Approximately 3,280,000 low-income Florida residents receive free health care coverage through Medicaid, the nationwide health insurance program for Americans who would otherwise be left without access to health care. Funding for Medicaid is provided by the federal and state governments, and nearly two-thirds of Florida’s Medicaid expenditures go towards services for seniors and the disabled.
Medicaid eligibility is based on the income and countable assets of each applicant. Florida seniors who already receive Supplemental Security Income benefits are prequalified for Medicaid, and they only need to complete an additional Medicaid screening if they require Medicaid funding for long-term residential care services.
Statewide Medicaid Managed Care Long-Term Care Program
Low-income seniors age 65 and older who require the type of care that’s normally provided in a nursing home may be eligible to receive additional care services and support within an assisted living setting through the Statewide Medicaid Managed Care Long-Term Care program.
In order to qualify for long-term care services under the SMMC LTC, seniors must earn under $2,313 per month when applying as an individual or under $4,626 per month when applying with a spouse. This income limit is set at three times the SSI monthly limit and is subject to change annually.
Medicaid asset limits are $2,000 per individual and $3,000 for a couple. Countable assets include the cash value of any life insurance policies worth $1,500 or more, stocks and bonds, cash and any real estate other than the applicant’s principal residence.
Assets that aren’t counted towards the Medicaid asset limits include the home of the applicant or applicants valued at up to $585,000, irrevocable prepaid burial contracts, personal belongings and one vehicle.
In accordance with federal law, seniors who meet the financial requirements for the SMMC LTC must also be assessed by a registered nurse or designated assessor through the Comprehensive Assessment and Review for Long-Term Care Program.
To request a CARES assessment, seniors need to apply to the Institutional Care Program. The assessment is reviewed by a physician or registered nurse to determine the least restrictive placement that meets the applicant’s medical needs. Seniors accepted into the SMMC LTC may be provided with one or more of the following services within an assisted living environment:
- An adult companion
- Intermittent and skilled nursing
- Medication management and administration
- Transportation
- A personal emergency response device
- Adult day health care
- Physical therapy
- Personal care
- Nutritional assessment
Note: Florida is an income-cap state, therefore Medicaid applicants whose earnings exceed the qualifying income limits cannot achieve Medicaid eligibility by using their excess income to pay for health care services.
To apply for Medicaid or to learn more about the SMMC LTC program, contact
ACCESS Florida at (866) 762-2237. To request a CARES assessment, contact the
Department of Elder Affairs at (727) 376-7152.