Seniors in Florida who need help paying for various medical goods and services, as well as long-term care, can apply for one or more of the plans that make up the Statewide Medicaid Managed Care (SMMC) program. The SMMC is relatively new, starting in 2014 as a more structured approach to the Medicaid waivers that had been offered in the past.
The SMMC is split into three plans: Long-term Care (LTC), Managed Medical Assistance (MMA) and Dental. Residents can apply for each of these plans as needed.
The Long-term Care plan is designed for seniors (65+), as well as adults of any age who are disabled, requiring a nursing facility level of care. Although the eligibility requirements are based on nursing facilities, it’s possible to be placed in and reimbursed for assisted living if it’s deemed the most appropriate in any individual case.
The Managed Medical Assistance plan covers Medicaid-approved goods and services, such as doctor visits, hospitals, mental health treatment and prescription drugs, as well as transportation to and from the point of service.
The Dental plan is mandatory for all Medicaid recipients in Florida and covers all approved dental services.
Eligibility requirements for Medicaid and the SMMC:
- Aged 65+ (or disabled)
- At or below maximum annual income of $16,612 ($22,491 for couples)
- At or below maximum countable assets of $2,000 ($3,000 for couples)
- Resident of the state of Florida
In Florida, funding from Medicaid toward assisted living costs is not an entitlement, which means applicants are often placed on a waiting list even if fully eligible to receive services. Nursing home care is an entitlement in Florida, so there is no delay if this is deemed the appropriate level of care.
More information on Medicaid and the SMMC can be found on the
Florida Agency for Health Care Administration (AHCA) website.
Applications can be made online via
ACCESS Florida, which is managed by the Department of Children and Families. Call customer service at (866) 762-2237 during business hours for assistance.