Fort Myers Senior AdvisorWhat does Florida Medicaid's long-term care program pay for?
The Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program pays a managed care plan to cover nursing home care and home and community-based services such as personal care, adult day care, respite, home-delivered meals and assisted living services for people who qualify medically and financially.
In assisted living, Medicaid pays for services, not room and board; the resident still pays the facility for rent and meals, usually from Social Security, with Optional State Supplementation helping some. AHCA profiles show 38 Lee County ALFs reporting Medicaid services (11 listing the assisted living waiver and 31 assistive care services).
What are Florida's 2026 Medicaid income and asset limits for long-term care?
For April 2026 the Department of Children and Families uses an income limit of $2,982 a month and an asset limit of $2,000 for a single applicant for institutional and home and community-based care, with protections for a spouse who stays at home.
| DCF figure (April 2026) | Amount |
|---|---|
| Monthly income limit, one applicant | $2,982 |
| Countable asset limit, one applicant | $2,000 |
| Nursing home personal needs allowance | $160 |
| Community spouse resource allowance (CSRA) | $162,660 |
| Minimum monthly maintenance needs allowance | $2,644 |
| Maximum community spouse income allowance | $4,067 |
| Home equity limit | $752,000 |
| Transfer penalty divisor | $10,645 |
Source: Florida DCF transmittal I-26-02-0003 (Feb. 24, 2026), Appendix A-7, SSI-Related Medicaid Financial Eligibility Standards, April 2026.
What if a Lee County applicant's income is over $2,982 a month?
Florida is an income-cap state, so an applicant over the limit can still qualify by setting up a Qualified Income Trust (often called a Miller trust) and depositing the excess income into it each month; the trust money then goes toward the cost of care.
The trust must be set up correctly and funded every month, which is why many Fort Myers families use an elder law attorney for this step. A mistake can cost a month of eligibility.
Is there a waitlist for Florida Medicaid home and community-based care?
Yes: people who are not already in a nursing home and want long-term care services at home or in assisted living are screened by their Aging and Disability Resource Center and placed on a statewide waitlist ranked by priority, while nursing home residents who qualify are enrolled without waiting.
In Lee County the screening is done by the Area Agency on Aging for Southwest Florida's Elder Helpline at 1-866-413-5337. Rescreening when a situation changes can raise a person's priority, so call back after a fall, hospitalization or caregiver crisis.
How do Lee County families choose a Medicaid long-term care plan?
Once a person is enrolled, Florida's choice counseling line at 1-877-711-3662 explains which long-term care plans serve Lee County, and the family should check that the plan contracts with the ALF, home care agency or nursing home they want before choosing.
A plan's provider network matters more than its brochure. Ask the facility which plans it accepts for residents already living there, then confirm with the plan's case manager.
The short version
| Florida Medicaid LTC pays for | Florida Medicaid LTC does not pay for | |
|---|---|---|
| Assisted living | Personal care and services in contracted ALFs | Rent and meals |
| Nursing homes | Long-term stays for eligible residents | A private room upgrade |
| Access | Immediate for nursing home residents | Immediate home and community services for everyone |
Built from Chapters 400, 408, 429 and 651 of the Florida Statutes, Fla. Admin. Code chapters 59A-4, 59A-36 and 65A-2, and AHCA, DCF, OIR, Elder Affairs, CMS, VA and CareScout publications cited on the page; see our editorial standards.
