Florida Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Florida.
7.6 million Medicaid long-term care recipients nationwide
Florida Agency for Health Care Administration (AHCA)
Processing Time
30-45 days for institutional Medicaid, 45-90 days for waiver programs
Florida Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Florida, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Florida follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month (Institutional Medicaid)
Married Couple (One Applying)
$2,982/month per applicant
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$137,400 (community spouse)
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Florida Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $8,500/month average (the average monthly nursing home cost in Florida).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Florida
Nursing Home Care
Medicaid pays 100% of nursing home costs in Florida once eligibility is established. The average monthly cost is $8,500/month average. Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Assisted Living for the Elderly Waiver: Florida's ALF waiver serves over 4,000 individuals in licensed assisted living facilities. Coverage includes personal care services and case management, but residents must pay room and board from their income or other resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Florida offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Aged/Disabled Adult Waiver
Serves adults age 65+ and disabled individuals age 18-64 who need nursing facility level of care but prefer to remain in the community.
Program Details →Assisted Living for the Elderly Waiver
Provides personal care services and case management for individuals residing in licensed assisted living facilities. Does not cover room and board.
Program Details →Channeling for Frail Elderly Waiver
Community-based services including case management, homemaker services, personal care, and respite care for frail elderly individuals.
Program Details →How to Apply for Medicaid in Florida
Florida Medicaid applications typically take 30-45 days for institutional Medicaid, 45-90 days for waiver programs. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Florida through:
- Online at ACCESS Florida
- Mail application to local Department of Children and Families office
- In-person at DCF office
- Through nursing facility or hospital social worker
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Florida from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Florida-Specific Programs and Resources
Long-Term Care Diversion Program
Helps individuals transition from nursing facilities back to the community by providing home modifications, assistive technology, and other services.
Learn MoreNeed Help with Florida Medicaid?
Contact Florida Agency for Health Care Administration (AHCA) for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-877-254-1055Application Helpline
1-866-762-2237