Does Medicaid Pay for Assisted Living in Florida?

Yes, Florida Medicaid pays for the care services in an assisted living facility, and it does not pay the room and board. The payment runs through Florida’s Statewide Medicaid Managed Care Long-Term Care program, and a parent qualifies with a nursing-home level of care, monthly income of $2,982 or less (or a qualified income trust), and $2,000 or less in countable assets. Medicare pays for neither the care nor the rent.

Florida runs long-term care through managed care plans. The Department of Elder Affairs decides the medical need and runs the waitlist, and the Department of Children and Families decides the financial eligibility, so a family deals with both agencies.

1. What Does Florida Medicaid Pay For in Assisted Living?

Florida Medicaid pays for the care a resident receives in the facility. The Department of Elder Affairs lists the services every long-term care plan must offer, and the list includes Assisted Living Facility Services, personal care, medication administration and medication management, case management, and nursing facility care for a resident who later needs it. Each service is provided based on medical necessity, or where it is needed to delay or prevent a move to a nursing home.

Florida Medicaid does not pay the rent and the meals. Federal Medicaid rules deny matching funds for the cost of room and board in home and community-based care, with narrow exceptions for respite care and live-in caregivers, so Florida’s long-term care program does not pay an assisted living facility’s room and board as a covered service. The resident pays that part from Social Security, a pension or other income.

The care has to come from a facility that contracts with the resident’s plan, so ask which Florida Medicaid long-term care plans a facility accepts before signing an admission agreement.

2. Does Medicare or Medicaid Pay for Assisted Living Facilities?

Medicare does not pay for assisted living. Medicare is health insurance, and the federal government’s own Medicare site states that Medicare does not pay for long-term care, meaning help with bathing, dressing and the other tasks of daily living, whether at home, in assisted living or in a nursing home. Medicare still pays for a resident’s doctor visits, hospital stays and covered therapy while the resident lives in a facility. Our guide to whether Medicare covers assisted living covers the medical side.

Medicaid is the public program that pays for assisted living care, and it pays last. A parent with both programs is called dually eligible, and Medicare pays first for anything Medicare covers. Our page on having Medicare and Medicaid at the same time explains how the two fit together.

3. How Much Will Medicaid Pay for Assisted Living in Florida?

Medicaid pays the long-term care plan, and the plan pays the facility for the covered care at a rate the two of them set. A family does not see that rate. What a family sees is the resident’s own share, called the patient responsibility, which is the resident’s income left over after Florida’s allowances.

Florida sets the allowance for an assisted living resident in the long-term care program at the facility’s basic monthly room and board rate plus 20% of the federal poverty level, according to the Department of Children and Families fact sheet updated July 2025. A resident keeps that amount to pay the room and board and personal costs, and income above it goes toward the cost of care. A parent in a nursing home keeps $160 a month instead, because the nursing home’s Medicaid payment already includes the room.

Florida also runs a cash program called Optional State Supplementation for assisted living residents whose income is very low. The state sends the resident a check toward the amount owed to the facility, based on the resident’s income and the facility’s rate.

4. Is There a Waitlist for Medicaid Assisted Living in Florida?

Yes. Florida law requires the Department of Elder Affairs to keep a statewide pre-enrollment list for long-term care outside a nursing home, which includes assisted living, and to release people from it only when the state determines there is money to enroll them. Nursing home care is not on the list.

The order of release comes from a frailty-based screening that produces a priority score. Staff at the local Aging and Disability Resource Center perform the screening, and the whole screening must be finished before a person is placed on the list. A person with a high priority score is rescreened every year or after a significant change, and when two people have the same score, the one placed on the list earlier goes first. A person with a low score is not placed on the list at all and is told about community resources and the right to ask for a new assessment after a change.

A family has to keep the place on the list. A letter from the department gives 30 calendar days to schedule a screening, a missed rescreening with no reply to three documented contact attempts ends the placement, and a person removed from the list starts over with the earlier priority disregarded.

Florida law lets three groups skip the screening and the list. The one that matters most for older adults is a resident of a Florida-licensed skilled nursing facility for at least 60 consecutive days who asks to move back to the community. Adults referred by Adult Protective Services as high risk, and certain young adults with a chronic condition, are the other two.

5. How Do You Get Medicaid to Pay for Assisted Living?

There are four steps, and they run through two different agencies.

1. Call the local Aging and Disability Resource Center for the screening. The Department of Elder Affairs directs families to the regional center for the waitlist, or to the Elder Helpline at 1-800-96-ELDER (1-800-963-5337).
2. Get the CARES level-of-care decision. The CARES unit of the Department of Elder Affairs decides whether the applicant needs a nursing-home level of care. A CARES nurse or assessor does the assessment at no cost to the applicant.
3. File the Medicaid application through ACCESS Florida. The Department of Children and Families decides the money side. On the online application, the applicant must check the box for HCBS/Waivers or Nursing Home on the Benefit Information screen, because ordinary Medicaid does not include long-term care.
4. Choose a plan, then a facility the plan contracts with. Florida’s choice counseling site at flmedicaidmanagedcare.com lists the long-term care plans in each region.

The financial rules are the ones on our guide to how to qualify for Medicaid in Florida, and the filing itself is covered step by step in how to apply for Medicaid for a nursing home. You can check where your parent stands with the Florida Medicaid eligibility calculator.

6. How Can You Pay for Assisted Living With No Money?

Florida assisted living had a statewide median price of $5,610 a month in 2025, according to the CareScout Cost of Care Survey, so most families pay privately for a while and turn to Medicaid when the savings run low. Our page on what assisted living costs in Florida breaks the price down by region.

Three rules decide how much a parent keeps when the money runs low.

• The income cap. Florida’s 2026 cap for long-term care Medicaid is $2,982 a month of gross income. A parent over the cap still qualifies with a qualified income trust, which the Department of Children and Families requires for home and community-based care as well as for nursing homes.
• The asset limit. A single applicant may have $2,000 in countable assets. The homestead, one car and personal belongings do not count, so most families own less that counts than they think.

The third rule is the five-year look-back, and it catches the most families. Florida applies its transfer rules to home and community-based care, so a gift made within 60 months of the application creates a penalty period. Florida divides the amount given away by $10,645 to set the number of months Medicaid will not pay. Our Medicaid penalty calculator runs the arithmetic, and Medicaid does not pay for long-term care during the penalty.

What Does Help With an Assisted Living Medicaid Application Cost?

A Medicaid application, including the eligibility analysis, the verification packet, the filing and the answers to the agency’s requests, is a flat fee from $3,500. A qualified income trust is a flat fee from $750. Crisis planning for a single applicant already in care is a flat fee from $9,000. Advertised fees are honored for 90 days from the posted date, and any government costs are additional and passed through at cost.

Frequently Asked Questions

Common Situations

The mother whose savings will last eight more months. A widow in an assisted living facility in Sarasota has $45,000 left and income of $2,100 a month. Her son calls the regional Aging and Disability Resource Center now for the screening, because the waitlist runs on her priority score rather than on her bank balance, and he asks the facility which long-term care plans it accepts.

The father who went to rehab and stayed. A father is discharged from the hospital to a nursing home and remains there for two months. When he is ready to move to assisted living, Florida law lets a resident of 60 consecutive days skip the waitlist, so the family applies for long-term care Medicaid before he leaves rather than after.

Sources of Law

• Fla. Stat. §409.979(1) (eligibility for long-term care managed care, age 65 or disabled, CARES nursing facility level of care); §409.979(2) and (3)(a) to (e) (pre-enrollment list, frailty-based priority score, screening by aging and disability resource centers, rescreening, 30-day letter, termination); §409.979(3)(f) (priority enrollment, including a resident of a Florida-licensed skilled nursing facility for at least 60 consecutive days). Read at leg.state.fl.us, retrieved October 1, 2026.
• 42 C.F.R. §441.310(a)(2) (no federal financial participation for room and board in home and community-based services, except respite care and certain live-in caregivers). Retrieved October 1, 2026.
• Florida Department of Elder Affairs, Statewide Medicaid Managed Care Long-Term Care Program (required plan services, eligibility, waitlist through the ADRC, Elder Helpline) and CARES Program (level-of-care determinations at no cost). Retrieved October 1, 2026.
• Florida Department of Children and Families, Medicaid (ACCESS Florida application; HCBS/Waivers or Nursing Home box) and SSI-Related Medicaid Program Fact Sheet, updated July 2025 (qualified income trust for HCBS; personal needs allowance of $160 in a nursing facility and of the ALF room and board rate plus 20% of the federal poverty level in assisted living; Optional State Supplementation; Long-Term Care Insurance Partnership). Retrieved October 1, 2026.
• DCF ESS Policy Manual §1640.0606 (transfer of assets policy applies to HCBS); Fla. Admin. Code R. 65A-1.712 (resources) and 65A-1.713 (income). 2026 figures ($2,982 income cap, $2,000 asset limit, $10,645 transfer penalty divisor) as verified on our eligibility calculator.
• Medicare.gov, Long-term care (Medicare does not pay for long-term care). CareScout Cost of Care Survey 2025, Florida statewide median for assisted living, carescout.com. Both retrieved October 1, 2026.
• Case retold below: Waskiewicz v. Department of Children & Families, No. 5D21-2949 (Fla. 5th DCA May 19, 2023). Opinion read in full; retrieved October 1, 2026.

Why Paying the Bills From the Right Account Matters

I have come across a case where a daughter did everything a careful fiduciary is supposed to do and still cost her mother four months of Medicaid. Her mother lived in a Florida assisted living facility. The mother’s VA benefits, her Social Security and her Florida Retirement System pension all flowed into a VA fiduciary account, and the facility was paid straight from that account. The VA had overpaid the mother’s benefits and wanted the money back, so the daughter moved $30,000 from her mother’s checking account into the fiduciary account and held it there to repay the VA (an honest debt, and the daughter repaid it in full in May 2021).

The mother applied for Medicaid’s institutional care program, the nursing home coverage, for January to April 2021. The state counted the $32,908 in the fiduciary account as her mother’s money and denied those four months, because nothing legally stopped the daughter from spending it on the mother’s care. The VA had offered several ways to repay, including payments over time, and had never frozen the account. A Florida appeals court affirmed the denial in 2023, and noted that holding the money for the VA was proper, and even commendable.

In reviewing Florida cases on how the state counts a parent’s money, I have a few take-home points. The first is that a debt the family intends to pay does not make the money unavailable. Florida asks whether anything legally restricts the account, and a plan to pay someone later is not a restriction. The practice pointer is to pay a known debt before the month of the application, or to show the agency a legal restriction that existed before the family started planning.

The second is timing. The denial covered four full months of care, and Florida counts the balance in each month separately. Avoid filing a long-term care application for a month when the account balance still sits over $2,000, whatever the money is earmarked for. One limit is worth stating plainly. The opinion does not say what those four months of care cost the family, so nobody reading it can put a dollar figure on the mistake.

Kevin D. Klagge, Esq., admitted in Florida since 2012. The case described above is a decision of a Florida court rather than a matter handled by this firm. Past results do not guarantee a similar outcome.

Updated on October 1, 2026. Reviewed by Kevin D. Klagge, Esq., Fla. Bar No. 99502. Attorney Kevin Klagge represents families, businesses, and international clients in estate and tax planning, business structuring, and international law, with a focus on Florida legal tools. He litigates estate and business issues in court. General information about Florida law, not legal advice, and no attorney-client relationship is created. Do not send confidential information until we have agreed to represent you.