Medicaid, the nationwide health coverage program for low-income children, adults and seniors, provides basic health care for 16% of Florida’s residents. About 29% of the elderly and disabled in Florida are on Medicaid, and 64% of Florida’s Medicaid expenditures go towards emergency, acute and long-term services for seniors and disabled individuals.
Because Medicaid is designed to help those who cannot afford health insurance, seniors must meet strict asset and income limits to qualify for coverage. Individuals can earn no more than $2,313 a month, while couples applying together have an income limit of $4,626. Income from all sources is counted towards Medicaid limits, including wages, alimony payments, pension and any income earned from rental properties.
Asset limits are also in place for Medicaid applicants. Individuals can own no more than $2,000 in countable assets, while couples are limited to $3,000 in cash, stocks, bonds and real estate. Some assets are exempt, such as one vehicle, a home that the applicant owns and lives in worth up to $585,000 and a non-revocable burial trust.
Note: Florida is a Medicaid cap state, which means seniors with incomes that exceed Medicaid limits cannot qualify for Medicaid by spending down the excess income.
Statewide Medicaid Managed Care Long-Term Care Program
Florida has a Medicaid waiver program for Medicaid enrollees who need the type of care normally provided in a nursing home. Known as the Statewide Medicaid Managed Care Long-Term Care Program, this waiver is designed to help seniors remain in an assisted living facility with the support they need to remain as safe and independent as possible.
Services available through the SMMC LTC include:
- Adult day health care
- Case management
- Skilled and intermittent nursing
- Medication administration and management
- Medical supplies and equipment
- Physical, occupational, speech and/or respiratory therapy
- Homemaker
- Transportation assistance
- A personal emergency response system
Note: Services are delivered on a case-by-case basis and are assigned according to medical need.
Seniors must be referred to the SMMC LTC through the
Comprehensive Assessment and Review for Long-Term Care Services, the federally mandated screening program for Medicaid enrollees who request Medicaid-funded long-term care. If a senior is deemed suitable for the SMMC LTC, the CARES assessor makes a referral to the waiver program along with recommendations regarding the necessary services.
For more information about Florida Medicaid and the SMMC LTC program, contact the
St. Lucie County Elder Help line at (866) 684-5885.