Florida’s state-funded assisted living program is the Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) program, which uses Medicaid dollars to pay for care services delivered in a licensed assisted living facility. It does not pay for room and board, and you have to meet both a strict financial test and a medical test showing you need nursing-home level care. Enrollment is capped by funding, so qualifying does not guarantee an immediate slot.1Florida Agency for Health Care Administration. Statewide Medicaid Managed Care Long-Term Care Program
Who Qualifies
You must be 65 or older, or at least 18 with a qualifying disability that makes you eligible for Florida Medicaid. On top of that, a medical assessment has to conclude that you need a nursing facility level of care.2Online Sunshine. Florida Statutes 409.979 – Eligibility Meeting only the financial rules is not enough; meeting only the medical standard is not enough. Both are required before you can enroll.
Income and Asset Limits
Income
Your gross monthly income cannot exceed 300% of the federal SSI benefit rate. For 2026, the SSI benefit rate for an individual is $994, which sets the income cap at $2,982 a month.3Social Security Administration. SSI Federal Payment Amounts for 2026 Everything counts: Social Security, pensions, investment income. Being over the cap does not automatically end the conversation, though. A Qualified Income Trust can bring you under it.
Assets
A single applicant can have no more than $2,000 in countable assets. Several important things do not count: your primary home (as long as its equity stays below the Medicaid home equity limit), one vehicle, burial plots, irrevocable prepaid funeral plans, and personal belongings. If you are married and only one spouse needs care, the at-home spouse gets separate, more generous protections described below.
The Qualified Income Trust Workaround
Plenty of Florida seniors end up over the income cap because Social Security plus a pension pushes them past $2,982. A Qualified Income Trust, sometimes called a Miller Trust, routes the excess through an irrevocable trust so that income no longer counts toward eligibility. Each month, your income flows into the trust and is distributed under Medicaid rules: you keep a $160 personal needs allowance, Medicare premiums are paid, and the rest becomes your patient responsibility toward care costs.
Two things to know about the QIT. It must be set up before Medicaid approves your application, so if you think you might need SMMC-LTC, have an attorney draft it early rather than after a slot opens. And it comes with a mandatory payback: whatever remains in the trust after the beneficiary dies goes to AHCA to repay the Medicaid benefits received during their lifetime.4Florida Medicaid Trust and Annuity Recovery Program. Qualified Income Trust Recovery
The CARES Medical Assessment
Every applicant has to go through the Comprehensive Assessment and Review for Long-Term Care Services (CARES) evaluation. A registered nurse or trained assessor conducts it, usually in person at your home, at no cost.5Florida Agency for Health Care Administration. CARES Assessment of Long-Term Care Needs The evaluator looks at how you handle daily activities: bathing, dressing, eating, toileting, moving around. A physician or registered nurse then reviews the findings and decides whether you meet the nursing facility care standard. There is no way around this step.
How to Apply
Start With an ADRC Screening
The entry point is a screening by an Aging and Disability Resource Center (ADRC). Reach your local ADRC through the Department of Elder Affairs website or by calling the statewide Elder Helpline at 1-800-963-5337.6Florida Agency for Health Care Administration. Statewide Medicaid Managed Care Long-Term Care Program – Screening The phone screening runs roughly 45 minutes to an hour and produces a priority score based on your functional needs. That score decides whether you go on the waitlist and where. A low rank means you will not be placed on the list, but you can ask for rescreening once a year or whenever your condition changes significantly.
Expect a Waitlist
SMMC-LTC is not an entitlement. The Department of Elder Affairs only extends enrollment offers when funding supports new participants, and the frailest applicants move to the top. When two people have identical priority scores, whoever was placed on the list first goes first.2Online Sunshine. Florida Statutes 409.979 – Eligibility Wait times are unpredictable and depend on your score and open slots in your region. Use the waiting period to gather financial documents and, if useful, look into Optional State Supplementation for interim help.
Financial Application and Enrollment
When a slot opens, you are contacted and must submit a formal financial application to the Department of Children and Families. Delays in producing paperwork can cost you the slot, so have these documents ready:
- Bank statements for every account, including checking, savings, and CDs
- Proof of income such as Social Security award letters and pension statements
- Insurance policies, including life insurance with cash value
- Property records such as deeds and vehicle titles
- Your QIT documents, if you set one up
DCF reviews the paperwork against the income and asset limits. If you have not already done the CARES assessment, the Department of Elder Affairs coordinates it during this stage. Once both approvals are in, you are enrolled in a managed care plan and services begin.
What the Program Covers
Each managed care plan contracted with AHCA has to include assisted living facility services along with other long-term care supports.7Elder Affairs Florida. Statewide Medicaid Managed Care Long-Term Care Program Covered services generally include:
- Personal care assistance with bathing, dressing, mobility, and toileting
- Medication management
- Case management to coordinate your overall care plan
- Physical, occupational, and speech therapy
- Medical transportation
- Adult day health care
The exact list can vary by plan, so compare options at enrollment. Your plan assigns a care coordinator who builds an individualized plan around the needs identified in your CARES assessment.
What You Still Pay
The program pays for care services, not housing. You remain responsible for room and board at the facility, and most of your monthly income goes toward that. From your total income, you keep the $160 personal needs allowance and pay your Medicare premiums. What remains is your patient responsibility, and it goes to the assisted living facility. The managed care plan pays separately for your covered care services.
If your income is low, the patient responsibility may not fully cover a facility’s room and board rate. That gap can make it harder to find a facility willing to accept you, so ask about it while comparing options.
Protections if You Are Married
Federal spousal impoverishment rules protect the spouse who stays at home (the “community spouse”) when only one spouse needs care. In 2026, the community spouse can keep up to $162,660 in countable assets under the Community Spouse Resource Allowance. The primary home, one vehicle, and retirement accounts held in the community spouse’s name are not counted toward that limit.
The community spouse is also entitled to a Minimum Monthly Maintenance Needs Allowance of $2,644 per month in 2026. If the community spouse’s own income falls below that figure, part of the applicant spouse’s income can be redirected to close the gap, reducing the patient responsibility paid to the facility. These rules exist so paying for one spouse’s care does not leave the other unable to cover basic living costs.
Optional State Supplementation as a Fallback
Florida runs a separate, smaller program called Optional State Supplementation (OSS) for people who receive SSI or are determined eligible by DCF. OSS provides a modest monthly payment toward the cost of living in an assisted living facility, adult family-care home, or other specialized living arrangement.8Online Sunshine. Florida Statutes 409.212 – Optional Supplementation Family members can voluntarily add funds directly to the facility, up to four times the OSS provider rate, without those contributions counting as income for OSS eligibility.
OSS is worth checking if you qualify for SSI but do not meet the nursing-home level of care required for SMMC-LTC, or if you need help now while sitting on the SMMC-LTC waitlist.
Facility License Types Matter
Not every assisted living facility in Florida can take a resident with complex medical needs. Facilities operate under different license categories that determine what they can legally provide:9Online Sunshine. Florida Statutes Chapter 429 – Assisted Living Facilities
- Standard license, covering routine personal care and help with daily activities
- Extended Congregate Care (ECC), allowing more intensive services so residents can age in place
- Limited Nursing Services (LNS), permitting nursing tasks such as wound care and managing braces or splints for residents who do not need around-the-clock nursing
- Limited Mental Health, required for any facility serving residents with mental health conditions
Confirm the facility’s license type matches your needs. A standard-license facility cannot provide the nursing support that a medically complex resident may require, and your managed care plan may not cover placement there if the facility cannot deliver the services in your care plan.
If a Service Is Denied
If your managed care plan denies, reduces, or stops a service, you can challenge the decision, but the order matters. Start with the plan’s internal appeal. The denial letter, called a Notice of Adverse Benefit Determination, explains how to file.10Florida Agency for Health Care Administration. Medicaid Fair Hearings
If the plan rules against you, then request a Medicaid Fair Hearing through AHCA. You can request one by calling the Medicaid Helpline at 1-877-254-1055, emailing MedicaidHearingUnit@ahca.myflorida.com, or mailing a written request to the Medicaid Hearing Unit in Tallahassee. Skipping the plan-level appeal will usually cause the Fair Hearing request to be rejected.