, and potentially a Monthly Maintenance Needs Allowance for a non-applicant spouse, must be paid to the nursing home. This is called a Patient Liability.
†Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
‡Another pathway to Medicaid eligibility is through SSI. In Florida, persons who are determined eligible for SSI are automatically approved for Regular Medicaid. This includes long-term services and supports via Regular Medicaid, given one meets the functional criteria.
Explore Florida Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Florida.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — Florida
How the main LTC programs available in Florida compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $14–17/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | Not in Florida | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Florida Medicaid programs
FL SMMC LTC — Participant-Directed Option (PDO)
Home Care for the Elderly (HCE)
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Florida
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in FloridaHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: AHCA · ahca.myflorida.com
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Florida
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Florida. The process typically takes 45–90 days from application to first paycheck.
Apply in Florida: AHCA · ahca.myflorida.com
Medicaid Eligibility Screener — Florida
Answer 7 quick questions — we'll check the financial and care requirements for Florida and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly any income from any source is counted towards the limit, including employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In FL, the VA Aid & Attendance, which is above and beyond the Basic VA Pension, does not count.
- When only one spouse applies for Nursing Home Medicaid or HCBS, only the applicant's income is counted.
- The non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $2,644 (eff. 7/1/25 – 6/30/26).
- A non-applicant spouse can increase their Spousal Income Allowance if housing/utility costs exceed the 'shelter standard' of $794 / month (eff. 7/1/25 – 6/30/26).
- A Spousal Income Allowance cannot push a non-applicant's monthly income over $4,067 (Maximum Monthly Maintenance Needs Allowance).
- For Regular Medicaid, the income of both spouses is counted. There is no MMMNA for the non-applicant spouse.
Florida's Personal Needs Allowance of $160 / month is one of the highest in the nation.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, bank accounts, and real estate in which one does not reside.
- In Florida, IRAs in payout status are exempt. This means the Required Minimum Distribution (RMD) is being withdrawn.
- Non-countable (exempt) assets include personal belongings, household furnishings, an automobile, and generally one's primary home.
- All assets of a married couple are considered jointly owned regardless of which program one applies for.
- The Community Spouse Resource Allowance (CSRA) allows the non-applicant spouse to retain up to $162,660 of the couple's assets (2026).
- There is no CSRA for Regular Medicaid.
Florida exempts IRAs in payout status (when RMDs are being withdrawn), unlike many states that count them.
- The primary home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $730,000 (in 2026).
- Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Florida's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Florida has a 60-month (5-year) Look-Back Period for Nursing Home Medicaid and HCBS that immediately precedes the application date.
- During the look-back, Medicaid checks to ensure no assets were gifted or sold under fair market value, including assets transferred by one's spouse.
- Violations result in a Penalty Period of Medicaid ineligibility.
- The Look-Back Rule does NOT apply to Regular Medicaid.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule still violates the Look-Back Period.
- MMMNA: $2,644 · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Nursing Home Medicaid or HCBS, only the applicant's income is counted.
- The non-applicant spouse may receive a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $2,644 (eff. 7/1/25 – 6/30/26).
- The Spousal Income Allowance can increase if housing/utility costs exceed the 'shelter standard' of $794 / month, but cannot exceed $4,067 / month (Maximum MMNA).
- The Community Spouse Resource Allowance (CSRA) allows the non-applicant spouse to retain up to $162,660 of the couple's assets.
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Medically Needy Pathway — Florida has a 'Share of Cost' / 'Spend-Down' Program for Regular Medicaid / MEDS-AD. The medically needy income limit (MNIL) is $180 / month for a single applicant and $241 / month for a couple (2026). The spend-down amount is the difference between one's monthly income and the MNIL. Once met, one is income-eligible for the remainder of the month. The medically needy asset limit is $5,000 for an individual and $6,000 for a couple.
- Qualified Income Trusts (QITs) / Miller Trusts — Allow persons over the income limit to qualify for Nursing Home Medicaid or HCBS. Excess income is deposited into an irrevocable trust. A trustee legally controls funds, which can only be used for specific purposes (medical bills, Personal Needs Allowances, Medicare premiums). Florida must be named to receive remaining funds upon death.
- Asset Spend-Down — Spend excess assets on non-countable items such as home modifications (wheelchair ramps, stair lifts), prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to become eligible and protect your home from Medicaid's Estate Recovery Program.
Florida Medicaid Programs
Statewide Medicaid Managed Care (SMMC) Long-Term Care (LTC) Program
Former HCBS Waivers (Alzheimer's Disease Waiver, Nursing Home Diversion Waiver, Assisted Living for the Elderly Waiver, and Consumer Directed Care Plus Waiver) have been replaced with the SMMC-LTC Program. Benefits may include adult day health care, meal delivery, respite care, personal emergency response systems, and personal care assistance.
Program of All-Inclusive Care for the Elderly (PACE)
Combines the benefits of Medicaid, including long-term care, and Medicare into a single program. Additional benefits such as dental and eye care may be available.
How to Apply
- Apply online via MyACCESS
- Download and complete a 'Government Assistance Application'
- Contact your Department of Children and Families (DCF) Customer Service Center
- Call the DCF Application Center at 1-866-762-2237
Prior to submitting a Medicaid application, it is imperative that seniors are certain they meet all eligibility requirements. Persons with income and/or assets in excess of the limits can benefit from Medicaid planning.
More Florida Long-Term Care Resources
Take the Next Step for Florida Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- Agency for Healthcare Administration (AHCA) — Florida Medicaid — Official site