Long Term Managed Care Medicaid In Florida

Long Term Managed Care Medicaid In Florida

What Is Medicaid Long Term Managed Care?

Florida Long-Term Medicaid is a public health insurance program that provides healthcare benefits to low-income individuals who need long-term care services. This program is funded by both state and federal government sources and is administered by the Florida Medicaid program.

Long-term care refers to a range of services that provide medical and non-medical support to individuals with chronic illnesses, disabilities, or other conditions that limit their ability to carry out daily activities. These services can include nursing home care, assisted living, home healthcare, and adult day care, medical supply, among others.

How To Use The Benefits Under Long Term Medicaid?

One of the most commonly used long-term care services is nursing home care. Nursing homes provide 24/7 supervision and medical care to individuals who require assistance with daily activities, such as bathing, dressing, and eating. Medicaid pays for the majority of nursing home care in Florida, and individuals approved for coverage will pay a small portion of the cost based on their income level.

Assisted living is another long-term care option available through Florida Medicaid. Assisted living offers similar services as nursing homes but in a community setting. Individuals live in their own apartments or rooms and receive assistance with daily activities as needed. Medicaid pays for a portion of the cost, and individuals pay the rest based on their budget and mutually agreed upon fee between the resident and the facility.

Home healthcare is another common long-term care service provided under Medicaid. Home healthcare services can include skilled nursing care, physical therapy, occupational therapy, and a caregiver to assist with personal care, respite, companion, and homemaking duties. Home healthcare allows individuals to receive medical care services in the comfort of their own homes, reducing the need for nursing home or assisted living care.

Adult day care is another long-term care option provided under Medicaid, providing daytime supervision and social activities to individuals who may benefit from structured activities and socialization. Adult day care centers can offer activities such as exercise classes, arts and crafts, music therapy, and educational programs.

Other services that are available and were not elaborated on in this article are; non-emergency transportation, medication management and administration, medical supply including adult diapers and chux, home-delivered meals, behavioral management, case management, personal emergency response systems, nutritional assessment and much more.

Am I Eligible For Long Term Medicaid In Florida?

To qualify for long-term Medicaid in Florida, individuals must meet certain financial and medical requirements along other requirements:

  • Financial Eligibility: As of 2022, the applicant’s monthly income cannot exceed $2,523 per month. For couples, when both parties are applying, the joint income limit is $5,046 / month. The applicant’s assets must also be below a certain threshold, which is $2,000 for an individual and $3000 for a couple. The financial eligibility is much more flexible when it’s a couple and only one person applies for Medicaid.
  • Medical Eligibility: The applicant must have a medical condition that impairs his/her ability to to preform in all ADLs and be in need of “nursing facility level of care”.
  • The applicant must be a Florida resident
  • The applicant much be a US citizen or have Green Card for at least 5 years.
  • Must be 65 years of age or older OR be 18-64 years of age AND have been designated disabled by the social security administration.

What Should I do If I Don’t Qualify For Long Term Medicaid?

If you don’t qualify for long term Medicaid due to financial reasons, you should consider consulting with an Elder Law attorney. They specialize in legal planning based on Medicaid guidelines.


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Disclaimer: this blog is for informational use only. 
It is not intended to serve as, or replace, legal, psychological 
and/or medical advice. 
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