There are essentially Three Medicaid Programs that cover Long Term Care in the State of Florida.

  1. The Medicaid Waiver Program – A program funded by the state and federal government and administered at the county level covering limited home health care and assisted living care.
  2. The Medicaid Diversion Program – A program funded by the state and federal government and administered at the state level covering limited home health care and assisted living care.
  3. The Medicaid Institutional Care Program (ICP) – A program funded by the state and administered by the state and federal government covering the cost of nursing home care.

All three programs have virtually identical primary requirements from a qualification standpoint.

  • Must meet a nursing home level of care
    • Determined by a doctor on form 3008 for nursing home care
    • Determined by the CARES unit for HHC and ALF
  • Must meet asset requirements (to follow)
  • Must meet income requirements not to exceed (Gross Income)
    • $2,199 Individual (unless a Special type of Trust is utilized)
    • Unlimited for Community Spouse

The home health care benefits are non-standardized and subject to DCF’s subjective determination.

The assisted living benefits are non-standardized because each facility negotiates its own contract and determines the amount of monthly cost that is for “Room and Board” which is payable by the patient. So while the patient may qualify for benefits the facility to be utilized will determine the patient’s portion of bill responsibility.

Nursing Home benefits are standardized from the client perspective