Florida Medicaid for Seniors & Long-Term Care

Updated August 2026

Florida delivers Medicaid long-term care services through the Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) program, administered by the Agency for Health Care Administration (AHCA). Enrollees choose or are assigned to an LTC managed care plan, which coordinates the full range of long-term care services — nursing facility care, home health, personal care, and community-based alternatives.

$2,000

Individual asset (resource) limit

~$2,982/mo

Income cap requiring a Miller Trust

SMMC-LTC

Statewide managed long-term care program

Florida was a national pioneer in managed long-term care

Florida launched its Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) program in 2013 — making it one of the first states to move Medicaid long-term care services into a managed care model at scale. Most other states still use fee-for-service or 1915(c) waiver structures. In Florida, LTC services are delivered by contracted LTC managed care plans, not directly by the state.

How Florida's long-term care Medicaid works

There is a waitlist for SMMC-LTC, managed by local Aging and Disability Resource Centers (ADRCs). Contact your ADRC as early as possible by calling the statewide Elder Helpline at 1-800-963-5337 (1-800-96-ELDER). While waiting for SMMC-LTC enrollment, some services may be available through fee-for-service Medicaid or through community programs administered by the Department of Elder Affairs (DOEA).

Who qualifies for SMMC-LTC?

Three conditions must all be met, per Florida Department of Elder Affairs eligibility rules. The CARES assessment — the Comprehensive Assessment and Review for Long-Term Care Services, conducted by the Department of Elder Affairs — determines whether an individual meets the clinical criteria for nursing home level of care, a threshold required before SMMC-LTC enrollment can proceed. The assessment looks at functional limitations, cognitive status, and care needs.

Age and disability: age 65 or older, OR age 18 or older with a qualifying disability
Medicaid eligibility: financially eligible for Medicaid under SSI-related income and asset rules
Level of care: assessed by the CARES unit as needing nursing home level of care, meeting at least one established clinical criterion

What SMMC-LTC covers

LTC managed care plans must cover a specified minimum set of services, per AHCA contract requirements, spanning both institutional and community-based care. All services are provided based on medical necessity or the need to delay or prevent nursing facility placement, and an LTC plan case manager develops an individualized care plan with each enrollee.

Nursing facility care (skilled and intermediate)
Personal care assistance at home
Adult day health care
Home health — nursing visits, physical, occupational, and speech therapy
Assistive care services and homemaker services
Home-delivered meals
Caregiver training and respite care
Assistive technology and home accessibility modifications
Case management and care coordination
Personal emergency response systems
Transportation to covered services

Income and asset rules for nursing facility Medicaid

Florida uses an income cap for nursing facility Medicaid. Applicants whose monthly income exceeds the income cap — approximately $2,982 per month in 2026 — must establish a Qualified Income Trust (QIT), also called a Miller Trust, to qualify. Income above the cap flows into the trust and is used to pay for cost of care; without the trust, the applicant does not qualify even with low assets.

The asset (resource) limit for an individual is $2,000. Exempt assets include a primary home (if a spouse or dependent relative lives there, or if the applicant intends to return), one vehicle, personal belongings, and prepaid burial funds up to $2,500, per DCF's SSI-Related Programs Financial Eligibility Standards.

For married couples, the Community Spouse Resource Allowance (CSRA) protects a portion of the assets for the at-home spouse. For 2026, the community spouse may keep between $32,532 and $162,660 in countable assets, with the exact amount determined by total marital assets. The community spouse also retains a Minimum Monthly Maintenance Needs Allowance (MMMNA) from the institutionalized spouse's income.

PACE and Medicaid estate recovery

Programs of All-Inclusive Care for the Elderly (PACE) are available in select Florida counties for individuals 55 and older who qualify for nursing home level of care but choose to remain in the community, receiving all medical and long-term care services through a single PACE organization. Availability is limited — contact your local ADRC or AHCA for current PACE locations.

AHCA administers Florida's Medicaid Estate Recovery Program (MERP). After a Medicaid beneficiary dies, AHCA may file a claim against the estate to recover costs paid for nursing facility care, home- and community-based waiver services, and related hospital and prescription services provided after age 55. Florida's MERP extends to real property interests beyond the probate estate in some cases. A surviving spouse, child under 21, or blind or disabled child prevents recovery during their lifetime, though a lien may still be placed. Consult a Florida elder law attorney before making asset transfers.

Spousal impoverishment protections at a glance

Federal law (42 U.S.C. § 1396r-5) protects the community spouse when the other spouse enters a nursing facility or the SMMC-LTC program. Florida applies these protections under AHCA Medicaid rules, defaulting to the federal minimum CSRA floor unless a fair hearing or court order establishes a higher amount.

Protection	2026 amount	Notes
Community Spouse Resource Allowance (CSRA)	$32,532–$162,660	Federal floor/ceiling; Florida uses the minimum floor ($32,532) unless a fair hearing or court order establishes a higher amount
Minimum Monthly Maintenance Needs Allowance (MMMNA)	$2,705–$4,067/month	Federal range effective 7/1/2026–6/30/2027; allocated from the institutionalized spouse's income
Institutionalized spouse asset limit	$2,000	Countable resources only; exempt assets include the home (while the community spouse occupies it), one vehicle, and personal effects

Community Spouse Resource Allowance (CSRA)

2026 amount: $32,532–$162,660
Notes: Federal floor/ceiling; Florida uses the minimum floor ($32,532) unless a fair hearing or court order establishes a higher amount

Minimum Monthly Maintenance Needs Allowance (MMMNA)

2026 amount: $2,705–$4,067/month
Notes: Federal range effective 7/1/2026–6/30/2027; allocated from the institutionalized spouse's income

Institutionalized spouse asset limit

2026 amount: $2,000
Notes: Countable resources only; exempt assets include the home (while the community spouse occupies it), one vehicle, and personal effects