Medicaid is a federally mandated health plan that provides health coverage to those who are unable to pay for health insurance. It’s jointly funded by federal and state governments, and mandatory benefits include:
- Emergency and acute hospital services
- Doctor visits
- Nurse practitioner services
- X-rays and lab services
- Nursing facility services
- Transportation to Medicaid appointments
- Home health services
Medicaid is administered by each state, and optional, state-specific benefits may include:
- Vision testing and prescription eyeglasses
- Prosthetics
- Dental care and dentures
- Podiatry services
- Prescription drug coverage
- Self-directed personal care
- Private duty nursing
- End-of-life care
To qualify for long-term Medicaid coverage with access to home and community-based services, seniors aged 65 and older must:
- Be U.S. citizens or hold eligible immigration status
- Have a valid Social Security number
- Live full-time in Florida
- Have a monthly income of $2,313 or less
- Own $2,000 or less worth of countable assets, or
- Own $3,000 or less worth of countable joint assets when applying with a spouse
A number of assets are exempt under Medicaid rules, including one vehicle and an owner-occupied home valued at $585,000 or less. Also exempt is any income that a non-applicant spouse earns.
For more information on Florida’s Medicaid program, contact ACCESS Florida at (866) 762-2237.
Statewide Medicaid Managed Care Long-Term Care Program
The Statewide Medicaid Managed Care Long-Term Care program is a Medicaid nursing home diversion program that provides community-based long-term care services for eligible seniors. These services are delivered through managed care organizations in noninstitutional settings, such as assisted living facilities.
To enroll in the SMMC LTC program, seniors must be screened by the Comprehensive Assessment and Review for Long-Term Care Services program. This federally mandated assessment determines the placement for each applicant, which provides the most independence without compromising health or safety.
Seniors enrolled in SMMC LTC are provided benefits based on medical need, and these services may include:
- Adult day health care
- Personal and attendant care
- Homemaker services
- Intermittent nursing
- Medication administration and management
- Disposable medical supplies
- Durable medical equipment
- A medical alert device
- Speech, respiratory, occupational and/or physical therapy
- Transportation
- Hospice care
To request a CARES assessment, contact the Department of Elder Affairs, Planning and Service Area 9A, in West Palm Beach at (561) 840-3150.