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Will Florida Medicaid pay for care at home? The long-term care program, the pre-enrollment list, and paying a family caregiver
Yes, Florida Medicaid pays for help at home, not just nursing homes. The catch is the list. Nursing home coverage starts as soon as your parent qualifies. Care at home has a waiting list, called the pre-enrollment list since July 2026, and the state doesn't publish how long it is. This page explains how to get on it, how people come off it, and what helps in the meantime. Plain answers for Citrus, Hernando, and Pasco County.
The program is called Statewide Medicaid Managed Care Long-Term Care, usually shortened to the long-term care program or SMMC LTC. Once someone is enrolled, a private health plan under contract with the state arranges and pays for their care, at home, in an assisted living facility, or in a nursing home. The state's coverage rules say the plans must provide services that let people "live in the community and to avoid institutionalization." That's the part families don't hear about.
Every answer was checked against Florida law and the state agencies that run the program. None of it is a recommendation for your own situation. Last reviewed: September 13, 2026.
The short version:
- Does Florida Medicaid pay for in-home care for the elderly? Yes, through the long-term care program. Personal care, homemaker help, adult day care, respite, home-delivered meals, medical equipment, and changes to the home are all on the list.
- Who is eligible for Medicaid long-term care in Florida? Your parent has to qualify two ways. Medically, by needing the level of care a nursing home gives. Financially, with income under $2,982 a month and assets under $2,000 in 2026. Income over the cap can be fixed with a special trust.
- How do I apply for Medicaid long-term care in Florida? Call the Elder Helpline first, not Medicaid. A phone screening decides your parent's priority score, and the score decides how soon a slot opens. Answer the screening questions completely and honestly.
- How long is the wait for Florida Medicaid long-term care? The state doesn't say. People come off the pre-enrollment list by priority score, as funding allows. A parent in immediate danger of a nursing home placement scores higher and moves faster.
- Can a family member get paid to be a caregiver through Florida Medicaid? Yes, once your parent is enrolled, through the plan's participant direction option.
- What can we do while my parent is on the list? Ask about Florida's three smaller state programs on the same call. They pay for some of the same help, plus respite for dementia, and since July 2026 they share the same list.
What the program is
Does Florida Medicaid pay for in-home care for the elderly?
Yes. Florida's long-term care program covers home and community-based services, which is the official name for help that lets someone stay out of a nursing home. Florida Medicaid pays a health plan a flat monthly amount for each enrolled person, and the plan arranges the care. The Department of Elder Affairs describes it as funding "all home and community-based services and nursing home care."
The plan's case manager writes a care plan for your parent that says which services they get and how many hours. That's why nobody can tell you ahead of time how many hours a week Medicaid will cover. It depends on what the assessment finds your parent needs, and it can change as their needs change.
What does Florida Medicaid pay for at home?
The state's own list has 25 services. The ones families use most at home:
- Personal care: help with bathing, dressing, using the bathroom, and eating
- Homemaker: "general household activities," such as cleaning, laundry, and shopping
- Adult companion care: someone to be there, help with errands, and keep your parent safe
- Adult day health care: "supervision, social programs and activities" at a day center, so a working caregiver can keep working
- Respite care: a substitute caregiver so the family caregiver can take a break
- Home-delivered meals
- Medical equipment and supplies, such as a hospital bed, a walker, or incontinence supplies
- Home accessibility adaptation: changes to the house "to help you live and move," such as grab bars, a ramp, or a widened doorway
- Personal emergency response system: the button your parent wears to call for help
- Attendant nursing care and intermittent skilled nursing, plus physical, occupational, speech, and respiratory therapy
- Caregiver training for the family
- Transportation to long-term care services
The same program also pays for assisted living and for nursing home care. So a parent who starts with help at home doesn't have to reapply if they later need more.
What is a Medicaid long-term care waiver?
It's the older name for the same thing. Medicaid was originally built to pay for nursing homes. To pay for care at home instead, a state has to get a waiver, meaning federal permission to spend the money differently. Florida's home-care waiver is now run through the long-term care program, so "the waiver," "the LTC program," and "SMMC LTC" all mean the same program on this page.
One thing that comes with the waiver: the federal government lets Florida cap how many people it serves at home each year. Nursing home Medicaid has no cap, which is why it has no waiting list. Care at home does.
Who qualifies
Who is eligible for Medicaid long-term care in Florida?
Your parent has to pass two separate tests, run by two separate agencies.
The medical test, decided by the Department of Elder Affairs through its CARES program. Your parent has to be 65 or older, or 18 or older and disabled, and need what Florida law calls nursing facility care. That doesn't mean they have to be in a nursing home. The law counts someone who "requires or is at imminent risk of nursing home placement" and needs "observation throughout a 24-hour period." In plain terms: without help, they'd end up in a nursing home.
The financial test, decided by the Department of Children and Families. The 2026 limits are in the next question.
Passing both tests puts your parent in line. It doesn't start services. That's the pre-enrollment list, covered further down.
What is the income limit for Florida Medicaid long-term care in 2026?
For a single person applying, $2,982 a month in gross income, before any deductions, and $2,000 in countable assets. These are the July 2026 figures from the state's own eligibility chart.
| 2026 limit | Single applicant | Married, both applying |
|---|---|---|
| Monthly income | $2,982 | $5,964 |
| Countable assets | $2,000 | $3,000 |
Countable assets means bank accounts, investments, and property other than the home. The home doesn't count as long as your parent lives there or intends to return, up to $752,000 in equity in 2026. Our Medicaid and your house page covers the home rules and the five-year look-back on gifts.
When one spouse applies and the other doesn't, the spouse at home can keep up to $162,660 in assets in 2026 and enough of the couple's income to reach at least $2,705 a month. Those figures protect the healthy spouse from being left with nothing.
What if my parent's income is over the limit?
They can still qualify by setting up a qualified income trust, sometimes called a Miller trust. It's a bank account with a specific legal document behind it. Each month, your parent deposits enough of their income into it to bring what's left under the limit. The money in the trust pays their share of care costs. When they die, whatever is left goes to the state, up to what Medicaid spent.
Florida's rules say the trust has to be irrevocable, hold only your parent's income, and name the state as the payee at death. The deposit has to be made every month coverage is wanted, in the month the income comes in. Missing a month can cost that month's coverage. An elder law attorney usually drafts the trust. The Florida Senior Legal Helpline can tell you whether one is needed before you pay anyone.
Can Medicaid deny long-term care?
Yes, on either test. The medical assessment can find that your parent doesn't yet need a nursing-home level of care. The financial review can find income or assets over the limit, or a gift within the past five years that triggers a penalty period. And even when both tests pass, a low priority score on the screening means a long stay on the list, which feels like a denial even though it isn't one.
Denials come with appeal rights. If the medical decision seems wrong, ask the CARES office what the assessment found and whether a doctor's letter would change it. If the financial decision seems wrong, the Senior Legal Helpline handles Medicaid appeals for people 60 and older.
The pre-enrollment list
Is there a waiting list for Medicaid home care in Florida?
Yes. Florida calls it the pre-enrollment list. Until July 1, 2026, it was called the wait list, and most articles still use that name.
Here's how it works. The state limits how many people it pays for at home each year. Everyone who wants care at home is screened by phone and given a priority score based on how frail they are and how much help they have. People with the highest scores are offered a slot first, as funding allows. If two people have the same score, the one who's been on the list longer goes first.
The screening puts people in ranks from 1 to 8. Ranks 1 through 5 come from the score itself, with 5 the highest. Three situations skip the scoring and go to the top: rank 6, a young adult aging out of children's services; rank 7, imminent risk, meaning your parent can't care for themselves, has no capable caregiver, and is likely to be placed in a nursing home within a month or very likely within three; and rank 8, a referral from Adult Protective Services as high risk.
That's why the screening call matters. If your parent's situation is a rank 7, say so plainly. Tell the screener about every fall, every missed medication, every night they were alone and shouldn't have been, and whether anyone can actually be there. Understating it out of pride keeps your parent on the list longer.
What changed with the pre-enrollment list in 2026?
A new law, chapter 2026-74, took effect July 1, 2026. Four things changed for families.
- The name. The wait list is now the pre-enrollment list. Same list, new name.
- One list for four programs. The Aging and Disability Resource Center now places people on, and releases them from, one list that covers the Medicaid long-term care program and three state programs described further down: Community Care for the Elderly, Home Care for the Elderly, and the Alzheimer's Disease Initiative.
- Who releases people. The Department of Elder Affairs now releases people based on the priority score, and the resource center does the pre-release check. Before, the CARES program did that check.
- Fewer duplicate assessments. CARES can now use the assessment the resource center already did instead of doing a second one. The Legislature's own analysis says the old duplicate step "increased wait times for seniors in need of services."
Rescreening also changed. Someone with a high priority score is rescreened every year, or sooner if their situation changes significantly. If your parent gets worse while on the list, call and ask for a rescreening. Don't wait for the annual one.
How long is the wait for Florida Medicaid long-term care?
Nobody outside the state can tell you, and the state doesn't publish it. We looked for a figure from the Department of Elder Affairs, the Agency for Health Care Administration, and the Legislature's analysis of the 2026 law. None of them gives the size of the list or a typical wait. The department's own guidance says the time "depends upon several factors including funding and submission of proper documentation."
What we can say is how the release works. Each month, the Department of Elder Affairs releases people from the list "based on their score and frailty-based levels," as many as the year's funding allows. A rank 7 or 8 moves quickly. A rank 3 can wait a long time. If your parent is already in a nursing home and wants to come home, there's a separate door: anyone who has lived in a Florida nursing home for at least 60 days in a row and asks to move back to the community skips the list entirely.
Can my parent be dropped from the list?
Yes, and it happens more than families expect. Florida law lets the department remove someone who no longer has a current priority score, asks to be removed, misses an appointment and doesn't answer three documented attempts to reach them, or gets an offer and doesn't act on it. Someone dropped from the list has to start over, and "any previous priority considerations must be disregarded." The time already waited is gone.
The deadlines are short. When your parent's name comes up, the state sends a notice, and your parent or you have 30 days to contact the department. After release, the family has 30 days to return the doctor's form (the 3008) and 30 days to file the Medicaid application. Keep the resource center's phone number where you'll see it, make sure they have a number that gets answered, and open every letter from the state the day it arrives.
How to apply
How do I apply for Medicaid long-term care in Florida?
The state's own instructions start with a phone call, not a form. Here's the order.
- Call the Elder Helpline for your county. Citrus and Hernando: 1-800-262-2243 (Elder Options, the Aging and Disability Resource Center in Gainesville). Pasco: 727-217-8111 (Area Agency on Aging of Pasco-Pinellas). Statewide: 1-800-963-5337. Ask for a screening for long-term care services.
- Do the screening by phone. A staff member asks about your parent's health, what they can and can't do, and who helps them. This is the 701S screening, and it produces the priority score. The center is supposed to call within three business days of the referral.
- Wait for a release notice. If the score is low, the state may not send one right away. If it's high, a notice comes when a slot opens. Respond within 30 days.
- Get the doctor's form. Your parent's doctor fills out form 3008, the medical certification. Return it within 30 days.
- Apply for Medicaid with the Department of Children and Families. Online at myflfamilies.com or by phone at 1-866-762-2237. This is the financial test. Have bank statements, income statements, and the deed ready. File within 30 days of release.
- CARES confirms the medical need. This is the Department of Elder Affairs step. Since July 2026 it can use the assessment already done.
- Pick a plan. Once both agencies say yes, your parent chooses a long-term care plan. Choice counselors help at 1-877-711-3662.
If your parent already has regular Florida Medicaid, step 5 is shorter, but the screening and the list still apply.
Which long-term care plans serve Citrus, Hernando and Pasco County?
Florida divides the state into lettered regions. Citrus and Hernando are in Region B. Pasco is in Region C. As of the state's July 2026 enrollment report, these plans had members in our counties:
| Plan | Citrus and Hernando (Region B) | Pasco (Region C) |
|---|---|---|
| Florida Community Care | Yes | Yes |
| Humana | Yes | Yes |
| Simply Healthcare | Yes | Yes |
| Sunshine Health | Yes | Yes |
| UnitedHealthcare | Yes | No |
The plans cover the same list of services. Where they differ is which home care agencies, adult day centers, and assisted living facilities they contract with locally. Before choosing, ask each plan which agencies serve your parent's town. A plan with no personal care agency near Inverness or Brooksville isn't much use there.
Paying a family caregiver
Can a family member get paid to be a caregiver through Florida Medicaid?
Yes, once your parent is enrolled in a long-term care plan and lives at home. The program is called the participant direction option. Under it, your parent becomes the employer. The state's manual says participants "may hire any individual of their choosing to provide their PDO services, including neighbors, family members, or friends."
Five services can be delivered this way: personal care, homemaker, adult companion care, attendant care, and intermittent skilled nursing. For the first three, the worker doesn't need a license or certification. The plan's case manager has to put the service on your parent's care plan first, and the number of paid hours comes from that plan. The pay rate comes from the plan too, and we haven't found a published statewide figure, so ask the plan directly.
Two things to know. If your parent can't manage being an employer, they can name a representative to do it, but that representative can't be the paid worker. And for a caregiver who lives in the home, the manual says "societal norms may be considered for determining paid hours," meaning the plan can decide that some of what a live-in family member does is ordinary family help, not paid work.
Whether a spouse can be the paid worker is something the state's manual doesn't address. It says family members without excluding spouses. Ask the plan before counting on it.
Can caregivers get paid by Medicare?
No. Medicare pays for short-term skilled care at home after an illness or injury, through a certified home health agency, and only while your parent is homebound. Medicare's own site says it doesn't pay for "custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need," and it doesn't pay for homemaker services or 24-hour care. It has no program that pays a family member.
For the long-term, everyday help most families are looking for, Medicaid is the program, not Medicare.
While you wait
What can we do while my parent is on the list?
Florida has three state-funded programs that pay for some of the same help, run by the same Aging and Disability Resource Center you already called. Since July 2026 they share the pre-enrollment list with Medicaid, so the screening you did covers all of them. Ask about each by name.
| Program | Who it's for | What it pays for |
|---|---|---|
| Community Care for the Elderly (CCE) | Age 60 or older, functionally impaired. No Medicaid required. | Adult day care, chore help, companionship, home-delivered meals, home health aide, homemaker, personal care, respite, transportation. A sliding-scale co-payment; none below the federal poverty level. |
| Home Care for the Elderly (HCE) | Age 60 or older, at risk of nursing home placement, living with an adult caregiver, income and assets within Medicaid limits. | A $160-a-month payment to the caregiver, plus special subsidies for incontinence supplies, medications, home changes, and home health aides. |
| Alzheimer's Disease Initiative (ADI) | Age 18 or older with a diagnosis of Alzheimer's or a related dementia. | Respite care: in-home, at a facility, emergency, and extended care up to 30 days. |
These programs have their own funding limits and their own waits. But a rank that's too low for a Medicaid slot this year can still be high enough for a Community Care slot, and $160 a month from Home Care for the Elderly is money a family caregiver can get now. Our care at home page covers what else is available locally.
Is there a PACE program in Citrus, Hernando or Pasco County?
Not one that's taking people yet, as of the state's July 2026 report. PACE, the Program of All-Inclusive Care for the Elderly, is a different way to get Medicaid and Medicare care at home: one organization provides everything, usually built around a day center. It's for people 55 and older who qualify for nursing home care but can live safely at home.
The state lists InnovAge as approved for Hillsborough, Hernando, and Pasco, but its July 2026 report shows no enrollees in Hernando or Pasco. Two more are waiting on federal approval: one for Hillsborough, Hernando, and Pasco, and Hope PACE for Citrus, Levy, and Sumter. If one opens near you, it's worth a look, because PACE has no pre-enrollment list. Ask the Elder Helpline whether anything has changed since this page was reviewed.
Free help in Citrus, Hernando and Pasco County
Who can I talk to about this for free?
Elder Helpline / Aging and Disability Resource Center: the screening, the pre-enrollment list, and the three state programs all start here.
1-800-262-2243 Citrus and Hernando
727-217-8111 Pasco
Florida Senior Legal Helpline: free legal advice by phone for Florida residents 60 and older. Medicaid eligibility and appeals are within what they cover.
1-888-895-7873
Monday to Friday, 9:00 a.m. to 4:30 p.m. There are income limits, but they don't count your savings.
SHINE: free Medicare and Medicaid counseling from trained volunteers. Useful for sorting out what Medicare will and won't cover. See our SHINE page.
1-800-963-5337
Also worth reading
- Medicaid, nursing homes and your house: the payback, the five-year look-back, and which homes are already protected
- How to pay for senior care in Florida: all the options, sorted by income
- Care at home on the Nature Coast: the kinds of help available and who provides them
- Memory care and dementia help: warning signs, the 24-hour helpline, and respite programs
- Legal questions Florida families ask about an aging parent: power of attorney, lady bird deeds, probate and guardianship in one place
Sources
- Florida Statutes section 409.979, eligibility and the pre-enrollment list, as amended by chapter 2026-74, Laws of Florida (effective July 1, 2026); section 409.985(3), nursing facility care defined; section 409.966(2), Medicaid regions; section 409.983(4), initial assessment
- Florida House of Representatives final bill analysis, CS/HB 1121 (March 11, 2026); Florida Senate bill analysis, SB 1630 (2026)
- Agency for Health Care Administration: long-term care services list, who can receive services, screening, wait list release, plan choice, and recipient FAQs; Participant Direction Option Manual (May 2022); Rule 59G-4.193, prioritization ranks; Medicaid Monthly Enrollment Report, July 2026; Monthly PACE Report, July 2026
- Florida Department of Children and Families, ESS Policy Manual Appendix A-9 (July 2026 financial standards) and section 1840.0110 (qualified income trusts)
- Florida Department of Elder Affairs: 2025 Department Overview; Programs and Services Handbook chapter 2 (701S screening and priority ranks); Aging and Disability Resource Center directory; CCE, HCE and ADI program pages
- Medicare.gov, home health services coverage