Now I’m approved for Medicaid, What’s Next?

To qualify for Florida’s Long-Term Community Care (LTCC) Medicaid program for nursing home care, you must meet the medical criteria for a nursing home level of care. That means that your condition is serious enough that you either need to be in a nursing home, require the need for round-the-clock nursing care, or would need to be in a nursing home if you were not receiving supportive long-term care services in another environment.

Nursing Homes, now more commonly known as Skilled Nursing Facilities (SNFs), function as a licensed healthcare facility for individuals who require a higher level of medical care than can be provided in an assisted living facility or at home. Skilled nursing staff consists of RNs, LPNs, and certified nurse’s assistants (CNAs) who are available to provide 24-hour medical attention and assist with Activities of Daily Living Skills. They have a Medical Director who oversees the care and works alongside a core team of healthcare professionals including Administrator, Nursing, Physical, Occupational, and Speech Therapy, Dieticians, Social Workers, as well as others.

When needing long-term care and moving into a Skilled Nursing Facility, most people pay privately for the cost of the long-term care services until they can become eligible for Medicaid. Since very few people have long-term care insurance or can afford to pay for the high cost of nursing home care privately very long, eventually most people qualify for Medicaid. Medicaid has become the primary source of funding for nursing home care and has become the long-term care insurance of the middle class.

To Qualify for Florida’s Long-Term Care (LTCC) Medicaid program, you must have limited assets. The state considers assets as money in the bank, retirement accounts, land, and personal property, including cars.

A single applicant’s allowable “countable assets” limit is $2,000 to be eligible for Medicaid in Florida as of 2023. If both of the married couple needs to move into a skilled nursing facility in Florida, then the Medicaid eligibility allowable “countable assets” limit collectively is $3,000 as of 2023.

Most people receiving long-term care assistance live at home and are not in a nursing home. They are able to reside in their home environment because of the care that they are receiving from their family members and/or from professional medical services, such as Home Health Care.

Home Health Care Services can include skilled nursing, therapy services, or home health aides; including medication management, bathing assistance, or personal care services like meal preparation or cleaning.

LTCMC Medicaid plans offer Home Health Services as part of their benefit package. So if you are a participant in a LTCMC plan, then you are eligible to receive assistance from skilled nurses, home health aides, or personal care attendants in your home, as long as your doctor or LTCMC care coordinator has authorized for those services and has deemed the treatment as medically necessary.