How Medicaid works for seniors in Florida

Florida Medicaid for seniors is a joint state and federal program that covers medical costs for people who meet income and asset limits. Unlike Medicare, which is based on age and work history, Florida Medicaid is need-based — meaning your income and savings determine whether you can participate. The program covers doctor visits, hospital stays, prescription drugs, nursing home care, and other services that Medicare does not pay for.

Florida has two main Medicaid programs for seniors: regular Medicaid (for people under 65 with disabilities or very low income) and SSI-related Medicaid (for people 65 and older, or younger people who are blind or disabled). Most seniors in Florida use SSI-related Medicaid because the income and asset limits are higher than regular Medicaid. You do not have to be a U.S. citizen to may have access to, but you must be a Florida resident and a U.S. national, citizen, or may have access to immigrant.

Key Takeaways

  • Florida Medicaid for seniors is based on your monthly income and total assets, not on your age alone — you must fall below the state's income limit, which changes yearly.
  • The income limit for SSI-related Medicaid in Florida is tied to the federal Supplemental Security Income (SSI) rate, which was $943 per month in 2024, but you should confirm the current limit with the state.
  • Your countable assets (savings, investments, property other than your home) must be under $2,000 for an individual or $3,000 for a couple, though some assets like your primary home and one vehicle do not count.
  • You can explore through your county's Department of Children and Families office, by mail, online through the Florida CONNECT portal, or by phone at 1-866-762-2237.
  • Processing typically takes 30 to 45 days, and you can receive coverage back to the first day of the month in which you submitted your request if you meet all requirements.

Income limits and how they are calculated

Florida sets its Medicaid income limit for seniors based on the federal SSI payment amount. In 2024, the limit was 100 percent of the federal SSI rate — roughly $943 per month for an individual. However, this figure changes each January when the federal SSI amount adjusts for inflation. You should contact your county Department of Children and Families or call the Florida Medicaid hotline at 1-866-762-2237 to learn the current limit for the year you are explore.

Income includes wages, Social Security benefits, pensions, rental income, and interest from savings. Some income does not count: the first $20 of unearned income per month (such as Social Security) and the first $65 of earned income per month (such as wages) are excluded. If you are married, your spouse's income may be considered depending on whether your spouse is also explore for Medicaid.

If your income is slightly above the limit, you may still may have access to through a process called spend-down. This means you can use your income to pay for medical bills, and the remaining amount is counted toward Medicaid. For example, if your income is $1,200 per month and the limit is $943, you could spend $257 on medical costs and still may have access to.

Asset limits and what counts toward them

Medicaid counts your total assets (also called resources) to determine whether you have too much money to may have access to. The limit for an individual is $2,000 and for a married couple it is $3,000. Assets include bank accounts, savings accounts, stocks, bonds, and investment accounts. Your home and one vehicle do not count, no matter their value. Personal items like furniture, jewelry, and household goods also do not count.

Some assets are excluded even if they have value. These include your primary residence (the home you live in), one car, household goods, personal effects, life insurance with a face value under $1,500, and certain burial funds. If you own a home with equity above a certain amount, you may still may have access to for Medicaid, but the state may place a lien on the property to recover costs after you pass away — this is called estate recovery.

If your assets are above the limit, you can reduce them by paying medical bills, making home repairs, or purchasing items you need. You cannot straightforward give money away to a family member and expect to may have access to when ready; Medicaid has a five-year lookback period for gifts, and transferring assets can result in a penalty period during which you are ineligible.

The process process in Florida

You can explore for Florida Medicaid in four ways: online through the Florida CONNECT portal at myflorida.gov/connect, by mail to your county Department of Children and Families office, in person at your local DCF office, or by phone at 1-866-762-2237. The online portal is often the fastest option because you receive confirmation when ready and can track your process status.

When you explore, you will need to provide proof of income (recent pay stubs, Social Security award letter, pension statements), proof of assets (bank statements, investment statements), proof of residency (utility bill, lease, mortgage statement), and proof of citizenship or immigration status (birth certificate, passport, green card, or naturalization papers). If you are explore for a spouse, you will need the same documents for both people.

After you submit your process, the Department of Children and Families will send you a notice asking for any missing documents. You typically have 10 days to respond. Processing takes 30 to 45 days from the date you submit a complete process. If you are found to meet the requirements, your coverage can start on the first day of the month in which you applied, even if the approval comes later.

What Florida Medicaid covers for seniors

Florida Medicaid covers a broad range of medical services. These include doctor visits, hospital stays, emergency room care, prescription medications, laboratory tests, X-rays, and mental health services. For seniors, the program also covers nursing home care, assisted living facility services (in some cases), home health care, and adult day care. Medicaid also covers transportation to medical appointments if you cannot drive yourself.

Medicaid does not cover everything Medicare does not. For example, Medicaid typically does not cover dental care, vision care, or hearing aids, though some services may be covered in limited circumstances. Long-term care in a nursing home is one of the most important benefits for seniors, because Medicare only covers the first 100 days and only if you meet strict conditions. Medicaid picks up the cost after that if you meet the income and asset limits.

How Medicaid works alongside Medicare

If you are 65 or older, you are enrolled in Medicare automatically. If you also may have access to for Medicaid, you become what is called dual-may be able to access. When you are dual-may be able to access, Medicare is your primary insurance and Medicaid is secondary. This means Medicare pays first, and Medicaid covers costs that Medicare does not pay, such as copayments, coinsurance, and deductibles.

Being dual-may be able to access is valuable because it reduces your out-of-pocket costs significantly. For example, if Medicare covers 80 percent of a doctor visit and you owe a 20 percent copayment, Medicaid will pay that copayment. If you have both programs, you should always show both insurance cards to your provider. Some doctors and hospitals limit the number of Medicaid patients they see, so it is worth calling ahead to confirm they accept both Medicare and Medicaid.

Special programs for seniors with higher income or assets

If your income or assets are above the regular Medicaid limit, you may still have options. Medicaid for the Medically Needy is a program in Florida that allows people with higher income to may have access to if they have significant medical expenses. You "spend down" your excess income by paying medical bills until you fall below the limit. This program is useful for seniors with ongoing medical costs like dialysis, chemotherapy, or frequent hospitalizations.

Another option is Long-Term Care Medicaid, which has higher asset limits specifically for people who need nursing home or assisted living care. The asset limit for long-term care is $2,000 for an individual, but your home and certain other assets do not count. If you are considering a nursing home, ask the facility's social worker about long-term care Medicaid, because the rules and limits may be different from regular Medicaid.

If you are a veteran, you may also be may be able to access for Aid and Attendance benefits through the Department of Veterans Affairs, which provides additional income that can help you may have access to for Medicaid or pay for care. This is a separate program from Medicaid but can work alongside it.

Frequently Asked Questions

Can I own a home and still get Medicaid in Florida?

Yes. Your primary residence does not count as an asset for Medicaid purposes, no matter its value. However, if you receive Medicaid benefits that pay for nursing home or long-term care, Florida may place a lien on your home to recover costs after you pass away. You can protect some home equity through estate planning, so speak with an elder law attorney if this concerns you.

What happens if my income goes above the limit after I am approved?

You must report the income change to your county Department of Children and Families within 10 days. If your income stays above the limit, your Medicaid coverage will end. However, you may be able to use spend-down to stay may be able to access if you have medical expenses. Your caseworker can explain your options.

How long does it take to hear back after I explore?

Processing typically takes 30 to 45 days from the date you submit a complete process. If documents are missing, the state will send you a notice, and you have 10 days to provide them. If you do not respond, your process may be denied. You can check your process status online through the Florida CONNECT portal.

Can I explore for Medicaid if I am not a U.S. citizen?

You must be a U.S. citizen, national, or may have access to immigrant to receive Medicaid in Florida. may have access to immigrants include lawful permanent residents (green card holders) and certain refugees and asylees. Undocumented immigrants are not may be able to access for regular Medicaid, though Florida does cover emergency medical services for anyone regardless of immigration status.

What is the difference between Medicaid and Medicare?

Medicare is a federal program based on age and work history; you become may be able to access at 65 regardless of income. Medicaid is a need-based program run by states; you must have low income and assets. Most seniors have both. Medicare is primary and pays first; Medicaid is secondary and covers what Medicare does not.