Florida Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) Program

The Statewide Medicaid Managed Care Long-Term Care program (SMMC LTC) is how Florida Medicaid pays for long-term care at home, in assisted living and in nursing homes. Members choose a long-term care health plan, which arranges their services. This page is part of our Florida Long-Term Care Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

SMMC LTC in brief

Put simply, responsibility for SMMC LTC sits with Florida Agency for Health Care Administration (AHCA); financial eligibility by the Department of Children and Families (DCF); screening by the Department of Elder Affairs through ADRCs. Its target group is 18 and older; on care need, the rule is: Needs a nursing facility level of care. On waiting lists, the current picture is: Yes, for home and community care (not for nursing homes). Each of these points is covered in more depth below, alongside the general Florida rules from our state guide. If SMMC LTC is not the right fit, the related pages at the end point to other Florida programs and general guides.

What the program is

AHCA runs SMMC LTC through contracted long-term care plans. For home and community care, the first step is a phone screening through the local Aging and Disability Resource Center (ADRC), which places the person on a waitlist with a priority score. When a slot is released, the person completes a level of care assessment (with the Department of Elder Affairs’ CARES program) and a Medicaid financial application with DCF. Then they choose a plan, and a plan case manager arranges services. People who need nursing home care can enter the program without waiting.

In a managed long-term services and supports program, the state pays a health plan a monthly amount to arrange all of a member’s long-term care, at home, in assisted living or in a nursing home. Members pick a plan where more than one is available, and that plan’s care coordinator manages the plan of care. The plan must follow the state’s eligibility and coverage rules, and members keep the right to appeal decisions they disagree with. See Managed long-term services and supports.

Who qualifies in 2026

Eligibility for SMMC LTC comes down to these points. The person:

• Is 18 or older
• Needs a nursing facility level of care as decided by CARES
• Qualifies for full Medicaid under Florida’s long-term care financial rules (see the money test below)
• Lives in Florida and is a U.S. citizen or qualified non-citizen
• For home and community care: has been released from the waitlist

The money test. SMMC LTC requires full Medicaid eligibility under Florida’s long-term care financial rules. The income and asset figures in the table above are Florida’s 2026 Long-Term Care Medicaid figures from our state guide. Exempt items generally include the home within the equity cap, a car, household goods and a modest burial fund. Married couples get extra protection in Florida: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.

How the care assessment works. For SMMC LTC, an assessor checks how much help the person needs with bathing, dressing, eating, toileting, mobility and medications, and whether memory loss calls for supervision. The visit is normally face to face, at home or in a hospital or facility. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.

What services it can pay for

The plan of care decides which services are used. SMMC LTC can cover:

• Nursing facility care
• Personal care and homemaker help
• Adult day care
• Home-delivered meals
• Respite for family caregivers
• Assisted living services (the resident pays room and board)
• Case management
• Home accessibility changes
• Personal emergency response
• Participant-directed options for some services

The menu is broad, but the plan is built from need, and unpaid family help is factored in. When needs grow, request an updated assessment.

Directing your own care and paying family

SMMC LTC includes a Participant Directed Option for some services, such as attendant care and homemaker help, under which members can hire workers they choose, including some family members.

How to apply

There are two tracks, a financial one and a care one, and both must say yes. The usual path for SMMC LTC is:

1. Call your local ADRC for a screening. Your score sets your place on the waitlist.
2. Keep the ADRC updated if needs change, since rescreening can change priority.
3. When released from the waitlist, complete the CARES level of care assessment.
4. Apply for Medicaid with DCF (online or on paper).
5. Choose a long-term care plan; the plan’s case manager arranges services.

Our documents checklist and Applying for a waiver guide list the paperwork.

Waiting lists

Florida keeps a statewide waitlist for home and community care under SMMC LTC, ordered by priority score from the ADRC screening rather than strictly by date. Some groups, such as people transitioning from a nursing home after a qualifying stay, can be enrolled without waiting. Nursing home Medicaid does not have a waitlist.

General advice is in Waiver waiting lists.

How it relates to nursing home Medicaid

In Florida, the same program covers nursing homes and home care. Nursing home residents who qualify enter SMMC LTC directly; home care has a waitlist. Both use Florida’s 2026 income rule ($2,982 a month, with a Qualified Income Trust above that) and asset limit. Some families use a nursing home stay as a path into the program and then move to the community.

Rules shared with nursing home Medicaid. As in nearly every state, Florida’s financial rules for home and community programs follow its nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. Florida Medicaid can also use estate recovery to seek repayment for long-term care services received after 55. Some participants pay a monthly share of income toward services.

Personal needs allowance. If the person does move to a nursing home, Florida’s 2026 personal needs allowance is $160 a month. Most of the rest of their income goes toward the cost of care. The state guide explains the nursing home side.

Tips for families

• Do not wait for a crisis. Lists and assessments for SMMC LTC take time, and the start date is usually when you first request help.
• Keep copies of every SMMC LTC form, notice and letter, and write down the name of each person you speak with and the date.
• Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
• Report changes in income, assets, address or living situation to Florida Medicaid when they happen.
• Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
• Protect a spouse at home. Spousal protections must be claimed; a certified Medicaid planner or legal aid office can explain them for your family.

Common questions

Why is there a waitlist for home care but not for nursing homes? Federal rules require Medicaid to cover nursing home care for people who qualify. Home and community care is limited by available funding.

Does SMMC LTC pay for assisted living? Plans can pay for care in assisted living facilities in their network. The resident pays room and board.

Can family be paid? Plans offer a participant-directed option for some services, under which some family members can be hired.

Related pages

• Florida Long-Term Care Medicaid guide
• Managed long-term services and supports
• Miller trusts
• Three kinds of Long-Term Care Medicaid
• PACE programs

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.