Florida Medicaid Nursing Home Coverage
Florida Medicaid (LTC / Nursing Facility) pays for nursing home care for income-eligible Florida seniors. This guide covers eligibility rules, income and asset limits, the application process, required documents, and important rules families need to understand before applying.
Eligibility at a Glance
Income Limit
$2,742/mo
300% of SSI · Individual
Asset Limit
$2,000
Countable assets · Individual
Look-Back Period
5 Years
Asset transfer review
Spousal Assets Protected
$154,140
Community Spouse Resource Allowance
Spousal Income Protected
$3,853/mo
Min. Monthly Maintenance Allowance
Avg. Nursing Home Cost
$9,200/mo
Medicaid rate: ~$230/day
Florida Nursing Home Medicaid Income Limit
300% of the SSI Federal Benefit Rate ($2,742/month for individuals in 2026). Florida uses a medically needy income standard for some applicants — those above the limit may 'spend down' through medical bills to become eligible.
Florida has a Medically Needy spend-down pathway — seniors above the income limit may still qualify by spending down excess income on medical expenses. Consult a Florida elder law attorney to determine if this applies to your situation.
Florida Nursing Home Medicaid Asset Limit
Countable assets limit is $2,000 for an individual. Exempt assets include: one primary residence (if intent to return or spouse/dependent lives there), one vehicle, prepaid burial plans, and term life insurance with no cash value. Florida also exempts an irrevocable pre-need funeral contract.
Florida 5-Year Look-Back Rule
Florida Medicaid reviews all asset transfers made within 5 years (60 months) of the application date. Transfers for less than fair market value during this period may result in a penalty period during which Medicaid will not pay for nursing home care. Consult a Florida elder law attorney before transferring any assets.
Important Florida Nursing Home Medicaid Rules
Medically Needy Spend-Down
Florida has a Medically Needy pathway for seniors whose income exceeds 300% of SSI but who have high medical expenses. Under spend-down, a resident can deduct medical expenses (including nursing home bills) from their income to reach the Medicaid income standard. This is more common in assisted living contexts; nursing home Medicaid typically uses the standard income limit.
CARES Assessment Required
Before Florida Medicaid will approve nursing home coverage, a CARES (Comprehensive Assessment and Review for Long-Term Care Services) assessment must be completed by a registered nurse. This evaluates the applicant's medical needs to confirm nursing home level of care is required. The CARES assessment is conducted at no cost to the applicant.
Patient Responsibility / Co-Pay
Florida Medicaid nursing home residents keep $130/month as a Personal Needs Allowance. All other income (Social Security, pension, etc.) must be paid to the nursing home as Patient Responsibility. Medicaid pays the remainder of the facility's approved daily rate.
Estate Recovery
Florida participates in Medicaid Estate Recovery. After the death of a Medicaid nursing home recipient (age 55+), the Florida Agency for Health Care Administration (AHCA) may file claims against the estate for the cost of care. A surviving spouse, minor child, or disabled child can delay recovery. An elder law attorney can help explore homestead protections and other strategies.
How to Apply for Florida Nursing Home Medicaid
Florida Agency for Health Care Administration (AHCA) + DCF
Phone: 866-762-2237 · Website: myflorida.com/accessflorida
- 1Apply through ACCESS Florida at myflorida.com/accessflorida or call 866-762-2237
- 2A CARES assessment (Comprehensive Assessment and Review for Long-Term Care Services) is conducted to establish medical necessity for nursing home level of care
- 3Submit documentation of income, assets (5-year look-back), and identification
- 4Florida DCF reviews financial eligibility; AHCA oversees clinical/medical eligibility
- 5Processing time is typically 45–90 days. Many nursing homes accept 'Medicaid pending' admissions.
- 6If approved, coverage backdates to the application date or admission date (whichever is later)
Documents Required for Florida Nursing Home Medicaid
Gather these documents before starting your application. Missing documents are the #1 cause of application delays.
- Social Security card and Medicare card
- Birth certificate or proof of age
- Proof of Florida residency (utility bill, lease, etc.)
- Social Security award letter and all other income documentation
- Bank statements for 5 years (all accounts)
- Property records for all real estate
- Life insurance policies
- Certificates of deposit and investment account statements
- Marriage certificate (if applicable)
- Divorce decree (if applicable)
* Gather 5 full years (60 months) of bank statements for ALL accounts. This is the single most common documentation gap in Medicaid nursing home applications.
Florida Nursing Home Medicaid by the Numbers
697
Licensed Nursing Homes
80,000
Medicaid Beds
65%
Medicaid Bed %
$9,200
Avg Monthly Cost
Sources: CMS, Florida Agency for Health Care Administration (AHCA) + DCF, 2026 data.
Is There a Waitlist for Florida Nursing Home Medicaid?
Florida does not maintain a statewide waitlist for nursing facility Medicaid. However, many facilities have limited Medicaid beds and maintain informal waitlists. The SMMC Long-Term Care program (for assisted living) does have waitlists.
Find Medicaid-Accepting Nursing Homes in Florida
Our care advisors can identify nursing homes in Florida with open Medicaid beds and help you start the application process — no phone call required.
Florida Nursing Home Medicaid FAQs
Does Florida Medicaid cover nursing home care?▾
Yes — Florida Medicaid covers skilled nursing facility care for eligible seniors. The income limit is $2,742/month (300% of SSI) and the asset limit is $2,000. Florida also has a Medically Needy pathway for those above the income limit with high medical expenses. Apply through ACCESS Florida at 866-762-2237.
What is the average cost of nursing home care in Florida?▾
The average cost of nursing home care in Florida is approximately $9,200/month ($307/day) for a semi-private room in 2026 — notably above the national average. Florida costs are highest in Miami-Dade and Broward counties ($10,000–$14,000/month) and lowest in rural North Florida ($7,500–$8,500/month).
How do I apply for Florida Medicaid nursing home coverage?▾
Apply at ACCESS Florida (myflorida.com/accessflorida), call 866-762-2237, or visit your local Florida Department of Children and Families (DCF) office. A CARES assessment (clinical eligibility) is conducted separately. Provide 5 years of bank statements, all income documentation, and identification. Processing takes 45–90 days.
Can a nursing home in Florida accept a resident while Medicaid is pending?▾
Yes — most Florida nursing homes accept residents as 'Medicaid pending' during the application review period. Confirm this policy with each facility, as Medicaid-pending capacity varies. If approved, Medicaid coverage backdates to the application date.
Does Florida have Medicaid estate recovery for nursing home care?▾
Yes. After the death of a Medicaid recipient aged 55+, Florida AHCA may file claims against the probate estate for the cost of nursing home care paid by Medicaid. A surviving spouse's presence in the home typically delays recovery until the spouse's death. Consult a Florida elder law attorney for specific planning strategies.
Does Florida protect the community spouse's income and assets?▾
Yes — Florida follows federal Spousal Impoverishment Protection rules. The Community Spouse Resource Allowance (CSRA) protects up to $154,140 in assets (2026) for the spouse remaining at home. The Monthly Maintenance Needs Allowance (MMMNA) ensures the community spouse retains at least $3,853/month in income.
Related Florida Medicaid Guides
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