Medicaid is a nationwide health coverage program for low-income, low-asset Americans of all ages. It’s jointly funded by the federal and state governments. In Florida, Medicaid is administered by the Agency for Health Care Administration, a statewide health policy and planning entity of the Florida Department of Children and Families.
Permanent Florida residents aged 65 and older who meet strict income and asset limits may qualify for no-cost Medicaid coverage, including coverage for assisted living costs. Single seniors must earn less than $2,313 a month and own less than $2,000 in countable assets, while couples applying together must earn less than $4,626 a month and own less than $3,000 worth of countable assets.
Income includes wages, pensions, alimony and investment interest. Countable assets include cash and bank account balances, stocks, bonds and all real estate (except for a principal residence of the applicant(s) that is located in Florida and valued at $585,000 or less).
Florida Medicaid applicants are also subject to a 5-year look-back period to audit any assets that were sold or given away during the five years prior to their Medicaid application. If this audit reveals assets that could have otherwise been liquidated to fund senior-care services, Medicaid may impose a penalty in the form of an ineligibility period, which is calculated based on the value of the assets divided by the average cost of private nursing home care.
Seniors aged 65 and older who qualify for Medicaid coverage and require residential care services at a nursing home level, may be eligible for assistance through the Statewide Medicaid Managed Care, Long-Term Care Program (SMMC LTC).
The SMMC LTC program helps to delay or prevent nursing home placement of Florida seniors by funding additional care services within an assisted living setting.
In accordance with federal law, all potential program participants must complete a Comprehensive Assessment and Review for Long-Term Care Services (CARES), which will be reviewed by a designated registered nurse or physician.
Seniors who are approved for the SMMC LTC program will be provided with long-term services based on their needs. These services can include:
- Adult companion and attendant care
- Adult day health care
- Medical equipment and supplies
- Intermittent and skilled nursing
- Medication administration and management
- Personal care
- Speech, physical, occupational or respiratory therapy
- Homemaker
- Transportation
To learn more about Medicaid and the SMMC LTC program, contact the
Indian River County elder helpline at (866) 684-5885.