Florida caregiver benefits
Last checked: May 18, 2026
Florida Medicaid may help pay for some care at home or in the community. The main long-term home care path for many adults is the Statewide Medicaid Managed Care Long-Term Care program, often called SMMC LTC.
Start with Florida’s Aging and Disability Resource Center system. Ask for Long-Term Care screening. Also check whether the person already has Medicaid services through a health plan that may cover home health, transportation, or other medically needed help.
Quick answer
Yes, Florida Medicaid can cover some home and community care when the person meets the program rules. The main route for adult long-term care at home is SMMC LTC. It can include personal care, homemaker help, respite, adult day health care, home-delivered meals, transportation to LTC services, and a personal emergency response system when approved in the care plan.
SMMC LTC is different from regular Medicaid. Regular Medicaid is a state plan benefit. SMMC LTC home and community services are limited and may involve screening, a waitlist, a medical review, Medicaid financial eligibility, and enrollment in a Long-Term Care plan.
Main Florida programs and routes
| Program or route | Who it may help | Where to start | What to ask for |
|---|---|---|---|
| Statewide Medicaid Managed Care Long-Term Care, or SMMC LTC | Adults age 18 or older who need long-term services and supports and may need a nursing-home level of care | Call the Elder Helpline at 1-800-963-5337 and ask for the ADRC | Ask for Long-Term Care screening and where the person stands on the waitlist |
| Medicaid health plan services, often through Managed Medical Assistance | People who already have Florida Medicaid and need medically needed home health, personal care, supplies, or rides to covered care | Call the Medicaid health plan or Florida Medicaid Helpline | Ask about home health, personal care rules, non-emergency medical transportation, and prior approval |
| PACE, the Program of All-Inclusive Care for the Elderly | People age 55 or older who live in a PACE service area, meet care-level rules, and can live safely in the community | Ask AHCA, the local ADRC, or a PACE site whether the address is in a service area | Ask if PACE is open in the county and how it works with Medicare and Medicaid |
| Non-Medicaid aging network help while waiting | Older adults and caregivers who need meals, respite, rides, caregiver help, or local referrals now | Call the local ADRC through the Elder Helpline | Ask what services may be open while Medicaid Long-Term Care is pending |
Florida warning
Rules can change. Counties, managed care plans, waiver contractors, and local agencies may use different names for the same step. Always confirm current rules with Florida AHCA, DCF, DOEA, the local ADRC, or the person’s Medicaid plan.
What Medicaid home care may cover in Florida
Medicaid home care means help that may let a person stay at home, in a family home, or in another community setting instead of moving into a nursing facility. In Florida, coverage depends on the route.
The SMMC LTC program lists many home and community services. The person does not get every service on the list. Services must be approved based on need and the care plan.
Personal care
This can mean hands-on help with bathing, dressing, eating, and personal hygiene. For a caregiver, this is often the most urgent need.
Homemaker and companion help
This may include light housekeeping, laundry, meal tasks, and other routine help that supports safe daily living.
Adult day health care
This can provide supervision, social activity, and care during the day at an adult day center. Meals may be included if the person is there at mealtime.
Respite care
Respite gives the caregiver a short break. Florida says it may be provided in the home, an assisted living facility, or a nursing facility when approved.
Meals and nutrition help
SMMC LTC may include home-delivered meals and nutrition support when this is part of the person’s care needs.
Transportation
SMMC LTC may cover rides to LTC services. Florida Medicaid may also cover non-emergency medical transportation when the person has no other way to get to a Medicaid-covered service.
Emergency response button
A personal emergency response system, sometimes called PERS, is a device that lets the person call for help in an emergency.
Home changes and supplies
SMMC LTC may cover some home access changes, medical equipment, and supplies. It does not mean Medicaid will fix every home repair.
State plan services vs waiver services vs managed care
State plan Medicaid means regular Medicaid-covered services. These may include doctor care, hospital care, home health visits, supplies, and rides to covered care when rules are met.
Waiver or home and community services means long-term supports that help a person live outside a nursing facility. In Florida, the main adult route is SMMC LTC.
Managed care means services are delivered through a health plan. Most Florida Medicaid members receive services through the Statewide Medicaid Managed Care system. The plan can matter because each plan has its own provider network, care managers, and approval process.
If the person already has a Medicaid card, do not wait to ask about current plan benefits. Call the plan and ask about home health, personal care, transportation, supplies, and care management. At the same time, call the ADRC if the person needs long-term care at home.
Programs to check first
1. SMMC Long-Term Care
SMMC LTC is the first program to check when an adult needs steady help at home with daily care. Florida says the program serves eligible people age 18 and older who need long-term services and support.
The first step is a phone screening through the ADRC. The screening gives a priority score and rank. That score affects waitlist placement. If the person is later released from the waitlist, CARES reviews medical need and DCF reviews financial Medicaid eligibility.
2. Existing Medicaid health plan services
If the person already has Medicaid, call the plan listed on the Medicaid card. Ask for a care manager. Ask whether the person can get home health visits, supplies, non-emergency transportation, or other services while waiting for SMMC LTC.
Florida’s home health page says home health visits can include skilled nursing and home health aide services when medically needed and within the coverage rules. Some services may need a doctor’s order and prior approval.
3. PACE
PACE may be an option for some people age 55 or older. It is not open everywhere. It is for people who live in a PACE service area, meet care-level rules, and can be served safely in the community.
PACE can be important when the person has both Medicare and Medicaid needs and would benefit from care tied to an adult day center model. Ask the ADRC or AHCA whether there is a PACE site for the person’s ZIP code.
4. Other local elder services while Medicaid is pending
The ADRC can also tell you about local meals, respite, transportation, caregiver programs, and aging services. These may not be Medicaid. Funding may be limited. Still, it is worth asking while the Medicaid process is moving.
For respite basics, see respite care for caregivers. To plan costs while waiting, use the care cost calculator.
Who may qualify
Florida Medicaid home care rules depend on the program. For SMMC LTC, the person may need to meet all of these broad rules:
- Live in Florida.
- Be age 18 or older for SMMC LTC.
- Need long-term services and supports.
- Go through ADRC screening unless an exception applies.
- Meet medical eligibility through CARES when enrollment is open for the person.
- Meet Medicaid financial eligibility through DCF or Social Security, depending on the case.
- Enroll in a Long-Term Care plan if approved.
Florida says SMMC LTC is not the same as regular Medicaid. It is not an open-ended benefit for everyone who has Medicaid. There can be limited space for home and community services.
Income and asset rules
Do not guess on income or asset limits. Florida Medicaid financial rules can depend on age, disability, marital status, SSI, nursing facility level of care, a qualified income trust, and other facts.
If income is too high, ask DCF or an elder law attorney whether a Medicaid path such as Medically Needy or a qualified income trust applies. Learn more about common Medicaid money issues here: Medicaid spend-down and Medicaid look-back period.
How the assessment works
There are two main care review steps for SMMC LTC.
Step 1: ADRC screening
The ADRC screening is usually done by phone with the person and caregiver. Florida says it can take about 45 minutes to an hour. The screening asks about health, daily care needs, caregiver help, and safety.
At the end, the person receives a priority score and rank. Florida uses that score for waitlist placement. Ask for a copy of the screening results.
Step 2: CARES medical review
When enrollment is available, CARES reviews the person’s medical need. A nurse or assessor may visit the home. A doctor or registered nurse reviews the case.
For SMMC LTC, Florida says the person must meet the required care level. This often means nursing-home level of care, or a hospital level of care for certain cystic fibrosis cases.
Be honest during the screening and assessment. Do not describe the best day. Describe the usual day and the bad days. Say what happens if the caregiver is not there.
How to apply
Florida’s process can feel split because more than one office is involved. Use this order.
Step 1: Call the ADRC
Call the Elder Helpline at 1-800-963-5337. Ask for the local ADRC and Long-Term Care screening.
Step 2: Apply or update Medicaid with DCF
Use the Florida MyACCESS system to apply, upload documents, or check the case. You can also ask DCF for help if you cannot use the online system.
Step 3: Watch for letters
Florida may send letters about screening, waitlist status, Medicaid financial eligibility, medical eligibility, and plan choice. Save every letter and envelope.
Step 4: Choose a Long-Term Care plan when told to enroll
If approved and released for enrollment, the person may get a welcome packet. Choice Counselors can help with plan enrollment by phone at 1-877-711-3662.
Phone script: calling the ADRC
“Hi, I care for my [mother/father/spouse/relative] in Florida. They need help with bathing, dressing, meals, and staying safe at home. I want to request screening for the Statewide Medicaid Managed Care Long-Term Care program. Can you tell me what information you need and how to get a copy of the screening results?”
Phone script: calling the Medicaid plan
“My family member has Florida Medicaid. We are also asking about Long-Term Care screening. While we wait, can a care manager review whether home health, personal care, medical supplies, or transportation can be approved through the current plan?”
Documents to gather
- Medicaid card, Medicare card, and health plan card
- Photo ID and proof of Florida address
- Social Security number or immigration papers, if requested
- Proof of income, bank accounts, life insurance, property, and other assets
- Doctor names, diagnoses, medicines, hospital stays, and discharge papers
- List of daily tasks the person cannot do alone
- Fall history, wandering, memory issues, toileting needs, wounds, or feeding needs
- Power of attorney, guardianship papers, health care surrogate form, or authorized representative form, if you have one
- Denial letters, plan letters, and prior approval letters
Use our caregiver checklists and phone scripts to keep calls and papers organized.
What to do while waiting
Do not wait silently if the person is getting worse. Florida allows rescreening in some cases when there is a significant change. A change can include a new illness, a change in living situation, a caregiver change, loss of a spouse or caregiver, or damage to the home.
While waiting, take these steps:
- Ask the ADRC if the person is on the waitlist and how to report a major change.
- Ask the current Medicaid plan for a care manager.
- Ask the doctor whether home health, therapy, supplies, or a safety device is medically needed.
- Ask about Medicaid transportation for Medicaid-covered appointments if rides are a barrier.
- Ask the ADRC about non-Medicaid meals, respite, and caregiver support.
- Keep notes of every call. Write the date, person you spoke with, and what they said.
If the person may need paid family care, read Can I get paid to be a caregiver? and try the paid caregiver quiz. Florida does not pay every family caregiver. Payment depends on the program, the care plan, the worker rules, and whether family members are allowed for that service.
If the person served in the military or is the surviving spouse of a veteran, also check VA Aid and Attendance. VA benefits are separate from Medicaid and have their own rules.
If services are denied or cut
Do not throw away the notice. The notice tells you what was denied, reduced, stopped, or delayed. It should also tell you how to appeal and which office handles the appeal.
If the screening seems wrong
Ask the ADRC for a copy of the screening. If answers were recorded wrong, ask how to update the screening. You may also ask about a fair hearing.
If CARES or DCF denies eligibility
Florida says a person who believes CARES denied medical eligibility in error, or DCF denied financial eligibility in error, has the right to ask for a Medicaid Fair Hearing within 90 days of the notice. Follow the notice directions.
If a plan denies, cuts, or stops a service
If the person is already in a Medicaid health plan, Florida says the plan appeal process usually comes before a Medicaid Fair Hearing. The denial letter is often called a Notice of Adverse Benefit Determination. Call the plan and ask how to file the plan appeal. Ask for the deadline. Ask whether services can continue during the appeal.
If the problem is delay, provider access, or transportation
That may be a complaint instead of an appeal. Florida Medicaid complaints can be filed with AHCA, and the Medicaid Helpline can help at 1-877-254-1055.
Phone script: appeal or complaint
“I received a notice that [service] was denied, reduced, or stopped. I need to know the exact appeal deadline, whether I must appeal with the plan first, and whether services can continue during the appeal. Please tell me where to send records from the doctor and caregiver notes.”
What if the first answer is no?
Ask which rule caused the no. Was it financial eligibility, medical level of care, screening rank, missing paperwork, plan approval, or provider access?
Then ask for the next step in writing. If the person is unsafe at home, ask the ADRC, doctor, hospital discharge planner, or Medicaid plan what urgent options exist. If the person had a major change since screening, ask about rescreening.
If the issue is tax or work-related support for the caregiver, see caregiver tax deductions. For background on home and community Medicaid paths, see Medicaid HCBS waivers explained.
Resumen en español
En Florida, Medicaid puede cubrir algunos servicios en el hogar si la persona cumple las reglas del programa. Para cuidado de largo plazo en casa, llame al Elder Helpline al 1-800-963-5337 y pida una evaluación para SMMC Long-Term Care.
Guarde todas las cartas. Si niegan o reducen servicios, revise la fecha límite para apelar. Si la persona ya tiene Medicaid, llame al plan y pida hablar con un administrador de cuidado.
FAQ
Does Florida Medicaid pay for 24-hour care at home?
Do not assume it will. Some services can be approved based on need, but Medicaid home care is not the same as having a 24-hour private aide. Ask the care manager what the care plan can approve and what limits apply.
Can Florida Medicaid pay a family caregiver?
Sometimes a program may allow a family member to be paid, but it depends on the service, plan, worker rules, and the person’s care plan. Ask the ADRC and Medicaid plan whether consumer direction or family caregiver payment is allowed in the specific case.
Who should I call first?
For long-term care at home, call the Elder Helpline at 1-800-963-5337 and ask for the ADRC. For Medicaid financial eligibility, use MyACCESS or contact DCF. For a service problem after enrollment, call the Medicaid plan or AHCA Medicaid Helpline.
What is the difference between Medicaid home health and SMMC LTC?
Home health is usually a medical service ordered because of an illness, injury, or condition. SMMC LTC is for long-term help with daily care needs, often tied to nursing-home level of care and a care plan.
What if my parent is on a waitlist?
Ask the ADRC how to report changes. Ask whether a new screening can be done if health, safety, housing, or caregiver support changed. Also ask the current Medicaid plan and doctor about services that may be available now.
Official sources used
- Florida AHCA: Statewide Medicaid Managed Care Long-Term Care Program
- Florida AHCA: Find Out About Long-Term Care Services
- Florida AHCA: SMMC LTC Screening
- Florida AHCA: SMMC LTC Recipient FAQs
- Florida Department of Elder Affairs: Aging and Disability Resource Centers
- Florida Department of Elder Affairs: Programs and Services, including CARES
- Florida Statewide Medicaid Managed Care: Enrollment
- Florida Statewide Medicaid Managed Care: Agency Phone Numbers
- Florida DCF: Medicaid
- Florida AHCA: Medicaid Home Health Services
- Florida AHCA: Non-Emergency Transportation Services
- Florida AHCA: Medicaid Fair Hearings
- Florida AHCA: Medicaid Complaints
- Florida AHCA: PACE
About this guide
This guide was written for family caregivers who need a clear first step. It focuses on Florida Medicaid home care routes, where to call, what to ask, and what to do if the answer is no.
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.
