Does Medicaid Cover Home Health Care in Florida?

Yes, Florida Medicaid covers home health care, but the program works very differently from Medicare. While Medicare focuses on short-term skilled care for people over 65 or with certain disabilities, Medicaid is a needs-based program that can provide more extensive long-term support, including personal care and aide services that Medicare does not cover. For many Florida families, understanding Medicaid's home health benefits is the key to keeping a loved one safely at home instead of in a nursing facility.

This guide explains what Florida Medicaid covers, which programs provide home health services, who qualifies, and how to apply in 2026. For a direct side-by-side comparison with Medicare, see our Medicare vs Medicaid home health guide.

Medicaid vs. Medicare: A Quick Clarification

Before diving into the details, it is important to distinguish between these two programs. The names sound similar, but they serve different populations and cover different things.

Medicare is a federal health insurance program primarily for Americans aged 65 and older, or younger people with certain disabilities. Medicare covers intermittent skilled care such as nursing visits and therapy sessions, and it pays 100% of covered home health visits with no copay or deductible. However, it does not cover long-term personal care or around-the-clock aide services. Unlike Medicaid, Medicare requires patients to meet specific homebound criteria to qualify for home health benefits. For a full breakdown of Medicare's eligibility rules, see our Medicare home health eligibility guide.

Medicaid is a joint federal and state program that provides health coverage to people with limited income and resources. In Florida, Medicaid is administered by the Agency for Health Care Administration (AHCA) and the Department of Children and Families (DCF). Unlike Medicare, Medicaid can cover extended home health aide services, personal care assistance, and long-term support services that help individuals remain in their homes.

Dual eligibility applies to Floridians who qualify for both programs. An estimated 1.2 million Floridians hold dual-eligible status, meaning they can receive skilled care through Medicare and long-term personal care through Medicaid simultaneously. If you are unsure whether you meet Medicare's requirements, our guide on how to qualify for Medicare home health walks through the four essential criteria.

What Florida Medicaid Covers for Home Health

Florida Medicaid's home health benefits are broader than Medicare's in several important ways. Depending on the specific program and your plan, Medicaid may cover:

• Skilled nursing visits: Registered nurses and licensed practical nurses providing wound care, medication management, injections, catheter care, and health monitoring in your home.
• Home health aide services: Unlike Medicare, which only covers aide services alongside skilled care, Medicaid can authorize standalone aide hours for bathing, dressing, grooming, and mobility assistance. This is often the most valuable Medicaid benefit for families. Learn more about home health aide services.
• Personal care assistance: Help with activities of daily living including toileting, eating, transferring between bed and wheelchair, and light housekeeping directly related to the patient's care.
• Adult day health care: Structured daytime programs at licensed facilities that provide supervision, social activities, meals, and health monitoring while family caregivers work or rest.
• Respite care: Temporary relief for family caregivers, allowing a trained professional to step in for a few hours or days so the primary caregiver can take a break.
• Medical supplies and equipment: Durable medical equipment, incontinence supplies, wound care materials, and other medically necessary items prescribed by a physician.

The exact scope of covered services depends on which Medicaid program you are enrolled in and the managed care plan you select. Not all plans offer every service listed above, so it is important to review your plan's benefits handbook or call your plan's member services line.

Florida Medicaid Programs for Home Health

Florida delivers Medicaid home health services through several distinct programs. Each has its own eligibility criteria and service scope.

Statewide Medicaid Managed Care (SMMC) Long-Term Care

The SMMC Long-Term Care (LTC) program is Florida's primary vehicle for delivering home and community-based services to people who need a nursing-home level of care but prefer to remain at home. Enrollees choose from managed care plans that coordinate their long-term services, including personal care, homemaker services, home health aide hours, adult day care, assistive devices, and home modifications. This program is managed by AHCA and serves as an alternative to nursing facility placement.

Medicaid State Plan Home Health

This is Florida's standard home health benefit available to all Medicaid recipients who have a physician's order for home health services. It covers skilled nursing, home health aide visits, physical therapy, and medical supplies. Unlike the SMMC LTC program, this benefit does not require a nursing-home level of care determination, but services are generally more limited in scope and duration.

PACE (Program of All-Inclusive Care for the Elderly)

PACE serves adults aged 55 and older who meet nursing-home-level-of-care criteria and live in a PACE service area. Florida PACE programs operate in select counties and provide comprehensive medical care, therapies, social services, meals, transportation, and home care through an interdisciplinary team. PACE participants receive all their Medicare and Medicaid benefits through the PACE organization.

Managed Medical Assistance (MMA) Plans

Most Florida Medicaid recipients are enrolled in an MMA plan for their acute medical care. While MMA plans primarily cover doctor visits, hospital stays, prescriptions, and preventive care, they also include a basic home health benefit for skilled nursing and therapy services ordered by a physician. MMA plans coordinate with the SMMC LTC program when a member needs long-term home care services.

Florida Medicaid Eligibility for Home Health

Qualifying for Florida Medicaid involves meeting both financial and, in some cases, medical criteria. The rules differ depending on which program you are applying for.

Income Limits

For 2026, Florida Medicaid income limits for home health-related programs are approximately:

• SSI-related Medicaid (aged, blind, or disabled): Individual monthly income limit of approximately $2,829. Couples have a higher threshold.
• SMMC Long-Term Care: Uses the special income level (SIL) of approximately $2,829 per month for an individual. If your income exceeds this amount, you may still qualify by establishing a Qualified Income Trust (also called a Miller Trust).
• MAGI-based Medicaid: For non-elderly, non-disabled adults, income limits are based on Modified Adjusted Gross Income and are generally lower, around 138% of the federal poverty level.

Asset Limits

Florida Medicaid generally limits countable assets to $2,000 for an individual. Your primary home (up to a certain equity value), one vehicle, personal belongings, and certain other items are typically exempt. Married couples have spousal protections that allow the non-applicant spouse to retain a portion of joint assets.

Medical Eligibility

For the SMMC Long-Term Care program and PACE, you must meet a nursing-home level-of-care requirement. This means a clinical assessment must determine that you need the type and intensity of care that would otherwise be provided in a nursing facility. The Comprehensive Assessment and Review for Long-Term Care Services (CARES) unit within the Department of Elder Affairs conducts these evaluations.

Use our home health cost estimator to understand what care might cost if you do not qualify for Medicaid coverage. For a detailed breakdown of Florida home health pricing by service type and region, see our guide on home health care costs in Florida.

How to Apply for Florida Medicaid

Applying for Florida Medicaid requires gathering documentation and submitting an application through one of several channels.

Application Methods

• Online: The ACCESS Florida portal at myflorida.com/accessflorida allows you to apply, upload documents, and check application status.
• In person: Visit your local Department of Children and Families (DCF) office to apply with the help of a caseworker.
• By phone: Call the DCF Customer Call Center at 1-866-762-2237 for assistance.
• By mail or fax: Download and print the application from the ACCESS Florida website and submit it to your local DCF office.

Documents You Will Need

• Government-issued photo identification
• Social Security number
• Proof of income (Social Security award letters, pay stubs, pension statements)
• Bank and financial account statements
• Proof of Florida residency
• Medical records or physician statements documenting your condition
• Insurance information (including Medicare card, if applicable)

Processing Time

Florida Medicaid applications typically take 45 to 90 days to process. Applications involving aged, blind, or disabled determinations often take longer due to additional medical reviews. You can expedite the process by submitting all required documents with your initial application. If approved, your coverage may be retroactive up to three months before your application date if you were eligible during that period.

Dual Eligibility: Medicare + Medicaid Together

For Floridians who qualify for both Medicare and Medicaid, the two programs work together to provide a broader range of home health services than either program offers alone.

Medicare covers the skilled, intermittent services: nursing visits, physical therapy, occupational therapy, and speech therapy. These are short-term, medically focused services tied to a specific plan of care.

Medicaid fills the gaps that Medicare leaves. This includes extended home health aide hours for personal care, adult day programs, respite care for family caregivers, and long-term maintenance services that keep individuals functioning safely at home.

Florida offers Dual-Eligible Special Needs Plans (D-SNPs) that coordinate Medicare and Medicaid benefits under a single managed care plan. D-SNPs simplify the process by assigning one care coordinator who manages both sets of benefits, reducing confusion and ensuring that services do not overlap or fall through the cracks. Major D-SNP plans operating in Florida include Humana, Aetna, UnitedHealthcare, and Sunshine Health.

If you or a family member hold dual-eligible status, explore our directory to compare Medicare-certified agencies in cities with large dual-eligible populations, including Miami, Hialeah, Tampa, Orlando, Jacksonville, and Fort Lauderdale, where many residents benefit from coordinated Medicare and Medicaid home health services.

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