Many families assume Medicaid only pays for nursing homes. In Florida, Medicaid can also help pay for care in an assisted living facility through the Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program. Here is how it works, in plain terms.
What is SMMC LTC?
SMMC LTC is Florida's Medicaid program for long-term care. Instead of paying facilities directly, the state contracts with managed care plans. Each plan covers long-term care services for its members and works with a network of providers, including assisted living facilities. The program is overseen by the Agency for Health Care Administration (AHCA).
Who qualifies
Eligibility has two parts, and both must be met:
- Medical (functional) need. The person must be 65 or older, or 18 or older with a disability, and need a nursing facility level of care. This is determined through a state assessment.
- Financial eligibility. Income and assets must fall within Medicaid limits, which are set by law and change over time. The Florida Department of Children and Families (DCF) decides financial eligibility. Rules for married couples and for income above the limit are complex, so many families talk to an elder law attorney or benefits counselor.
What Medicaid pays for, and what it doesn't
This is the part that surprises families. In assisted living, SMMC LTC generally pays for care services, such as:
- Help with bathing, dressing and other daily activities
- Medication assistance
- Case management through the plan
Medicaid generally does not pay for room and board (rent and meals) in assisted living. That portion is usually paid from the resident's own income, such as Social Security or a pension. Ask each community what its room-and-board charge is for Medicaid residents and how the plan payment works.
Step by step: how to apply in Broward County
- Call the ADRC. The Aging and Disability Resource Center of Broward County runs the Elder Helpline at (954) 745-9779. They complete the initial screening for long-term care.
- Get on the list. In Florida, people are placed on a waitlist for SMMC LTC and released based on priority, which considers need and risk. Wait times vary, so start early.
- Apply for Medicaid with DCF. When released from the waitlist, complete the financial application with DCF and the medical assessment.
- Choose a plan. Once eligible, you enroll in an SMMC LTC plan serving Broward County.
- Choose a facility in the plan's network. Confirm the assisted living facility accepts your plan before moving in. A case manager from the plan helps coordinate services.
Some people who already have full Medicaid, or who are moving out of a nursing home, may have a faster path. The ADRC can explain your options.
Tips from families who've done it
- Start before a crisis. Screening, waitlist and applications take time.
- Keep records ready: ID, Social Security and Medicare cards, bank statements, income proof and insurance information.
- Ask facilities about plans. Each community works with specific plans, so ask which ones before you apply.
- Private pay first is an option. Some families pay privately while the Medicaid process moves forward.
Medicaid at Colonial Gardens
Colonial Gardens Residences in Lauderhill accepts Florida Medicaid Long-Term Care through participating plans, as well as private pay. Private-pay assisted living starts at $3,500 per month in a shared room. Our community offers remodeled rooms, garden courtyards, home-style meals, 24/7 care and supervision, and secured memory care.
Our team can walk you through the process and tell you which plans we work with. Call or text (954) 484-1960, schedule a tour, or read more on our Medicaid assisted living page.
This article is general information, not legal or financial advice. Eligibility is determined by the State of Florida.