Medicaid is a state-federal program that provides medical coverage to low-income people, including children, pregnant women and seniors. Some of the services covered by Florida Medicaid include care in nursing facilities, inpatient and outpatient hospital care and hospice services. A Medicaid waiver, described in detail below, may pay for assisted living and other long-term care services.
Seniors who live in Coral Gables may qualify for Florida Medicaid if they meet the program’s financial eligibility standards. For full community Medicaid, the income limit is $916 for an individual and $1,241 for a couple. Asset limits also apply: $5,000 for an individual and $6,000 for a couple.
To apply for Medicaid coverage, Florida residents can fill out an online ACCESS Florida application. On the application, indicate if you need long-term care services, such as in-home or assisted living care.
Florida seniors receiving Supplemental Security Income (SSI) are automatically eligible for Medicaid. They don’t need to fill out a separate application unless they need help paying for nursing home care.
For more information about Medicaid in Florida, call the Florida Department of Children and Families at (866) 762-2237.
Statewide Medicaid Managed Care Long-Term Care Program
Florida may pay for various long-term care services through the Statewide Medicaid Managed Care Long-Term Care Program (SMMC LTC), including assisted living, skilled nursing and personal care. Long-term care plans are offered through health maintenance organizations (HMOs) and provider service networks (PSNs).
Seniors may qualify for the SMMC LTC program if they have been determined to require a nursing home level of care. This determination is made by the Department of Elder Affairs. In addition, the program has financial eligibility requirements. These requirements are more generous than those for full community Medicaid. Single seniors are permitted to earn up to $2,313 per month, while couples can earn as much as $4,626. The asset cap is $2,000 for singles and $3,000 for couples.
To enroll in the program, call the Alliance for Aging at (305) 670-3500. Qualified seniors are placed on a waiting list, and their position on the list is determined by their care needs. Seniors who reach the top of the waiting list are able to select a long-term care plan. In Miami-Dade County, plans are offered by Amerigroup, Aetna, Humana, Molini, Sunshine and United.
To learn more about the SMMC LTC program, call the Agency for Health Care Administration at (877) 711-3662.