Florida caregiver benefits guide
Last checked: May 18, 2026
Florida Medicaid home and community-based services, often called HCBS, may help a person get long-term care at home, in assisted living, or in another community setting instead of a nursing home.
For many older adults and adults with disabilities, the main route is Florida’s Statewide Medicaid Managed Care Long-Term Care program. Most families should start with their local Aging and Disability Resource Center, also called an ADRC, and ask for a long-term care screening.
Quick answer
Florida has Medicaid HCBS waiver routes that may cover home care, respite, adult day care, transportation to long-term care services, home changes, caregiver training, and other supports. The main route for older adults and many adults with disabilities is the Statewide Medicaid Managed Care Long-Term Care program, often called SMMC LTC.
Space for in-home and community services can be limited. Florida uses screening scores, priority ranks, and medical and financial eligibility checks before someone is enrolled. Do not wait for a crisis if your loved one is unsafe at home.
Start here
- Call the Elder Helpline at 1-800-963-5337. Ask for your local ADRC and request a screening for Florida Medicaid Long-Term Care home and community services.
- Ask for the exact next step. Say, “Do we need a long-term care screening, a Medicaid application through DCF, a CARES assessment, or all three?”
- Start a document folder today. Gather medical proof, income papers, bank records, insurance cards, legal papers, and notes about daily care needs.
Florida rules can change
Florida Medicaid rules, plan names, waiver names, and contractor names can change. Counties, managed care plans, waiver staff, and state agencies may use different words for the same step. Always confirm the current rule with Florida AHCA, Florida DOEA, DCF, APD, your local ADRC, or the Medicaid plan before you act.
Main programs and where to start
| Program or route | Who it may help | Where to start |
|---|---|---|
| Statewide Medicaid Managed Care Long-Term Care | Adults age 18 or older who need long-term services and meet the required level of care and Medicaid rules. | Call the Elder Helpline at 1-800-963-5337 or your local ADRC and ask for LTC screening. |
| iBudget Florida Waiver | People with developmental disabilities who may qualify through the Agency for Persons with Disabilities. | Apply through APD online or through the APD office for your area. |
| ICMC Program | Some people with intellectual and developmental disabilities, including people in certain iBudget pre-enrollment groups. | Ask APD or Florida Medicaid Managed Care if ICMC applies to the person. |
| Model Waiver | Children age 20 or younger who are medically complex, medically fragile, or have degenerative spinocerebellar disease. | Ask Florida AHCA and the child’s medical provider how referral works now. |
| Familial Dysautonomia Waiver | People with Familial Dysautonomia living in their own home or family home. | Ask Florida AHCA about the current waiver process. |
| PACE | People age 55 or older who live in a PACE service area and meet care rules. PACE is not the same as the LTC waiver. | Ask AHCA or your local ADRC if PACE serves your ZIP code. |
| DCF Medicaid financial eligibility | People who need Medicaid coverage or a Medicaid financial decision for long-term care. | Use MyACCESS, call DCF, or ask for help from a DCF Family Resource Center or partner. |
What an HCBS waiver is
HCBS means home and community-based services.
In plain English, it means Medicaid may pay for certain care outside an institution. That can mean care at home, adult day health care, assisted living services, or other community supports, depending on the waiver and the person’s care plan.
A waiver is not the same as regular Medicaid. A waiver has its own target group, service list, enrollment rules, and often a waitlist. A person can have Medicaid and still need extra steps before waiver services start.
For a plain-English national overview, see Medicaid HCBS Waivers Explained.
Main waivers in Florida
Statewide Medicaid Managed Care Long-Term Care
This is the main Florida Medicaid long-term care route for many older adults and adults with disabilities who need help at home or in another long-term care setting.
Florida AHCA says the LTC program is a multi-agency effort. AHCA runs the Medicaid program and enrolls eligible people in LTC plans. DCF decides financial Medicaid eligibility. DOEA decides medical eligibility and the level of care needed.
Florida DOEA says people may qualify for SMMC LTC if they are age 65 or older and Medicaid eligible, or age 18 or older and Medicaid eligible because of disability, and meet required level-of-care rules.
iBudget Florida Waiver
The iBudget Florida Waiver is for people with developmental disabilities. It is run day to day by the Agency for Persons with Disabilities, often called APD.
APD says iBudget can include medically needed social, medical, behavioral, therapy, and residential services. A person may live in their own home, family home, or a licensed community residential setting.
This is not the same route as the elder long-term care waitlist. Families should apply through APD and ask about waiver status, pre-enrollment, and any current managed care option that may apply.
ICMC Program for intellectual and developmental disabilities
Florida also lists the ICMC Program as a Medicaid program for people with intellectual and developmental disabilities. It may cover regular health care plus home and community services and other benefits.
If your loved one is waiting for iBudget or has APD eligibility, ask APD or Florida Medicaid Managed Care whether ICMC applies. Do not assume this program is open to every person with a disability.
Model Waiver
The Model Waiver is for children age 20 or younger who are medically complex, medically fragile, or diagnosed with degenerative spinocerebellar disease. AHCA says the purpose is to help delay or prevent institutional care and help the child live at home or in the community.
This waiver is narrow. Ask AHCA and the child’s doctor what referral steps are current before you count on this route.
Familial Dysautonomia Waiver
The Familial Dysautonomia Waiver is for eligible people with Familial Dysautonomia who live in their own home or a family home.
This is a very specific waiver. If this diagnosis applies, start with AHCA and ask for the current waiver contact, forms, and service list.
PACE as a related long-term care route
PACE stands for Program of All-Inclusive Care for the Elderly. It is not the same thing as the SMMC LTC waiver, but it can be a major long-term care path for some Florida families.
PACE may serve people age 55 or older who live in a PACE service area, meet the required care level, and can be safely served in the community at the time of enrollment. Ask your ADRC or AHCA if PACE serves your area.
Services that may help caregivers
Services are not automatic. They must fit the program rules, the person’s assessed needs, and the care plan.
Florida’s LTC service list includes many supports that can matter to family caregivers, such as:
- personal care
- adult day health care
- adult companion care
- caregiver training
- case management or care coordination
- home accessibility changes
- home delivered meals
- homemaker help
- medical equipment and supplies
- personal emergency response systems
- respite care
- transportation to long-term care services
- nursing, therapy, and other health-related services when approved
For more help thinking through care needs, see Respite Care for Caregivers, Care Cost Calculator, and Caregiver Checklists.
Can family caregivers be paid through a waiver?
Sometimes, but it is not automatic.
Florida’s SMMC LTC program has a Participant Direction Option, often called PDO. This option may let an enrolled person direct certain approved services and hire a direct service worker. AHCA’s PDO materials list services such as adult companion care, attendant care, homemaker services, intermittent and skilled nursing, and personal care as services that may be self-directed when they are on the care plan.
This does not mean every family caregiver can be paid. The person must first qualify for the program. The service must be approved. The plan must allow the arrangement. The worker may need background screening, paperwork, training, timesheets, and approval through the plan or fiscal employer agent.
For APD’s iBudget Waiver, APD lists Consumer Directed Care Plus, often called CDC+, as an option within iBudget. CDC+ can give the person more control over choosing and managing supports. Ask APD who can be hired, what checks are needed, and whether the family member you have in mind is allowed.
If your main question is pay, start with Can I Get Paid to Be a Caregiver? and the paid caregiver quiz. If the person is a veteran or surviving spouse, also check VA Aid and Attendance.
Do not rely on a pay rate you see online. Florida pay rules can depend on the plan, service, approved hours, worker role, and current contract rules. Ask for the rate and worker rules in writing before you plan your household budget.
Waitlists and priority
For SMMC LTC home and community services, Florida says space is limited.
The first step is screening by an ADRC. The screening is usually done by phone with the person or caregiver. AHCA says the screening creates a priority score and rank for waitlist placement.
Florida says release from the SMMC LTC waitlist is not based only on how long a person has been waiting. DOEA works with ADRCs and releases people based on score, frailty-based levels, and available enrollment.
AHCA lists low priority ranks and high priority ranks. High priority ranks include higher score groups and special categories such as imminent risk and Adult Protective Services high risk referrals.
If your loved one’s condition gets worse, ask the ADRC for a rescreening. AHCA lists examples of a significant change, such as a change in health after an illness or accident, a change in living situation, a change in caregiver relationship, home damage or decline, or loss of a spouse or caregiver.
How to apply
What to say when you call
“I care for a Florida resident who needs help with bathing, dressing, meals, supervision, and staying safe at home. I want to ask for a screening for Medicaid Long-Term Care home and community-based services. Can you connect me with the ADRC screening staff?”
If the person may have a developmental disability, say:
“I need to apply with APD for services, including possible iBudget waiver services. Can you tell me the correct APD office and application method for this county?”
Step 1: Call the ADRC for LTC screening
For older adults and many adults with disabilities, call the Elder Helpline at 1-800-963-5337 and ask for your local ADRC. The ADRC can screen for SMMC LTC and explain whether your loved one may be placed on the waitlist.
Step 2: Apply for Medicaid financial eligibility if told to do so
DCF decides Medicaid financial eligibility for many aged or disabled people who are not getting SSI. Florida uses MyACCESS for public benefits. You can also ask DCF or a community partner for help if online filing is hard.
If the person has too much income or assets, do not guess. Long-term care Medicaid rules can be strict. See Medicaid Spend Down and Medicaid Look-Back Period, then ask DCF or a qualified Florida elder law attorney about the person’s facts.
Step 3: Complete the medical eligibility process
After release from the waitlist, the ADRC may send a medical certification form. The person’s Florida-licensed physician, physician assistant, or advanced practice registered nurse may need to complete it. CARES staff then decide the required level of care.
Step 4: Watch for the welcome packet
If the person meets medical and financial eligibility, AHCA sends a welcome packet with plan choice information. Choice counselors can help by phone at 1-877-711-3662. If the person is already in an LTC plan, ask the plan care manager for the care plan, service list, and any PDO option.
Documents to gather
- Photo ID, Social Security number, Medicaid card, Medicare card, and insurance cards
- Proof of Florida address
- Income proof, such as Social Security, pension, wages, annuity, or VA income letters
- Bank statements, retirement accounts, life insurance, burial funds, deeds, vehicle titles, and trust papers if any
- Names and phone numbers for doctors, hospitals, home health agencies, and pharmacies
- Medication list, diagnoses, recent hospital or rehab papers, and care notes
- A list of daily help needed, such as bathing, dressing, toileting, eating, transfers, walking, memory supervision, wound care, or night care
- Power of attorney, guardianship papers, health care surrogate papers, or authorized representative forms if you have them
- Any denial, approval, plan notice, waitlist letter, or screening result
Keep copies. Write the date, time, phone number, and name of each person you speak with.
Common problems that slow families down
- Calling DCF only, when the person also needs ADRC screening for SMMC LTC.
- Missing mail or online notices from DCF, AHCA, the ADRC, APD, or a plan.
- Not reporting a major decline after a fall, hospital stay, caregiver loss, or unsafe living change.
- Assuming Medicaid will pay a family member before the person is enrolled and the service is approved.
- Using old program names from a blog or past letter without checking the current Florida agency page.
FAQ
Is Florida SMMC LTC the same as regular Medicaid?
No. Florida AHCA says SMMC LTC is not the same as regular Medicaid. It is for long-term services and supports. It has screening, waitlist, medical eligibility, financial eligibility, and plan enrollment steps.
Who should I call first?
For an older adult or adult with a disability who needs long-term care at home, start with the Elder Helpline at 1-800-963-5337 and ask for your local ADRC. For developmental disability services, contact APD.
Can I apply online?
You can use MyACCESS for Medicaid financial eligibility. SMMC LTC still starts with ADRC screening for the long-term care route. APD has its own application process for APD services and iBudget-related services.
Does the waitlist work by date only?
No. Florida says release from the SMMC LTC waitlist is based on score, frailty-based level, and available enrollment, not only how long the person has waited.
Can a spouse or adult child be paid?
It may be possible in some self-directed situations, but it is not guaranteed. Ask the LTC plan about PDO or ask APD about CDC+. Confirm whether the specific family member can be hired and what paperwork is required.
What if my loved one is a veteran?
Check VA benefits too. VA Aid and Attendance may add money to a VA pension for certain veterans and survivors who need help with daily activities. The VA caregiver program is separate and has its own rules.
Resumen en español
Si cuida a una persona en Florida que necesita ayuda en casa, llame primero al Elder Helpline: 1-800-963-5337. Pida una evaluación para servicios de Medicaid Long-Term Care en el hogar y pregunte por el ADRC local.
También puede necesitar una solicitud de Medicaid con DCF y una evaluación médica por CARES. Si la persona tiene una discapacidad del desarrollo, pregunte a APD sobre iBudget y otros programas actuales.
About this guide
This guide is written for Florida family caregivers who need a first path, not policy language. It uses official state and federal sources where possible. Program rules can change, so use the official links below before you file, appeal, or make money plans.
Official sources used
- Florida AHCA: Statewide Medicaid Managed Care Long-Term Care Program
- Florida AHCA: SMMC Long-Term Care Recipient FAQs
- Florida AHCA: SMMC LTC Screening
- Florida AHCA: SMMC LTC Waitlist Release
- Florida AHCA: Become Eligible for Medicaid
- Florida AHCA: Fair Hearing About Screening Results or Eligibility
- Florida State Medicaid Managed Care: Medicaid Fair Hearing
- Florida DOEA: Aging and Disability Resource Centers
- Florida DOEA: SMMC Long-Term Care Program
- Florida AHCA: CARES Assessment of Long-Term Care Needs
- Florida DOEA: CARES Notices and Forms
- Florida DCF: Public Benefits and Services
- Florida DCF: Economic Self Sufficiency Forms
- Florida APD: Apply for Services
- Florida APD: iBudget Florida Waiver
- Florida APD: Consumer Directed Care Plus
- Florida AHCA: ICMC Program
- Florida AHCA: Model Waiver
- Florida AHCA: Familial Dysautonomia Waiver
- Florida AHCA: Program of All-Inclusive Care for the Elderly
- Medicaid.gov: Home & Community-Based Services 1915(c)
- VA.gov: Aid and Attendance and Housebound Benefits
Disclaimer
This is general information, not legal, tax, medical, or financial advice. For legal or tax questions, talk with a qualified professional in your state. Confirm current rules with official Florida agencies or the person’s Medicaid plan.
