Florida Medicaid Program for Assisted Living
🏥 What It Covers
Under Florida’s Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program (an HCBS waiver), eligible seniors can receive:
Assistive Care Services in an Assisted Living Facility (ALF), including:
Help with Activities of Daily Living (bathing, dressing, eating)
Medication administration
Instrumental ADLs (like meal prep, housekeeping) ahca.myflorida.com+15ahca.myflorida.com+15reddit.com+15ahca.myflorida.com+5ahca.myflorida.com+5sunboundhomes.com+5medicaidlongtermcare.orgassistedliving.org
Other services such as adult day care, nursing care, therapies, transportation, and care coordination
What it does not cover: the cost of room and board at the ALF—that must be paid separately
Many facilities that accept Medicaid will accept about $1,300 to $1,500/month from Medicaid toward the personal care portion, and the resident or family often pays the remainder ahca.myflorida.com+11elderneedslaw.com+11reddit.com+11.
✅ Eligibility Requirements
Nursing‑Home Level of Care
You must be assessed by CARES (Comprehensive Assessment and Review for Long-term Care) and determined to require a nursing-home level of care—even if staying in an ALF medicaidlongtermcare.org+3nolo.com+3assistedliving.org+3.Financial Eligibility
Assets: ≤ $2,000 for single applicants. If married, different rules apply based on spouse’s assets en.wikipedia.org+7medicaidplanningassistance.org+7sunboundhomes.com+7.
Income: For the SMMC LTC waiver, the income limit is about $2,901/month (for 2025); approximately $2,250/month for ALF eligibility (300 % of the FBR) reddit.com+14medicaidplanningassistance.org+14medicaidlongtermcare.org+14.
Enrollment Availability
This waiver is not an entitlement—there’s a capped number of spots and often a waitlist reddit.com+8assistedliving.org+8medicaidlongtermcare.org+8.
📌 What to Do Next
Call CARES via Florida’s Elder Helpline or your local Area Agency on Aging to start the nursing‑home level‑of‑care assessment.
Apply for the SMMC LTC waiver and ask to be placed on the waiver waitlist for ALF services.
Find participating ALFs that accept Medicaid. Many have additional private-pay slots before transfer eligibility elderneedslaw.com+5reddit.com+5reddit.com+5reddit.com+4reddit.com+4ahca.myflorida.com+4.
Plan for the cost gap: Medicaid covers care services but not housing—expect to cover the difference via other income or family support.
🧭 Summary at a Glance
| Aspect | Covered by FL Medicaid waiver? |
|---|---|
| Personal care in ALF | ✅ Yes, up to ~$1,300–1,500/month |
| Room and board in ALF | ❌ No – you pay the remainder |
| Nursing‑home level of care requirement | ✅ Must be met via CARES assessment |
| Income & asset limits | ✅ Yes (≤ $2,000 assets; ~$2,250–2,900 income) |
| Enrollment waiting list | ⚠️ Yes, may have delays |
🗣️ Community Insight
From a Florida family’s experience on Reddit:
“We have her on the Medicaid waitlist, … We were overwhelmed to find out how few [ALFs] take Medicaid … The few that do have very long waitlists.” reddit.com+5sunboundhomes.com+5assistedliving.org+5medicaidlongtermcare.orgahca.myflorida.comnolo.comreddit.com+1assistedliving.org+1reddit.com
Another adds:
“Contact the Elder Helpline … It can take up to 18 months for someone to be approved.” reddit.com+1reddit.com+1
🛠️ What You Can Do Now
Start the CARES assessment ASAP to confirm level‑of‑care eligibility.
Apply and ask to be placed on the waiver waitlist.
Identify ALFs in your area that accept Medicaid participants.
Budget for the remaining cost—housing is separate.
Optionally, consider VA Aid & Attendance or private care to help cover expenses.
Does Medicare cover assisted living?
Medicare does not cover the cost of assisted living if you’re referring to:
Rent or room and board in an assisted living facility
Help with activities of daily living (ADLs) like bathing, dressing, or eating
General custodial care (non-medical personal care)
However, Medicare may cover specific medical services provided to someone living in an assisted living facility, such as:
Doctor visits
Outpatient care (e.g., physical therapy)
Certain home health care services (if medically necessary and ordered by a doctor)
Prescription drugs (under Medicare Part D)
Alternative Options
If you’re concerned about paying for assisted living, here are some common resources that might help:
Medicaid (depending on your state): May cover some assisted living costs.
Long-term care insurance
Veterans benefits (like Aid & Attendance)
Private pay or family support