Guide
Florida Medicaid for nursing homes and home care (SMMC LTC)
Updated October 15, 2026 · Reviewed against official sources
Florida has one of the largest populations of older adults in the country, with many Cuban, Puerto Rican, Colombian, Venezuelan, Mexican and Central American families. If your loved one needs help every day, the Medicaid program you most need to know about is SMMC Long-Term Care. Here we explain how it works, who qualifies and what steps to take, in order.
What is SMMC Long-Term Care?
SMMC stands for Statewide Medicaid Managed Care. Its Long-Term Care (LTC) part is run jointly by two agencies:
- The Agency for Health Care Administration (AHCA).
- The Department of Elder Affairs (DOEA).
The person enrolls in a managed care plan, which coordinates their services with the help of a case manager. According to DOEA, the program can cover, among other things:
- In-home services: personal care, homemaker services, home-delivered meals, nursing, a personal emergency response system and modifications to make the home more accessible.
- Support for family caregivers: respite care and caregiver training.
- Community services: adult day care and transportation.
- Services in an assisted living facility (ALF).
- Nursing facility care and hospice.
Medicaid pays for care services in assisted living, not rent or meals. The person covers those costs with their own income, such as Social Security.
Who qualifies
According to AHCA and DOEA, the person must meet three conditions:
- Be 65 or older, or be 18 or older and have a disability.
- Qualify for Medicaid financially. That part is decided by the Department of Children and Families (DCF).
- Need a nursing home level of care. DOEA's CARES unit decides this with a medical and functional assessment.
The 2026 reference numbers
These are 2026 federal figures published by CMS, which Florida uses as the basis for long-term care:
| Item | 2026 |
|---|---|
| Typical asset limit (one person) | $2,000 |
| Special income rule (300% of SSI) | $2,982 a month |
| Assets the spouse living at home can keep | $32,532 to $162,660 |
| Spouse's minimum protected income (starting July 1, 2026) | $2,705 a month |
If your loved one's income is over $2,982 a month, they may still qualify with a Qualified Income Trust (also called a Miller trust). Ask DCF, and consider talking with an elder law attorney to set it up correctly.
Medicaid also reviews asset transfers from the past 5 years (the look-back). Before giving away money or selling a property for less than it's worth, get advice. More details in Does Medicaid pay for nursing homes?.
The ADRC screening and the waitlist
This is the part families ask about most. To get home or community services through the program, you first need a phone screening with the Aging and Disability Resource Center (ADRC) in your area.
How it works, according to AHCA:
- The call lasts 45 minutes to an hour. They'll ask about your loved one's health, what they can do on their own and what help they have.
- The screening gives a score and a priority level. DOEA sends you the result in writing.
- With high priority, the person is placed on the program's waitlist.
- With low priority, they aren't placed on the list, but they get information about other community resources.
- You can ask for a copy of the screening, a fair hearing if you disagree, or a new screening every year or whenever there's a major change.
Practical tip: if things change (a fall, a hospital stay, more confusion, losing a caregiver or a change in living situation), call the ADRC and ask them to screen your loved one again. A change like that can raise their priority.
Some people who already have Medicaid don't have to go through the waitlist. For example, people who have spent at least 60 days in a row in a Florida-licensed nursing home and want to move back into the community.
What if my loved one needs a nursing home now?
The waitlist is for home and community services. If your loved one already needs to live in a nursing home and meets the medical and financial requirements, Medicaid can pay for that stay. In that case, the main work is the DCF application and the CARES assessment. The facility's social worker usually helps with the paperwork; also see the hospital social worker if your loved one is leaving the hospital.
How to apply, step by step
- Call the Elder Helpline: 1-800-96-ELDER (1-800-963-5337). They'll connect you with your county's ADRC.
- Do the phone screening with the ADRC. Have your loved one's list of medications, diagnoses and doctors handy.
- Apply for Medicaid with DCF. Gather ID, proof of income (Social Security letter, pensions), bank statements, insurance policies and the Medicare card.
- CARES assessment: a DOEA team confirms whether your loved one needs a nursing home level of care.
- Choose an LTC plan when you're offered a spot in the program. The state's Choice Counseling service explains which plans are available in your region.
- Answer all mail from DCF, AHCA and the plan, and keep copies. One unanswered letter can delay or close the case.
Apply in the same month care starts
This point is very important in Florida. Under state law, for adults who aren't pregnant, Medicaid pays starting the first day of the month the application is filed, not for months before. If your loved one moves into a nursing home on March 10, it's best to apply for Medicaid in March. If you wait until April, March's costs usually won't be covered.
If your loved one is already in a nursing home, ask the facility about "Medicaid pending" status and what to confirm in writing about payments while the application is being decided.
How to choose a place in Florida
In Florida, assisted living facilities (ALFs) have a standard license and may also have specialty licenses:
| Specialty license | What it allows |
|---|---|
| ECC (Extended Congregate Care) | More services so the person can keep living there when they need more help |
| LNS (Limited Nursing Services) | Limited nursing services |
| LMH (Limited Mental Health) | Care for residents with certain mental health conditions |
There are also Adult Family Care Homes, where the provider lives in the home and cares for up to 5 residents. For many families, they feel more like a real home.
Before you decide, ask each place whether it accepts your loved one's Medicaid LTC plan, since not every place works with every plan. You can look up licenses and inspection reports on FloridaHealthFinder, AHCA's official search tool. A report is a snapshot of one moment; if something catches your eye, feel free to ask the place what has changed since then. For nursing homes, also check Medicare star ratings, use our visit checklist and browse our directory of senior living in Florida.
While you wait: other help
- Local agencies on aging: they may offer meals, respite care and support funded by the Older Americans Act. The Elder Helpline can guide you.
- Free Medicare counseling: DOEA's SHINE program gives guidance at no cost.
- PACE program: available in some parts of Florida. Read about the PACE program.
- Adult day centers: see adult day centers and our guide to adult day care for seniors.
- Support for caregivers: read help for family caregivers and our article on respite care.
- Private home care: estimate the cost with our home care calculator.
If it's urgent because your loved one is leaving the hospital, go to our hospital discharge page.
Frequently asked questions
How long is the waitlist?
It depends on your loved one's priority, your region and the funding available. There's no set timeline. The most helpful thing is to do the screening as soon as possible and ask for a new one if their health changes.
Does Medicaid pay for assisted living in Florida?
It pays for care services through the LTC plan, but not for rent or meals. The person covers that part with their income.
Can I apply for Medicaid even if my loved one owns a home?
Yes. The main home usually doesn't count as an asset, up to a value limit. Confirm your situation with DCF.
What if my loved one doesn't have a qualifying immigration status?
Federal rules changed in 2026. Read our guide on immigration status and benefits.
Florida's Medicaid rules can change. This guide is for information only and is not legal advice.
Sources
- Florida AHCA, SMMC Long-Term Care program screening: https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/statewide-medicaid-managed-care-long-term-care-program-screening.html (accessed October 15, 2026)
- Florida Department of Elder Affairs, SMMC LTC program: https://elderaffairs.org/programs-and-services/statewide-medicaid-managed-care-long-term-care-program/ (accessed October 15, 2026)
- Florida Senate, Florida Statutes, section 409.904 (retroactive coverage): https://www.flsenate.gov/Laws/Statutes/2025/409.904 (accessed October 15, 2026)
- Florida AHCA, assisted living: https://ahca.myflorida.com/health-quality-assurance/bureau-of-health-facility-regulation/assisted-living-unit/assisted-living-facility.html (accessed October 15, 2026)
- Florida AHCA, Adult Family Care Homes: https://ahca.myflorida.com/health-quality-assurance/bureau-of-health-facility-regulation/assisted-living-unit/adult-family-care-home.html (accessed October 15, 2026)
- FloridaHealthFinder: https://quality.healthfinder.fl.gov/Facility-Provider/ (accessed October 15, 2026)
- CMS, 2026 SSI and spousal impoverishment standards: https://www.medicaid.gov/federal-policy-guidance/downloads/cib12092025.pdf (accessed October 15, 2026)
- CMS, updated 2026 standards: https://www.medicaid.gov/federal-policy-guidance/downloads/cib04272026.pdf (accessed October 15, 2026)
Senior living in the cities with the most options
Only those that accept Medicaid: Miami · Tampa · Jacksonville · Orlando · Hialeah · Port Saint Lucie · Sarasota · Palm Bay · Saint Petersburg · West Palm Beach · Bradenton · Naples
This is general information, not medical, legal or financial advice. Rules vary by state and by year: confirm with the official agency that applies to you.
Keep reading
Does Medicaid pay for care?
Yes, Medicaid pays for a nursing home if your loved one qualifies. 2026 limits, the 5-year look-back, spouse protections, waivers and how to apply.
What is assisted living
What assisted living is, who regulates it in each state (RCFEs in California, Type A and B in Texas), what it costs, and when Medicaid pays for services.
Home care
A caregiver from an agency or hired by your family, Medicare home health and Medicaid (IHSS, STAR+PLUS): typical costs and your duties as an employer.
Adult day care
What adult day care is, how it differs from adult day health care, what it costs and how to pay for it with Medicaid, PACE, CBAS or the VA.
