Florida Medicaid for Assisted Living, Explained

Many families assume Medicaid only pays for nursing homes. In Florida, Medicaid can also help pay for care in an assisted living home, including memory care. Here is how it works.

The program: Statewide Medicaid Managed Care Long-Term Care

Florida provides long-term care benefits through the Statewide Medicaid Managed Care (SMMC) Long-Term Care program. Members choose a managed care plan, and the plan pays for services in the setting that fits the person’s needs, including at home, in an assisted living facility or in a nursing home.

Who may qualify

In general, a person must:

• Be 65 or older, or 18 or older with a qualifying disability
• Need the level of care typically provided in a nursing facility (for example, because of dementia or difficulty with daily activities)
• Meet Medicaid’s financial limits on income and assets
• Be a Florida resident and a U.S. citizen or qualified non-citizen

Income and asset limits change each year, and there are rules that protect a spouse who still lives at home. An elder law attorney or Medicaid planner can help you understand your family’s situation.

What Medicaid pays for in assisted living

In an assisted living home, the program generally pays for care services, such as help with bathing, dressing, medication management and supervision. It usually does not pay for room and board. The resident typically contributes toward room and board from their own income, such as Social Security or a pension.

How to apply

• Start with a screening. Call the Florida Elder Helpline at 1-800-96-ELDER (1-800-963-5337) to reach your local Aging and Disability Resource Center, which screens for the program.
• Expect a wait list. Enrollment is often based on priority, and many applicants are placed on a wait list. Getting screened early helps.
• Apply for Medicaid eligibility through the Florida Department of Children and Families (DCF).
• Choose a plan once you are enrolled, and check that the assisted living home you prefer works with that plan.

Combining benefits

Some families also use VA Aid and Attendance, long-term care insurance or savings while waiting for Medicaid. Generations Senior Living accepts Medicaid at all three of our homes and is glad to help families understand their options.

Program rules change. Check with the Florida Agency for Health Care Administration, DCF or a qualified professional for the latest details.

Have questions about memory care for someone you love? Call Generations Senior Living at (352) 474-2696 or schedule a tour of one of our three homes near The Villages.