Medicaid Long-Term Care in Florida: A Family Guide
If you're helping a parent or grandparent who needs more care at home, in assisted living, or in a nursing home, the first surprise is usually who pays for it. Here is how it works in Florida, step by step.
What Medicare does and doesn't cover
Medicare doesn't cover long-term care (also called custodial care) if that's the only care someone needs: help with bathing, dressing, eating, or getting around. Medicare can cover a limited stay in a skilled nursing facility after a qualifying hospital stay, and some home health care, but not ongoing daily help. In Florida, long-term care for people who qualify is paid for through Medicaid.
Florida's program: SMMC Long-Term Care
Florida provides Medicaid long-term care through the Statewide Medicaid Managed Care (SMMC) Long-Term Care program, run by the Agency for Health Care Administration (AHCA). It serves adults who qualify for Medicaid and need long-term services, whether that care is at home, in an assisted living facility, or in a nursing facility.
How to apply, step by step
- Get screened. Call the Elder Helpline at 1-800-96-ELDER (1-800-963-5337) to reach your local Aging and Disability Resource Center (ADRC). The screening is done by phone.
- Wait list. The screening gives a priority score. People are released from the wait list each month based on their score and frailty, not on how long they have waited, so call back if your loved one's condition changes.
- Medical and financial eligibility. After release, the ADRC sends a medical certification form for the doctor to complete. The Department of Children and Families (DCF) decides financial eligibility, and the Department of Elder Affairs' CARES program assesses the level of care needed.
- Choose a plan. Once eligible, AHCA sends a welcome packet and you choose a long-term care plan.
Some current Medicaid recipients can skip the wait list, for example a nursing facility resident who has lived in a Florida-licensed skilled nursing facility for at least 60 consecutive days and wants to move back into the community.
Medicare plans for people with both Medicare and Medicaid
People who have both Medicare and Medicaid ("dual eligible") can choose a Dual-Eligible Special Needs Plan (D-SNP), a Medicare Advantage plan designed to work alongside Medicaid. CMS lists 130 D-SNPs in Florida for 2027, 98 of them from carriers we work with. A licensed agent can check which ones serve your loved one's county.
Planning ahead for the rest of the family
Families going through this often look at their own coverage next: a hospital indemnity plan that pays cash benefits for a hospital stay, or life and final expense insurance so the family isn't left with bills. We can walk you through those too.
Free, unbiased help
For Medicaid applications, the Elder Helpline and your ADRC are the right place to start. For free Medicare counseling, contact SHINE, Florida's State Health Insurance Assistance Program, through the same Elder Helpline. We are licensed insurance agents, not Florida Medicaid, and we can't enroll anyone in Medicaid.
Talk to a licensed agent: 954-306-1645Florida Medicare Advantage statewide guide · Florida plans by county · Home
Sources: Florida Agency for Health Care Administration (SMMC Long-Term Care program pages); Florida Department of Elder Affairs; CMS 2027 Landscape file (CY2027_Landscape_202610.csv). Program rules can change; confirm current details with the Elder Helpline.
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Not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 6 organizations which offer 349 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.