When a loved one needs ongoing care but you want to avoid a nursing home, Florida offers a program that might help. The Statewide Medicaid Managed Care Long-Term Care Program (SMMC LTC) helps thousands of Florida seniors receive care at home, in assisted living, or in a nursing facility if needed.
But this program can be tricky to use. Many families don’t know it exists or get confused by the rules. This guide breaks down how SMMC LTC works, who can get it, and how to apply.
What Is Florida’s SMMC Long-Term Care Program?
The Statewide Medicaid Managed Care Long-Term Care Program provides care services to Florida seniors and adults with disabilities who need significant help with daily activities. This program aims to:
- Help people stay in their homes or communities instead of nursing homes
- Provide needed care services based on each person’s situation
- Give people some choice in who provides their care
The program works through health plans (like insurance companies) that contract with Florida Medicaid. When approved for the program, you choose a plan available in your region, and that plan arranges and pays for your care services.
The Florida Agency for Health Care Administration oversees these plans to make sure they follow the rules and provide good care.
What Services Does SMMC LTC Cover?
The program offers many services that can help seniors stay at home or in their community. Not everyone gets all services – what you receive depends on your needs.
Services that might be covered include:
- Personal care assistance – Help with bathing, dressing, toileting, and other daily tasks
- Homemaker services – Help with housework, laundry, and meal preparation
- Adult day care – Supervised activities and care during the day
- Home-delivered meals – Nutritious meals brought to your home
- Home modifications – Changes to make your home safer, like grab bars or ramps
- Medical equipment – Things like wheelchairs, hospital beds, or shower chairs
- Personal emergency response systems – A button you can press to call for help
- Respite care – Short-term care to give your regular caregiver a break
- Assisted living facility services – Care in a residential setting (but not room and board)
- Nursing home care – Full-time care in a nursing facility if needed
Some services can be “participant-directed,” meaning you can choose who provides them. This might even include hiring family members to provide some types of care.
The Florida Department of Elder Affairs works with the Agency for Health Care Administration to coordinate these services for seniors.
Who Can Get SMMC LTC Services?
To qualify for this program, you must meet both medical and financial requirements.
1. Medical Requirements
You must:
- Be at least 65 years old (or 18+ and disabled)
- Need the level of care typically provided in a nursing home
- Live in Florida
The “nursing home level of care” doesn’t mean you need to be in a nursing home. It means you need significant help with everyday activities like bathing, dressing, eating, or moving around. Or you might need constant supervision due to dementia or other cognitive issues.
A state assessment team determines if you meet this level of care need through an in-person evaluation.
2. Financial Requirements
In 2025, the limits are:
Income Limits:
- Individual: Up to $2,901 per month
- Married couple (both applying): Up to $5,802 per month
Asset Limits:
- Individual: $2,000 or less
- Married couple (both applying): $3,000 or less
- Married (only one spouse applying): The applicant can have up to $2,000, while the non-applicant spouse can keep up to $157,920
Some assets don’t count toward this limit, including:
- Your home (if you live there or plan to return, and if it’s worth less than $730,000)
- One car
- Personal belongings and household items
- Burial plots and prepaid funeral plans
The Berg Bryant Elder Law Group can help families figure out if they qualify financially and suggest legal ways to protect assets while still qualifying for Medicaid.
The SMMC LTC Waitlist Challenge
One major challenge with this program is the waitlist. Unlike nursing home Medicaid, which has no waitlist, SMMC LTC has limited spots. When all spots are filled, new applicants go on a waitlist.
The waitlist isn’t first-come, first-served. Instead, people are ranked by how urgent their care needs are. Those with the most urgent needs get help first.
The Florida Department of Elder Affairs manages the SMMC LTC waitlist through the local Aging & Disability Resource Centers (ADRCs).
In Northeast Florida, Eldersource manages this process. Our office assists by offering scripting for you to provide a clearer explanation of your needs to improve your positioning on the list, and avoid common communication errors when describing your needs to them.
CARES performs the medical level-of-care assessment, but waitlist placement and releases are handled by DOEA/ADRCs based on frailty scores and available slots.
How to Apply for SMMC LTC
The application process has several steps:
- Initial Screening: Contact your local Aging and Disability Resource Center (ADRC) or call the Elder Helpline. They’ll do a phone screening to place you on the waitlist.
- Comprehensive Assessment: Once you’re selected from the waitlist, a state assessment team will visit to evaluate care needs.
- Medicaid Application: If you’re not already on Medicaid, you’ll need to apply through the Department of Children and Families. This can be done online through the ACCESS Florida portal.
- Plan Selection: If approved, you’ll choose a health plan from those available in your region.
- Care Planning: Your chosen plan will assign a case manager who will work with you to create a care plan and arrange services.
The entire process can take several months, so it’s best to start early. If your application is denied, you have the right to appeal the decision.
How an Elder Law Attorney Can Help
The SMMC LTC program has complex rules about income, assets, and eligibility. Many families find it helpful to work with an elder law attorney who knows these rules well.
An attorney can help with:
- Determining if you qualify for the program
- Creating legal strategies to protect assets while qualifying for Medicaid
- Preparing and reviewing application materials
- Appealing denied applications
- Finding ways to get services faster, like through the nursing home transition strategy
At Berg Bryant Elder Law Group, we work with families throughout Northeast Florida to help them access the care they need while protecting their life savings.
FAQs About Florida’s SMMC LTC Program
Does SMMC LTC cover room and board in assisted living?
No. The program covers care services in assisted living, but not room and board costs. The resident must pay these costs from their own income or other resources.
Can my family member be paid to take care of me through this program?
Yes, in many cases. The Consumer-Directed Care option lets you hire family members, including adult children and sometimes spouses, to provide certain services like personal care.
Is there an age requirement for SMMC LTC?
You must be at least 65 years old, or 18+ and disabled as determined by the Social Security Administration.
Can I get SMMC LTC if I own my home?
Yes. Your home is generally not counted as an asset if you live there or intend to return, as long as your equity interest is less than $730,000 (in 2025). If your spouse lives in the home, there’s no equity limit.
What happens if I’m denied SMMC LTC?
You have the right to appeal the decision. The denial letter will explain how to request a fair hearing.
How long is the waitlist for SMMC LTC?
It varies greatly depending on care needs and available funding. Those with the most urgent needs get priority. Some people wait months, while others may wait years.
Getting Help With SMMC LTC
If your loved one needs long-term care in Florida, Berg Bryant Elder Law Group can help you explore all options, including SMMC LTC and other programs that might meet your needs.
Our Florida Board Certified Elder Law Attorneys work with families throughout Northeast Florida, including Jacksonville, Orange Park, St. Augustine, and surrounding areas.
Don’t try to figure out these complicated Medicaid rules by yourself. Call our office to schedule a consultation. During this meeting, we can review your specific situation, discuss eligibility requirements, and create a personalized plan to help your loved one qualify for benefits while protecting family assets.
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.
