How Do You Apply for Medicaid for a Nursing Home in Florida?

To apply for nursing home Medicaid in Florida, you file an ACCESS Florida application with the Department of Children and Families and check the Nursing Home box, and the CARES unit of the Department of Elder Affairs assesses whether the applicant needs a nursing-home level of care. In 2026 a single applicant must have gross income of $2,982 a month or less, or a qualified income trust, and $2,000 or less in countable assets. The department also reviews every transfer from the previous 60 months.

Florida calls nursing home Medicaid the Institutional Care Program, and it delivers the care through the Statewide Medicaid Managed Care Long-Term Care program. This page covers that long-term care application. Ordinary health Medicaid for families and children is a different program, and this firm does not handle it.

1. Where Do You Apply for Nursing Home Medicaid in Florida?

The Department of Children and Families takes the application. An applicant can apply in any of these ways.

• Online through ACCESS Florida at myaccess.myflfamilies.com, which requires a MyACCESS account.
• In person at a Family Resource Center or through a member of the department’s Community Partner Network.
• By telephone or on paper, by calling the Customer Contact Center at 850-300-4323.

The box on the Benefit Information screen is the step most often missed. The department directs an applicant who needs long-term care in a nursing home or the community to check the box for HCBS/Waivers or Nursing Home, because ordinary Medicaid does not include long-term care. A parent who already receives SSI has Medicaid automatically, and still files an ACCESS application to get nursing home coverage.

A family member usually applies for the parent. The applicant, a spouse, a legal guardian or an agent under a power of attorney can appoint a designated representative, and the department’s manual bars a nursing home administrator from serving in that role unless the administrator is the guardian. A parent who has lost capacity without a durable power of attorney can leave the family looking for a guardianship before anyone can sign.

2. What Is the Level-of-Care Assessment?

The level-of-care assessment is the medical test. The CARES program of the Department of Elder Affairs decides whether the applicant needs the care a nursing home provides, and a CARES registered nurse or assessor completes the assessment at no cost to the applicant. A CARES physician or registered nurse reviews each file, and the program has 17 field offices statewide.

The Department of Children and Families requests the decision from CARES within two days of receiving a nursing home application, and CARES decides within 12 days of the request, under the department’s policy manual. Having the hospital discharge papers and the physician’s records ready keeps that schedule. Our page on how long Medicaid takes to approve in Florida covers the full timeline.

3. What Documents Do You Need for a Nursing Home Medicaid Application?

Florida verifies identity, residence, citizenship or eligible immigration status, income and assets. A complete nursing home file usually includes these documents.

1. Identity and status. A photo ID, the Social Security card, the Medicare card and proof of citizenship or immigration status.
2. Income. The Social Security award letter and every pension or annuity statement, showing gross income before deductions.
3. Five years of statements. Bank, brokerage and retirement account statements for the 60 months before the application month, because the department reviews every transfer in that window.
4. Property and policies. The deed to the home, any life insurance policies with their cash values, prepaid funeral contracts, and any long-term care insurance policy.
5. Authority and trusts. The durable power of attorney or guardianship papers, and a signed and funded qualified income trust where income is over the cap.

The department sends a written list of anything else it needs, with a due date 10 calendar days after the interview, or 30 days for medical information. A large check or withdrawal with no explanation draws a question, and our page on whether Florida Medicaid checks your bank account covers what the department looks for.

4. What Is the Income Cap, and What Is a Miller Trust?

Florida’s 2026 income cap for nursing home Medicaid is $2,982 a month of gross income, before deductions for taxes or insurance premiums. A parent over the cap still qualifies with a qualified income trust, also called a Miller trust.

The Department of Children and Families sets the requirements. The trust must be irrevocable, must hold only the applicant’s income and no assets, must leave whatever remains at death to the State up to the Medicaid benefits paid, and must be signed by the applicant, the spouse or someone with legal authority. The department’s Regional Legal Counsel reviews it. The trust works only through monthly deposits, and the department states that deposits cannot be made for a past or future month, so a month with no deposit, or too small a deposit, is a month without Medicaid.

5. What Is the Asset Limit?

A single applicant may have $2,000 in countable assets in 2026, or $3,000 where both spouses apply. Countable assets include bank accounts, CDs, investments, a second property and cash-value life insurance over the limit.

Much of what a family owns does not count. The homestead is exempt while the applicant lives there or intends to return, up to $752,000 of equity for a single applicant, and one car, household goods and personal belongings, and an irrevocable prepaid funeral are exempt too. A spouse at home keeps up to $162,660 in countable assets, so a married couple’s combined limit is $164,660. Our guide to how to qualify for Medicaid in Florida lists what counts and what does not, and the Florida Medicaid eligibility calculator runs your numbers in about a minute.

6. Why Is the Application Where Families Make Costly Mistakes?

The application is where every earlier decision is tested, and most of the costly mistakes happen before anything is filed. These are the ones that cost the most.

1. Giving money away to get under the limit. Florida divides the amount given away within the 60 months by $10,645 to set a penalty period, so a $53,225 gift costs five months of Medicaid while the nursing home still bills about $10,300 a month. A transfer between spouses carries no penalty. The Medicaid penalty calculator shows the months.
2. Filing in the wrong month. Coverage starts on the first day of the month the application is received, and for applications on or after February 1, 2019, Florida gives adults no retroactive months. A parent admitted in March whose application arrives in May leaves the family with March and April.
3. Signing the income trust late. A trust that is not funded in the month the income arrives does not count for that month.
4. Selling the house first. The homestead is exempt, and the sale proceeds are not. Our page on whether a nursing home can take your house in Florida explains what to do with the home instead.

Florida lets a nonlawyer prepare the application itself, and the Florida Supreme Court has held that advising a family on how to qualify, and drafting or funding a qualified income trust, is the practice of law. Our page on whether a non-lawyer can do Medicaid planning in Florida covers that line.

What Does a Nursing Home Medicaid Application Cost?

A Medicaid application for a file that is clean or already spent down, 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 Medicaid for a single applicant already in care or about to be, which includes reviewing five years of statements before anything is filed, is a flat fee from $9,000, and for a married couple the flat fee is quoted at consult. A spousal refusal letter is a flat fee from $500. 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 son who paid his own mortgage with his mother’s help. Three years ago a mother in Hillsborough County gave her son $40,000 toward his house. She now needs nursing home care. The gift falls inside the 60 months, so before filing, the family looks at whether the gift can be returned or whether the penalty should be planned for, rather than letting the department find it.

The wife whose husband just entered a nursing home. A couple in Pinellas County has $180,000 in savings and a paid-off homestead. The wife at home can keep up to $162,660, so the couple’s combined limit is $164,660. Florida counts both spouses’ assets at application, so the $15,340 above that line is spent on exempt items, such as a prepaid funeral or repairs to the home, before the month the application is filed.

Sources of Law

• Florida Department of Children and Families, Medicaid (ACCESS Florida application; the HCBS/Waivers or Nursing Home box) and SSI-Related Medicaid Program Fact Sheet, updated July 2025 (ways to apply; Institutional Care Program; CARES level of care; 60-month transfer review; qualified income trust requirements and monthly deposits). Retrieved October 1, 2026.
• Florida Department of Children and Families, ESS Program Policy Manual, chapter 0600, ffic.myflfamilies.com/manual/600.pdf, passages 0640.0109 (designated representatives; nursing home administrator), 0640.0400 (CARES request within two days, decision within 12), 0640.0401 (verification due dates) and 0640.0502 (date of entitlement). Florida Department of Elder Affairs, CARES Program. Both retrieved October 1, 2026.
• Fla. Admin. Code R. 65A-1.702(8) (retroactive coverage limited to children under 21 and pregnant women for applications on or after February 1, 2019); R. 65A-1.712 (resources, including the community spouse allowance at 65A-1.712(4)); R. 65A-1.713 (income). 2026 figures ($2,982 income cap; $2,000 and $3,000 asset limits; $162,660 community spouse allowance; $752,000 home equity limit; $10,645 penalty divisor) as verified on our eligibility calculator.
• The Florida Bar re Advisory Opinion, Medicaid Planning Activities by Nonlawyers, 183 So. 3d 276 (Fla. 2015) (preparing the application is not the practice of law; qualified income trusts and advice on obtaining Medicaid are).
• Case retold below: Longhi v. Department of Health & Rehabilitative Services, 691 So. 2d 583 (Fla. 1st DCA 1997). Opinion read in full; retrieved October 1, 2026.

Why the Paper Trail Behind a Gift Decides the Penalty

A Florida decision from 1997 shows how much of a Medicaid application turns on what a family wrote down before anyone knew care was coming. A mother lived with her daughter, and the daughter’s house was facing an imminent foreclosure. The mother decided to cash in her annuity and pay off the mortgage, and she mailed a written request for the annuity money. Then she fell and broke her hip. The check for $46,946.70 arrived six days after the fall, and the daughter deposited it in her own account and paid off the mortgage with $28,573.29 of it.

When the mother applied for nursing home Medicaid, the state treated the whole $46,946.70 as a gift to her daughter and imposed a penalty. The appeals court split the money in two. The $28,573.29 for the mortgage escaped the penalty, because the written request showed the mother had decided on it before the fall, and the timing of the check was a coincidence. The remaining $18,373.41 stayed penalized, because nothing showed the mother had discussed those uses before she fell.

My reading of that case is that the family won exactly as far as its paperwork reached. In reviewing Florida’s Medicaid decisions on transfers, I have a few take-home points. The first is that the state presumes a gift inside the look-back was made to qualify for Medicaid, and the family carries the burden to show another reason. The practice pointer is to put the reason for any family gift or loan in writing when it happens, with the date, because a note written after the fall persuades no one.

The second is that each transfer is judged on its own. Avoid mixing a documented payment with loose spending from the same check, because the explained part and the unexplained part get different answers. One limit is worth stating plainly. The look-back in 1995 was 30 months, and Florida now reviews 60, so the window a family has to explain is twice as long as the one in this case.

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.