How to Apply for Medicaid Long-Term Care in Florida

Getting Medicaid long-term care in Florida requires two separate approvals: financial eligibility through the Department of Children and Families (DCF) and clinical eligibility through the CARES assessment. Both must be completed before your loved one can enroll in SMMC LTC and begin receiving home care services. Here’s the process, step by step.

Step 1: Apply for Medicaid Through DCF

Florida Medicaid applications are processed by the Department of Children and Families. Apply online at myflorida.com/accessflorida, in person at a local DCF service center in Miami-Dade County, or by calling 1-866-762-2237.

You’ll need your loved one’s Social Security number, proof of Florida residency, proof of identity, income documentation (Social Security, pension, wages), and asset documentation (bank accounts, property, investments).

For long-term care Medicaid (ICP — Institutional Care Program), Florida has specific income and asset limits. The income threshold is generally the cost of care in a nursing facility (which is high enough that most individuals on Social Security qualify). The asset limit is $2,000 for an individual, though important exemptions exist: the primary residence (if the applicant intends to return or a spouse lives there), one vehicle, personal belongings, and certain burial arrangements.

For married couples, Florida has spousal impoverishment protections that allow the healthy spouse to retain a portion of assets and income.
Processing time: standard Medicaid applications take up to 45 days. Disability-based applications may take up to 90 days. If your loved one is currently in a hospital or nursing facility and needs services urgently, mention this in the application.

Step 2: Request a CARES Assessment

The Comprehensive Assessment and Review for Long-Term Care Services (CARES) determines whether your loved one meets the nursing-facility level of care required for SMMCLTC services. CARES is administered by the state, not by the managed care plans.

Contact the CARES program through your local Aging and Disability Resource Center (ADRC).  In Miami-Dade County, the Alliance for Aging at (305) 670-6500 serves as the ADRC and can help initiate the CARES process.

A CARES assessor will conduct an evaluation — typically in the home, hospital, or nursing facility— assessing your loved one’s ability to perform daily activities, their medical conditions, cognitive status, and overall care needs.

In our experience setting up CareChoice in Miami, the CARES assessment scheduling is the most common bottleneck. Wait times of two to four weeks for scheduling are common. Request the assessment as early as possible — ideally simultaneously with the Medicaid application, not after.

Step 3: Enroll in an SMMC LTC Plan

Once both financial (DCF) and clinical (CARES) eligibility are confirmed, your loved one is enrolled in an SMMC LTC managed care plan. In Miami-Dade, the available plans include Humana and Sunshine Health. Your loved one may choose a plan or be auto-assigned.

Step 4: Care Plan Development

The plan assigns a case manager who conducts an in-home assessment and develops a care plan.  The plan specifies which home care services are authorized (personal care, homemaker, companion, respite, etc.) and how many hours per week.

Step 5: Begin Services

CareChoice begins providing agency-directed home care according to the authorized care plan.  Services typically start within one to two weeks of care plan completion.

Total timeline: From initial Medicaid application to first day of home care services, Miami families should plan for approximately eight to fourteen weeks. Running Steps 1 and 2 simultaneously compresses the timeline.

Contact CareChoice → Miami team

Written by Gary Murray, Chief Marketing Officer | CareChoice