Long-Term Care Options in Florida
What each care setting covers, what it costs, and how Florida Medicaid treats it.
Picking the right care setting is usually the first decision in a Florida long-term care plan, and it drives everything after it — which Medicaid program applies, what the income and asset tests look like, and whether coverage is guaranteed or subject to a waitlist. The eight settings below cover the range from fully independent living through skilled nursing care, and what Florida Medicaid does and does not pay for each.
Independent Living
Independent living communities — sometimes called 55+, senior living, or retirement communities — are designed for older adults who are largely self-sufficient.
They offer apartment or cottage-style housing with amenities such as:
- Dining
- Housekeeping
- Transportation
- Social activities
However, no personal care or medical services are provided.
Residents pay privately (monthly fees or entrance fees), and Medicaid does not cover independent living.
Assisted Living
Florida uses the term Assisted Living Facility (ALF) — there is no separate “Personal Care Home” license category as in Pennsylvania. ALFs provide room, board, and personal care services such as help with:
- Bathing
- Dressing
- Medication management
Costs average over $5,600 per month as of 2026. Florida ALFs range widely in the level of care they can provide, depending on their specific license type and any extended congregate care or limited mental health endorsements they may hold.
Florida Medicaid can cover certain personal care services in an ALF through the Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) program, but does not pay room and board. Coverage of services varies by the specific managed care plan chosen.
Importantly, the SMMC-LTC program is not an entitlement — there is a waitlist, and access is not guaranteed. A common strategy is to establish Medicaid eligibility through a nursing home placement for 60 days or more first and then transition to an ALF setting.
Memory Care
“Memory care” is provided within ALFs that have obtained an Extended Congregate Care (ECC) license or similar endorsement, or within dedicated secured dementia units of an ALF.
Florida ALFs offering memory care must have:
- Staff trained in dementia care
- Secured environments
- Programming tailored to residents with Alzheimer's and related dementias
Florida Medicaid may cover personal care services in a memory care ALF through SMMC-LTC, subject to waitlist availability and plan contracts. Room and board is not covered by Medicaid.
Nursing Home Care
Florida nursing homes provide 24-hour skilled medical and nursing care for individuals requiring a Nursing Facility Level of Care.
Florida Nursing Home Medicaid (known as ICP Medicaid or Institutional Care Program) is an entitlement — all individuals who meet functional and financial eligibility requirements are guaranteed coverage without a wait.
The nursing home receives a daily Medicaid rate, and the resident contributes nearly all of their monthly income (less a small personal needs allowance) toward the cost of care.
At Home Care
Florida’s Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) program replaced all prior HCBS waivers, including the former Alzheimer’s Disease Initiative Waiver and Nursing Home Diversion Waiver.
Through private managed care organizations, SMMC-LTC pays for home and community-based services to help eligible individuals avoid nursing home placement, including:
- Personal care
- Adult day health care
- Meal delivery
- Respite care
- Certain services in ALFs
Participants must require a Nursing Facility Level of Care and meet financial eligibility.
SMMC-LTC is not an entitlement. Enrollment is capped (approximately 116,200 slots as of 2025) and a waitlist exists, managed by the Department of Elder Affairs and the Aging and Disability Resource Centers. Waitlist priority is based on medical need and frailty.
At Home Care – PACE - Program of All-Inclusive Care for the Elderly
Florida participates in the federal PACE program — the same program that Pennsylvania calls LIFE. PACE integrates all Medicare and Medicaid services into a single managed care program for individuals age 55 and older who require a Nursing Facility Level of Care but wish to remain in the community.
Services are coordinated through a PACE center and include:
- Primary care
- Home care
- Adult day services
- Transportation
- Prescriptions
- Dental and vision
PACE is available in certain areas of Florida.
Florida Medicaid covers PACE for eligible individuals. Like Pennsylvania’s LIFE program, PACE is not a waiver — it operates under a separate federal PACE authority.
CCRC / Life Plan Community
A Continuing Care Retirement Community (CCRC) — also referred to as a Life Plan Community — is a campus-based senior living community designed to provide multiple levels of care in a single location. The central appeal of a CCRC is continuity: as a resident’s health and care needs change over the years, they can transition between levels of care without leaving the community they have come to call home.
CCRCs in Florida may offer some or all of the following levels of care on a single campus:
- Independent living — for active, self-sufficient residents seeking a maintenance-free lifestyle and social community
- Assisted living — for residents who need help with activities of daily living such as bathing, dressing, or medication management
- Memory care — a specialized, secured environment for residents living with Alzheimer's disease or other forms of dementia
- Skilled nursing / nursing home care — for residents requiring 24-hour licensed medical and nursing services
Not every CCRC in Florida offers all of these levels. Some communities provide independent and assisted living but do not have a skilled nursing facility on campus. Others may include memory care but send residents to outside facilities when their medical needs escalate to a nursing home level of care. Before selecting a CCRC, families should ask directly which care levels are available on-site, what the transition process looks like when care needs increase, and what contractual obligations govern that transition.
Regulation
CCRCs in Florida are regulated by the Florida Office of Insurance Regulation under Chapter 651 of the Florida Statutes, which governs Continuing Care Contracts and requires CCRCs to meet financial disclosure, reserve fund, and reporting requirements to protect residents.
Cost & Contracts
Entry into a Florida CCRC typically requires a substantial entrance fee — which can range widely depending on the community and contract type — along with ongoing monthly fees. Contract structures vary and may include life care agreements (which bundle future nursing care costs), modified contracts, or fee-for-service arrangements. Prospective residents and their families should have any CCRC contract reviewed by an attorney before signing, given the significant financial commitment involved.
Florida Medicaid does not cover CCRC entrance fees or room and board costs. However, if a CCRC has a Medicaid-certified skilled nursing facility on campus, a resident who has exhausted their private funds and meets Medicaid eligibility requirements may qualify for nursing home Medicaid coverage in that setting — but not all CCRCs participate in Medicaid, and families should confirm this in advance.
Medicaid Coverage
The following table summarizes Florida Medicaid coverage for each long-term care setting.
| Setting | Florida Medicaid Coverage |
|---|---|
| Independent Living | ❌ Not covered |
| Assisted Living Facility (ALF) | ⚠️ Personal care services only — room and board not covered; waitlist likely |
| Memory Care (secured dementia unit within ALF) | ⚠️ Personal care services only — room and board not covered; waitlist likely |
| Nursing Home | ✅ Covered (entitlement — no waitlist) |
| Home Care — SMMC Long-Term Care (LTC) Program | ✅ Covered (not an entitlement — waitlist may apply) |
| PACE Program | ✅ Covered (not an entitlement — geographic availability varies) |
| Continuing Care Retirement Community (CCRC) | ⚠️ Only if CCRC has a Medicaid-certified skilled nursing unit on campus |
Assisted living specifically is covered in more depth in the Florida assisted living Medicaid guide. For nursing home eligibility and the mistakes that most often delay or deny an application, see Florida Medicaid eligibility, or return to the Resources hub.
Frequently asked questions
Does Florida Medicaid pay for assisted living?
Florida Medicaid can cover certain personal care services in an assisted living facility through the Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) program, but it does not pay room and board, and SMMC-LTC has a waitlist rather than guaranteed enrollment.
Is Florida nursing home Medicaid guaranteed once someone qualifies?
Yes. Florida Nursing Home Medicaid (ICP) is an entitlement: everyone who meets the functional and financial requirements is covered without a waitlist, unlike the SMMC-LTC home and assisted living program.
What is PACE and does Florida Medicaid cover it?
PACE (Program of All-Inclusive Care for the Elderly) integrates Medicare and Medicaid services for people 55 or older who need a nursing-facility level of care but want to stay in the community. Florida Medicaid covers PACE for eligible individuals in the areas where it is available.
Does Medicaid cover a CCRC (Continuing Care Retirement Community)?
Florida Medicaid does not cover a CCRC's entrance fee or room and board. If the CCRC has a Medicaid-certified skilled nursing facility on campus, a resident who has spent down and qualifies may get nursing home Medicaid coverage in that unit — but not every CCRC participates, so this should be confirmed before signing a contract.