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Paying for Long-Term Care With Florida Medicaid

Florida has a robust Medicaid system that allows for many extended healthcare solutions, including assisted living and nursing home care. Known as Long-Term Care Managed Care, this provision of Medicaid offers qualified subscribers access to assisted living facilities and nursing homes as well as around-the-clock nursing care. To qualify for an LTCMC plan, a person must meet two qualifications: both a need for long-term home care and financial eligibility.

When individuals apply for care under LTCMC, they must be able to demonstrate that their condition is serious enough to justify this type of care. This is done through Comprehensive Assessment and Review for Long-Term Care Services, a program in Florida that screens applicants and determines if they are eligible. During this process, a representative from CARES visits the person applying for long-term care and asks him or her questions about functioning ability, health, assistance they need and more.

Once CARES representatives determine people are eligible for long-term care, they must then show that the specific care for which they are applying is medically necessary. In other words, a person might qualify for long-term care under LTCMC, but they might not qualify for around-the-clock nursing care, but instead only an assisted living facility. This is determined by considering the person’s health and well-being as well as the primary function of the type of care he or she is seeking.

Once a person is deemed eligible for the particular care he or she is seeking, the person must then demonstrate that he or she meets the financial qualifications. If a person is receiving SSI, he or she is eligible. In the absence of this, the person must show that his or her monthly individual income is no more than $2,163 or $4,326 for a couple (who are both trying to qualify).

If individuals can demonstrate that they have a medical need for long-term care and are financially qualified, Medicaid will cover the cost of long-term care, such as an assisted living facility or at-home nursing care. Meet with a knowledgeable elder law attorney at the Charles Law Offices in Florida. 

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