Eligibility for a Florida Medicaid application can be a very complex process.

You might not know where to start with to get Medicare. If you’ve checked Medicaid details, you may find you’re extremely frustrated and this is where a decent attorney at the Finity Law Firm will help you find the answers if you’ve been confused.

The laws, rules, and application process may vary in every State.

If you are in Florida, you need to understand that the process may be different. This article will discuss how you can get Medicaid if you are based in Florida.

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Getting Medicaid in Florida

There may be a stage when you’re preparing an estate plan, you may start thinking about the Medicaid program and how it functions.

In the State of Florida, the responsibility for Medicaid rests with the AHCA. Medicaid helps the elderly and the handicapped with the costs of nursing care and other medical expenses. Eligibility to get Medicaid will depend upon your financial and income requirements.

Residents of Florida eligible for Supplemental Security Income (SSI) are automatically eligible by the Social Security Administration (SSA) to get Medicaid coverage.

Not every elderly and the handicapped are entitled to get Medicaid in Florida as requirements need to be met.

The government simply states that to get Medicaid in Florida, you need to be a Florida resident, needing health care/insurance assistance, and whose financial situation would be characterized as low income.

You must either be a national, resident of the United States or have acceptable immigration status.

However, the rules and laws include meeting certain income levels, assets, health, and financial requirements to get Medicaid. Individuals who do not meet the requirements prescribed in Florida usually get their applications denied and are unable to get Medicaid in Florida.

Individuals who can get Medicaid

You can get Medicaid in Florida if you meet the following requirements:

  • Pregnant women

  • Parents or relatives who are caretakers

  • Florida residents who receive SSI through the SSA

  • Patients who are disabled or over the age of 65

  • Children below the age of 21

  • Those who are eligible to receive Temporary Cash Assistance

  • People under age 26 who were in a foster home

  • People in nursing homes or those who receive community or home-based care.

Medicaid Plans in Florida

For each Medicaid plan, the financial conditions and the medical requirements vary. If you are rejected for one Medicaid plan, you may be eligible to get Medicaid for a different type of plan.

Following are the different types of Medicaid programs in Florida:

  •   Institutional / Nursing Home Medicaid
  •   Home and Community-Based Services
  •   Regular Medicaid / Aged Blind and Disabled

Like other states, Florida has replaced its Medicaid HCBS Waivers with a controlled Medicaid care program. To be specific, the current Medicaid managed care model has retained much but not all of the programs and benefits that were available under the older waiver program.

In Florida, Medicaid is also called the Statewide Medicaid Managed Care (SMMC) program.

The managed Medicaid care program for elderly and disabled long-term care programs is called the Long-Term Care (LTC) program. Many other health services beyond long-term care are provided by the Managed Medical Assistance (MMA) program.

You cannot qualify for Medicare or Medicare long-term care benefits if you have too many assets or income. Many elderly people would donate money to others, sell assets, or pass assets to others to retain the right to benefits.

That has to be done strategically, however; Florida retains a 5 year lookback period. This means that when you apply for Medicaid for long-term care, the state will look back on the past five years on your finances to assess if you made any non-exempt transfers or financial gifts or not. 

Income level to get Medicaid in Florida

In general, families with up to 100% of the Federal Poverty Level (FPL) can get Medicaid in Florida, as are pregnant women with up to 135% of the FPL.

Programs are available for elderly, disabled, or blind residents ranging from 88 percent to 150 percent FPL.

Individuals in Florida who qualify for SSI automatically qualify and can get Medicaid in Florida.

Hiring an Attorney for Medicaid

Planning to get Medicaid will be a significant part of your future when you’re no longer working and earning an income.

Getting Medicaid in Florida can be very complex and there are several rules that you must abide with to get your application approved.

However, if you meet the requirements, you can hire a lawyer to assist you with the process is a perfect way to get through this process and make sure you get the benefits that you are entitled to under Federal and State law. You may be leaving out crucial information and this can affect your benefits negatively.

The Finity Law Firm will evaluate and identify things you need to take advantage of the Medicaid benefit you are entitled to. Contact us today!


  1. Florida Medicaid Program Eligibility | Eligibility.com
  2. Florida Medicaid(SMMC-LTC) Income & Assets Limits for Nursing Homes & Long Term Care | American Council on Aging

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