Long-Term Care Medicaid in Florida: 2026 Guide

In Florida, three state agencies share the work of Long-Term Care Medicaid. The Agency for Health Care Administration (AHCA) runs the program, the Department of Children and Families (DCF) decides financial eligibility, and the Department of Elder Affairs (DOEA) decides medical eligibility through its CARES program. Medicaid can pay for nursing home care and, through the Statewide Medicaid Managed Care Long-Term Care program, for care at home and in assisted living. This guide explains the 2026 rules in plain language.

At a glance: Florida 2026 figures

Figures last updated for 2026. Sources are listed at the end of this page.

Figures change periodically. Double-check current amounts with the Florida Department of Children and Families before relying on them.

What Long-Term Care Medicaid covers in Florida

Nursing home care. Medicaid pays for care in a Medicaid-certified nursing facility. You pay most of your income toward the cost each month, and Medicaid pays the rest. Nursing home Medicaid does not have a waiting list.

Care at home and in the community. Florida delivers home and community-based services through the Statewide Medicaid Managed Care Long-Term Care program (SMMC LTC). Eligible people choose a long-term care health plan, which arranges services such as personal care, homemaker help, adult day care, home-delivered meals, respite for family caregivers, and care in assisted living. SMMC LTC is for people 18 and older who need a nursing-home level of care.

There is a waiting list for home and community care. You start by calling your local Aging and Disability Resource Center (ADRC) for a phone screening. Your score sets your place on the wait list. When a slot opens, you are contacted to finish the medical and financial steps.

PACE (Program of All-Inclusive Care for the Elderly) is available in some areas of Florida.

Assisted living. SMMC LTC plans can pay for care services in an assisted living facility that works with the plan. Medicaid does not pay room and board; the resident pays that from their own income.

Who qualifies

A person generally must:

• be 65 or older, or disabled (18 or older for SMMC LTC);
• live in Florida and be a U.S. citizen or qualified non-citizen;
• need a nursing-home level of care. The CARES program (Comprehensive Assessment and Review for Long-Term Care Services) at the Department of Elder Affairs decides this. A nurse or assessor visits in person, usually at home, at no cost. For SMMC LTC, a doctor, advanced practice nurse or physician assistant must also fill out the Form 3008 medical certification;
• meet the income and asset rules below, as decided by DCF.

Income rules

Florida has an income cap for its long-term care programs (often called the Institutional Care Program for nursing homes). In 2026, an applicant’s gross monthly income must be $2,982 or less.

If income is higher, the person can set up a Qualified Income Trust (QIT), also called a Miller trust. Income above the limit is deposited into the trust’s bank account each month, and Medicaid is repaid from what is left in the trust after the person’s death.

Once you are on Medicaid in a nursing home, most of your income is paid to the facility as your share of cost. You keep a personal needs allowance of $160 a month. Some income can also go to a spouse at home and toward health insurance premiums.

Asset rules

In 2026, a single applicant can have $2,000 in countable assets, and a couple who both apply can have $3,000.

Countable assets include cash, bank accounts, CDs, stocks, bonds, mutual funds, retirement accounts that can be cashed in, life insurance cash value above small amounts, and real estate other than the home.

Usually exempt:

• Your home (equity up to $752,000) if you live there or intend to return, or a spouse or dependent relative lives there
• One vehicle
• Household goods and personal belongings
• Irrevocable prepaid funeral contracts, burial plots, and limited burial funds
• Some property used to earn income

Spousal protections

• Assets: Florida lets the spouse at home keep the federal maximum Community Spouse Resource Allowance, $162,660 in 2026, plus the home, one car and personal belongings.
• Income: The spouse at home keeps all income in their own name. If it is below $2,705 a month (from July 1, 2026), part of the applicant’s income can be shifted to them, with extra for high housing costs, up to $4,067 a month.

Look-back and penalties

When you apply, Florida looks back at the 60 months (5 years) before the application date. This is called the look-back period. The state checks whether you, or your spouse, gave away money or property, or sold something for less than it was worth, during that time.

Common examples of transfers that can cause a problem:

• Cash gifts to children or grandchildren, even small yearly gifts. (A gift that is fine for federal gift-tax purposes can still count for Medicaid.)
• Adding a child’s name to a house deed or bank account in a way that gives them part ownership.
• Selling a house or car to a relative for much less than it is worth.
• Paying a family member for care without a written agreement made at the time.

Some transfers are allowed, such as transfers between spouses, or transferring a home to a child who is blind or disabled.

How the penalty works. If the state finds a transfer that is not allowed, it does not deny Medicaid forever. Instead, it sets a penalty period: a stretch of time when Medicaid will not pay for long-term care. The state divides the amount given away by the penalty divisor ($10,645 a month).

Example: Suppose you gave your son $50,000 three years before applying. $50,000 divided by $10,645 is about 4.7 months without Medicaid payment for long-term care.

The penalty period starts only once you have applied, are otherwise eligible, and are in (or need) long-term care. This is why gifts made while someone is healthy can still matter years later. If a gift is returned in full, the penalty can be removed.

Estate recovery in Florida

Under Florida’s Medicaid Estate Recovery Act, AHCA files a claim against the estate of a deceased Medicaid recipient.

• What is recovered: all Medicaid paid after the person turned 55. Payments made before age 55 do not create a debt.
• When it is not enforced: if the person is survived by a spouse, a child under 21, or a child of any age who is blind or permanently disabled.
• Protected property: property that Florida law protects from creditors (such as homestead property passing to heirs) is not subject to the claim.
• Hardship: heirs or the personal representative can ask AHCA to waive the claim, for example if an heir lived in the home for the year before death and owns no other home, or provided full-time care that delayed a nursing home move.

How to apply

• Nursing home care: apply for Medicaid with DCF online through the ACCESS Florida application at myflfamilies.com/medicaid. On the Benefit Information screen, check Nursing Home. You can also apply at a DCF service center or community partner.
• Home and community care (SMMC LTC): first call your local ADRC for screening and wait-list placement. When you are released from the wait list, the ADRC sends Form 3008 for your doctor, CARES does an in-person assessment, and DCF decides financial eligibility (check HCBS/Waiver on the ACCESS application). If approved, AHCA mails a welcome packet to help you choose a plan.

Gather what you can before you apply. The caseworker may ask for:

• Photo ID, Social Security card and Medicare card
• Proof of age and of U.S. citizenship or immigration status
• Proof that you live in the state (for example, a utility bill or lease)
• Proof of all income: Social Security award letter, pension statements, annuity statements
• Bank, credit union and investment statements (often for the full 60-month look-back period)
• Deeds, property tax bills and the value of any real estate
• Life insurance policies (showing cash value) and prepaid funeral or burial contracts
• Vehicle titles
• Health insurance cards and long-term care insurance policies
• Power of attorney or guardianship papers, if someone is applying for you
• For a spouse at home: their income and assets too, since both spouses’ assets are counted at the start

If you cannot find a document, apply anyway and tell the caseworker. They can explain what else is accepted.

Free public help in Florida

• DCF (ACCESS Florida): questions about Medicaid applications and financial eligibility.
• Aging and Disability Resource Centers (ADRCs): screening, the SMMC LTC wait list and information on local services. Florida’s ADRCs are part of the Area Agency on Aging network.
• SHINE (Serving Health Insurance Needs of Elders): Florida’s free Medicare counseling program (SHIP), run by the Department of Elder Affairs.
• Florida Long-Term Care Ombudsman Program: free, independent advocates for residents of nursing homes and assisted living.

Recent and upcoming changes

A 2025 federal law (Public Law 119-21) makes two changes that affect Long-Term Care Medicaid in every state, including Florida:

• Retroactive coverage gets shorter on January 1, 2027. Today, Medicaid can pay bills from up to 3 months before the month you apply, if you would have qualified then. For applications from January 1, 2027, this window shrinks to 2 months for older adults and people with disabilities. In plain terms: from 2027, it matters more to apply soon after care starts, so that earlier bills are not left unpaid.
• Home equity cap on January 1, 2028. States will no longer be able to set a home equity limit above $1,000,000 (except for some farm property). Florida’s 2026 home equity limit, $752,000, is already below the new cap, so this change is not expected to affect Florida’s limit.

The federal amounts that change each year (for example, the allowances for a spouse at home) will be updated on this page for 2027 once they are published.

State programs

Each program below has its own page with who qualifies, services, how to apply and waiting lists:

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

Frequently asked questions

Is there a wait for home care in Florida? Usually, yes. SMMC LTC uses a wait list based on a screening score. Nursing home Medicaid does not have a wait list.

Can Medicaid pay for assisted living in Florida? SMMC LTC plans can pay for care services in assisted living facilities that are in the plan’s network. Room and board are paid by the resident.

My monthly income is above $2,982. What can I do? You can set up a Qualified Income Trust and deposit the extra income into it each month. DCF can explain what it needs to see.

How much can my spouse keep? In 2026, up to $162,660 in assets, plus the home, a car and belongings, and income of at least $2,705 a month.

Will Florida take my home after I die? The claim is not enforced while a spouse, a child under 21 or a disabled child survives, and homestead property protected under Florida law is not subject to the claim. Other property can be.

Who decides if I need nursing-home level care? The CARES program at the Florida Department of Elder Affairs, after an in-person assessment.

Figures change periodically. Double-check current amounts with the Florida Department of Children and Families before relying on them.

Sources

• AHCA, Long-Term Care Program
• AHCA, Become Eligible for Medicaid (SMMC LTC steps, Form 3008, CARES)
• AHCA, SMMC LTC Recipient FAQs
• Florida DCF, Medicaid (ACCESS Florida)
• Florida Statutes 409.9101, Medicaid Estate Recovery Act
• SHINE
• CMS, 2026 SSI and spousal impoverishment standards
• Public Law 119-21 (2025)

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