Many families feel lost when a parent or spouse needs long-term care. You want them to get good care, but the costs can be shocking. In Florida, nursing homes cost around $13,000 per month, while assisted living runs $4,000-$8,000 monthly.
That’s where Medicaid comes in. But here’s what confuses most people: Florida Medicaid covers nursing homes and assisted living differently. This matters a lot when you’re trying to figure out the best care option for your loved one.
Let’s break down how Florida Medicaid works for both types of care so you can make better choices for your family.
The Two Florida Medicaid Programs for Long-Term Care
Florida has two main Medicaid programs that help pay for long-term care:
- Nursing Home Medicaid (ICP): This covers care in nursing homes, also called skilled nursing facilities.
- Home and Community-Based Services (HCBS): This covers care in assisted living facilities or at home.
While these programs share some basic rules, they work very differently when it comes to getting approved and what they pay for.
How Nursing Home Medicaid (ICP) Works in Florida
If your loved one needs a nursing home, here’s what you should know about the ICP Medicaid program:
1. Getting Approved for ICP Medicaid
To qualify, your loved one must:
- Need nursing home level care (based on a medical assessment)
- Have less than $2,000 in countable assets (for a single person in 2025)
- Have a monthly income below $2,901 (in 2025)
The good news: There is no wait list for ICP Medicaid. Once your loved one meets the financial and medical requirements, they can get approved right away.
Most people apply for ICP Medicaid after a hospital stay when their loved one is already in a nursing home for rehabilitation. Once Medicare stops paying (usually after 20-100 days), Medicaid can take over.
2. What ICP Medicaid Pays For
ICP Medicaid covers almost everything at the nursing home:
- Room and board
- Nursing care
- Medication management
- Therapy services
- Personal care
The resident must pay most of their monthly income to the nursing home but gets to keep a small personal needs allowance ($160 per month in 2025).
Most nursing homes in Jacksonville and Northeast Florida accept Medicaid, so finding a facility is usually not hard.
How Assisted Living Medicaid (HCBS) Works in Florida
If your loved one might do well in assisted living, the HCBS Medicaid program works quite differently:
1. Getting Approved for HCBS Medicaid
To qualify, your loved one must:
- Need assistance with daily activities (based on a medical assessment)
- Have less than $2,000 in countable assets (for a single person in 2025)
- Have a monthly income below $2,901 (in 2025)
The big catch: There is a wait list for HCBS Medicaid. Eldersource manages this waitlist for Northeast Florida counties. This wait list can be months or even years long, and there’s no guarantee when your loved one will get to the top of the list. We offer scripting and preparation to our clients.
The wait list gives priority to the frailest applicants. Those with the greatest needs get help first.
2. What HCBS Medicaid Pays For
Here’s the key difference: HCBS Medicaid does NOT pay for everything at an assisted living facility.
Instead, it covers specific care services—such as help with daily activities, medication management, and personal care—up to amounts set by your Medicaid managed care plan. The resident still pays room and board out of their own income (often using the state’s Optional State Supplementation allowance) and covers any costs above what Medicaid pays for care.
Not all assisted living facilities accept Medicaid, so your choices might be more limited.
The “Back Door” Strategy to Get Assisted Living Medicaid
Here’s a helpful tip many families don’t know: There’s a way around the HCBS wait list.
If your loved one:
- Goes to a nursing home
- Gets approved for ICP Medicaid
- Stays in the nursing home for at least 60 days
They can then transfer to assisted living with Medicaid benefits already in place. This is often called the “back door” to assisted living Medicaid.
This strategy works because once someone has ICP Medicaid, they can switch to HCBS Medicaid without going on the wait list.
Asset Protection Strategies for Both Programs
Both Medicaid programs have the same basic financial rules:
- $2,000 asset limit for singles (in 2025)
- $3,000 asset limit for married couples (both applying)
- Up to $157,920 asset allowance for a spouse at home (in 2025)
- 5-year lookback period for gifts and transfers
But this doesn’t mean you must spend everything. Legal planning can help protect assets while qualifying for Medicaid.
Some basic asset protection options include:
- Converting countable assets to exempt assets
- Using special trusts to hold excess income
- Setting up care agreements with family members
- Using spousal transfer strategies
That’s why it’s so important to start planning early. Putting the right legal strategies in place ahead of time can help protect your assets and make sure your loved one qualifies for the Medicaid program that’s the best fit for their needs.
FAQs About Florida Medicaid Long-Term Care
Does Medicare pay for nursing homes or assisted living?
Medicare only pays for short-term rehab in nursing homes (up to 100 days). It doesn’t pay for long-term care in nursing homes or any care in assisted living.
How much money can you keep and still qualify for Medicaid in Florida?
A single person can keep $2,000 in countable assets. A spouse at home can keep up to $157,920 in 2025, plus exempt assets like your home and one car.
Can I give away my money to qualify for Medicaid?
No. Medicaid looks back 5 years at all financial transactions. Gifts can cause penalty periods when Medicaid won’t pay for care.
Do I have to sell my home to get Medicaid?
Not always. Your home is exempt if you plan to return to it or if your spouse, disabled child, or certain other relatives live there.
How long does it take to get approved for Medicaid?
For nursing home Medicaid, approval typically takes 30-90 days. For assisted living Medicaid, you must first get off the wait list, which can take months or years.
Do all nursing homes and assisted living facilities accept Medicaid?
Most nursing homes accept Medicaid. Fewer assisted living facilities do, and they may limit how many Medicaid beds they offer.
How Berg Bryant Elder Law Group Can Help
At Berg Bryant Elder Law Group, we don’t just explain the rules – we help families create plans that work. Our Florida Board Certified Elder Law Attorneys know how to help your loved one get the right care in the right place.
Contact us today for a consultation where we’ll review your eligibility and discuss your options.
Author Bio
Kellen Bryant, Esq.
Founder
Florida Bar Board Certified Elder Law Attorney, Kellen Bryant focuses his law practice on advising and helping caregivers with a particular focus on asset protection and preservation from long-term care costs, creditors, and predators. Kellen Bryant is AV Preeminent® Rated, meaning his attorney peers rated him at the highest level of professional excellence. Kellen Bryant was nominated and selected as a Super Lawyer, Rising Star: 2022.
