FloridaHealthFinder | Facility/Provider (2024)

FAQs

How do nursing homes get paid in Florida? ›

Medicaid pays for both the nursing home and assisted living/in-home care but the rules differ in subtle but important ways. If your elder wants Medicaid for the assisted living facility or for in-home care we have more on Assisted Living Medicaid in Florida to assist you.

Florida seniors must have limited income and assets, and a medical need to qualify for Medicaid long-term care. In 2024, a single Nursing Home Medicaid applicant must meet the following criteria: 1) Income under $2,829 / month 2) Assets under $2,000 3) Require a Nursing Home Level of Care.

You should discuss your needs and options for long-term care with many trusted people including your primary care physician. A doctor must authorize a nursing home admission and sign the care plan.

In Florida, the Agency for Health Care Administration (Agency) is responsible for Medicaid. The Agency successfully completed the implementation of the Statewide Medicaid Managed Care (SMMC) program in 2014.

Assisted Living / Memory Care

The average cost of assisted living in Florida, according to Genworth's 2023 Cost of Care Survey, is $4,750 per month. However, the range of costs across the state varies greatly, with an average low of $2,295 / month and an average high of $8,055 / month.

Why Florida Utilizes a “Look Back” Period. Generally, in order to receive Medicaid Long-Term Care, the applicant must not have “given away” assets within five years of applying for Medicaid benefits. This five year window is known as the “look back” period.

Florida does not allow an applicant to own countable assets worth more than $2,000. However, if the person's income is under $856 a month, then the person cannot own assets more than $5,000.00. The Well Spouse can retain up to $148,620.00 (Jan 2023) in individual or joint assets in addition to exempt assets.

Families can expect to spend $300+ per day or more than $8,000 per month on nursing home care in Florida for a private or semi-private room. These are just the costs of care right now (June 2021). Keep in mind that nursing home costs increase every year. In Florida, prices increase 10-11% annually (on average).

Medicaid reimburses for 365 days of all-inclusive nursing facility services, per year, per recipient when the following occurs: Services are prescribed by a physician licensed in the state of Florida. Recipient occupies a Medicaid-certified bed.

Aging adults without money to support them through the rest of their lives can stay in a nursing home for up to 100 days—and Medicaid will cover the cost for this brief period. Seniors who reside in an assisted living facility and run out of funds will be evicted.

Are family members responsible for nursing home bills in Florida? ›

Florida does not currently have a filial responsibility statute, but that may change as Florida retirees, many of whom are living on Social Security income alone, age and require greater care. The best defense agains such laws is Elder Law plannning. If your parents aren't milliionaires, then early advice is essential.

Local government agencies often offer programs specifically designed to assist elderly individuals without caregivers. These programs may include financial aid, home-delivered meals, transportation services, and access to healthcare resources.

MIAMI – Oct. 18, 2022 – Molina Healthcare of Florida (“Molina”) is the top-rated Medicaid plan in Florida, with a rating of 4 out of 5 stars in the National Committee for Quality Assurance's (NCQA) Medicaid Health Plan Ratings 2022.

Even if the applicant never returns to the home, the homestead is protected and will never be made a countable asset for Medicaid purposes (unless rented!). Upon the applicant's death, the homestead is protected from creditors, including the state of Florida, if it descends to your heirs at law (i.e., your family).

Florida has allowed individuals to remain on Medicaid throughout the PHE even though their household situation may have changed. As a result of federal legislative changes in the Consolidated Appropriations Act, 2023, the continuous coverage provision will end on March 31, 2023.

Florida provides assisted living facility and nursing facility care, homemaker/chore services, and medical equipment to those who qualify through long-term care managed care plans. Florida Medicaid provides services to eligible residents through several programs: Medicaid for nursing home stays.

Medicaid is the key to getting paid for family caregiving in many cases. Through Medicaid long-term care waivers, relatives can be hired as caregivers. Florida has several Medicaid waiver programs that allow in-home care services, including care by family members.