To qualify for Florida’s HCBS waivers, you need to meet both a financial test and a medical test: your gross monthly income must be at or below $2,982 in 2026, your countable assets must be under $2,000, and a state clinical assessment must find that you need a nursing-home level of care. Eligibility for Florida’s Home and Community Based Services waivers is only the first step. Both main waiver programs run waitlists, so meeting the criteria gets you in line rather than into services immediately.
Which Waiver You’re Applying For
Florida delivers HCBS through two separate waiver programs run by two different agencies. The one you apply to depends on who needs care.
The Statewide Medicaid Managed Care Long-Term Care program (SMMC-LTC) serves adults 65 or older on Medicaid, and adults 18 or older with a qualifying disability on Medicaid, who need a nursing-facility level of care.1Florida Department of Elder Affairs. Statewide Medicaid Managed Care Long-Term Care Program Once enrolled, you pick a managed care plan, and that plan’s care manager builds your services around what your assessment says you need.
The iBudget waiver serves people with developmental disabilities, including intellectual disability, autism, cerebral palsy, Down syndrome, Prader-Willi syndrome, and spina bifida. Eligibility requires a diagnosis meeting the criteria under Chapter 393 of Florida Statutes, a determination that you would need the level of care provided in an intermediate care facility for individuals with intellectual disabilities, and Medicaid financial eligibility.2Florida Agency for Health Care Administration. Developmental Disabilities Individual Budgeting (iBudget) Waiver The iBudget covers services the LTC waiver does not, such as supported employment, behavioral analysis, and residential habilitation. Its waitlist is among the longest in Florida and can stretch for years.
Financial Eligibility
The financial rules apply to both waivers and are stricter than standard Medicaid.
Income
Your gross monthly income must be at or below 300 percent of the federal SSI benefit rate. With the SSI federal benefit rate set at $994 per month for 2026, the cap is $2,982 per month.3Social Security Administration. SSI Federal Payment Amounts Income means nearly everything: Social Security, pensions, annuities, and any other regular payments.
Assets
Countable assets must be below $2,000 for a single applicant. Bank accounts, stocks, bonds, and cash count. Several major assets are exempt:
- Your primary home, as long as you intend to return or a spouse still lives there.
- One vehicle, regardless of value.
- Personal belongings, including furniture, clothing, and household goods.
- Up to $2,500 in burial funds, plus irrevocable burial contracts.
If You’re Married
When only one spouse needs HCBS, federal spousal impoverishment rules protect the community spouse. The spouse remaining at home can keep a portion of the couple’s combined countable assets under the Community Spouse Resource Allowance. They can also receive a Minimum Monthly Maintenance Needs Allowance from the applicant spouse’s income, reaching up to $4,067 per month in 2026, depending on the community spouse’s own income and housing costs. Because of these protections, a married applicant’s financial picture is evaluated differently than a single person’s.
If Your Income Is Over the Limit
Being over $2,982 does not automatically disqualify you. Florida recognizes two pathways.
A Qualified Income Trust, also called a Miller Trust, lets you redirect excess income into an irrevocable trust each month so that your countable income drops below the cap. Florida must be named as the remainder beneficiary, meaning any funds left at your death go to repay Medicaid. Only income goes in, never savings or property proceeds. You must deposit full income checks from each source you divert; splitting a single Social Security check between the trust and a personal account is not allowed. Because the trust document has to meet specific requirements under Florida law and getting it wrong can disqualify you outright, most families use an elder law attorney to set one up.
The Medically Needy pathway is the other option. Under it, you “spend down” excess income on medical bills each month until your remaining income falls below the state’s medically needy threshold.
The Medical Test: CARES Assessment
Meeting the financial rules is not enough. You also need a clinical determination that you require a nursing-facility level of care, even though you plan to receive services at home. That determination is made by the CARES unit within the Department of Elder Affairs.4Elder Affairs Florida. Comprehensive Assessment and Review for Long-Term Care Services (CARES) Program
A CARES registered nurse or physician reviews your ability to handle basic daily activities such as bathing, dressing, eating, toileting, and moving around your home. They also assess more complex tasks like managing medications, preparing meals, handling money, and using a telephone. Your cognitive status, behavioral health, and medical conditions are all part of the review.5Office of Program Policy Analysis and Government Accountability. Department of Elder Affairs – CARES Program
The assessment is free and usually happens wherever you’re currently living or receiving care.
How to Apply
The starting point depends on which waiver you need. Contacting the wrong agency wastes weeks.
For SMMC-LTC (Age 65+ or Adults With Disabilities)
Contact your local Aging and Disability Resource Center, or call the Elder Helpline at 1-800-963-5337. The ADRC handles the initial screening and connects you with the CARES unit for the medical assessment. Florida has 11 ADRCs, each covering a designated region.6Florida Agency for Health Care Administration. Statewide Medicaid Managed Care Long-Term Care Program – Screening7Elder Affairs Florida. Aging and Disability Resource Centers (ADRCs)
For the iBudget Waiver (Developmental Disabilities)
Contact the Agency for Persons with Disabilities directly. APD’s toll-free number is 1-866-273-2273, and the mailing address is 4030 Esplanade Way, Suite 380, Tallahassee, FL 32399.8Agency for Persons with Disabilities. iBudget Florida
Financial Eligibility Is Handled Separately
Whichever waiver you’re pursuing, the financial side runs through the Department of Children and Families, which processes most Medicaid financial applications in Florida. If you already receive SSI, Social Security may have established your Medicaid eligibility already. Before you start, gather documentation of every income source, bank statements, and proof of any assets. Incomplete financial applications are the single most common cause of avoidable delays.
After Approval
Once both determinations are complete and you’re found eligible, you go on the waitlist with a priority score. When your name comes up, you’ll pick a managed care plan through an enrollment broker, and the plan will assign a care manager to build your plan of care.
The Waitlist and Priority Scoring
HCBS waivers are not entitlements. Each has a capped number of slots, so being found eligible does not mean immediate enrollment. The Department of Elder Affairs releases people from the waitlist each month based on priority score and available slots, not first-come, first-served.9Florida Agency for Health Care Administration. SMMC LTC Program Waitlist Release
Your score is built from factors picked up during your CARES screening:
- Whether you have a primary caregiver, their health, and whether they can keep providing care.
- Your living arrangement, with living alone scoring higher than living with a caregiver.
- How your health has changed over the past year and how much it limits daily activities.
- How much help you need with daily activities and with complex tasks like managing medications and finances.
- Your access to transportation, prescriptions, and other support.
Scores translate into ranks 1 through 5, with Rank 5 (scores of 46 and above) covering the most fragile individuals. Higher-priority designations exist for young adults aging out of children’s services, people at imminent risk of nursing home placement, and Adult Protective Services referrals. You’re notified of your rank and can appeal it.
Crisis Enrollment for iBudget
The iBudget waiver has a separate crisis pathway that moves people ahead of the regular waitlist. Applicants are ranked in this order:
- Homelessness or unsafe living: no stable shelter, in a homeless facility, or temporarily staying somewhere unsafe due to abuse risk, lack of supervision, or overcrowding.
- Dangerous behavior: behavior that creates a life-threatening situation or risk of serious injury, where previous interventions have failed.
- Caregiver breakdown: the primary caregiver can no longer provide care due to death, terminal illness, permanent disability, or advanced age.
Within each category, applicants are further ranked by how intensive their service needs are. Someone who qualifies under more than one category is placed in whichever carries the higher priority.10Florida Guardian ad Litem Program. Crisis Enrollment Criteria for APD’s Developmental Disabilities Waiver (iBudget) 65G-1.047
One Thing to Know Before You Apply: Estate Recovery
After a Medicaid HCBS recipient dies, Florida’s Medicaid estate recovery program seeks reimbursement from the deceased person’s probate estate for the long-term care services Medicaid paid for. The state tracks every dollar spent on your care and can file a claim against assets that pass through probate.
Several protections limit what the state can recover. It cannot pursue recovery while a surviving spouse is alive, or if the recipient has a child under 21, or a child of any age who is blind or permanently disabled. Recovery is also limited to probate assets, so property that passes through beneficiary designations, certain trusts, or enhanced life estate deeds (Lady Bird deeds) may not be reachable. A caregiver child exemption can protect the home if an adult child lived with you for at least two years before you entered a nursing facility and provided care that delayed institutional placement. Hardship waivers exist but are narrow and must be formally requested.
Because the planning options that matter most work before Medicaid starts paying, families who own a home or other significant probate assets often talk to an elder law attorney before filing the application rather than after.