Florida Medicaid Income Limits 2026: Eligibility Guide for Seniors

The Florida Medicaid income limit is not one number. For long-term care, a single applicant's gross monthly income cannot exceed $2,982 in 2026 (300 percent of the SSI Federal Benefit Rate), but a Florida senior who needs help with prescriptions, a married couple with one spouse entering a nursing home, and a retiree filling Medicare's gaps each face a different income and asset test under a different pathway.1

Florida Medicaid runs at least six separate eligibility pathways for seniors and adults with disabilities, and the rules for income, assets, the home, and a spouse's income change in each one. A senior who looks over the limit under one pathway can qualify under another. This guide walks through every pathway a family caregiver is likely to meet in 2026, the Florida Institutional Care Program (ICP), the Statewide Medicaid Managed Care (SMMC) Long-Term Care waiver, MEDS-AD (Regular Medicaid for the Aged and Disabled), the Medically Needy share-of-cost program, and the three Medicare Savings Programs, with the 2026 dollars, the asset rules, and the spousal protections.

In This Guide

• Key Takeaways
• Six Pathways, Six Different Limits
• Institutional Care Program (ICP)
• SMMC Long-Term Care Waiver
• MEDS-AD for the Aged and Disabled
• Under 65 and Not Disabled? The Coverage Gap
• Medically Needy (Share of Cost)
• Medicare Savings Programs
• The QIT (Miller Trust)
• Spousal Protections: CSRA and MMMNA
• The Five-Year Look-Back
• Where to Get Help
• Frequently Asked Questions
• Learn More

The Florida Medicaid Income Limit Is Six Different Limits

The most important thing to understand about Florida Medicaid is that "income limit" is the wrong question. The right question is which Florida Medicaid program am I applying for, because each program runs its own income and asset test.

Here are the six pathways most Florida seniors and families will encounter, with the 2026 limits side by side.1

The Medicare Savings Program brackets above are tied to the 2026 Federal Poverty Level: 100 percent of the FPL is about $1,330/month for one person and $1,803/month for two, and the QMB/SLMB/QI cutoffs are 100, 120, and 135 percent of that figure (plus the federal $20 general income disregard that comes from the SSI rules, not from Florida). The MSP resource limit is $9,950 for an individual and $14,910 for a couple. Those are the federal standards rather than absolute cutoffs, and SSA instructs staff to encourage people whose income or resources look somewhat higher to apply anyway.6,4

If your numbers are above one limit, scroll down to the next pathway. There is a strong chance one of them fits.

Pathway 1: The Institutional Care Program (ICP)

ICP is full-benefit Medicaid for Florida seniors and adults with disabilities who are living in a Florida-licensed skilled nursing facility and who meet nursing-facility level of care. ICP covers the resident's full nursing-home cost, room, board, nursing care, therapy, prescriptions, minus their patient-responsibility share. Do not wait some qualifying number of months in the facility before applying; the financial application (DCF) and the level-of-care assessment (CARES) both start as soon as the need exists.1,5

Unlike the SMMC Long-Term Care waiver, which has a frailty-ranked waitlist, ICP is an entitlement. As long as you meet the financial and medical level-of-care tests, the program must enroll you. The home-and-community waiver makes enrollment offers subject to the availability of funds and runs a waitlist; the institutional ICP pathway has no waitlist, and the waitlist rule expressly does not apply to ICP applicants or to ICP recipients already living in nursing facilities.7

2026 ICP financial test:1

• Single applicant income: $2,982/month (300 percent of the federal SSI Federal Benefit Rate, which is $994/month in 2026).1
• Single applicant assets: $2,000 in countable resources. DCF's own chapter states the limit as "$2,000 for an individual ($3,000 for eligible couple) or $5,000 if the individual's income is within the MEDS-AD limit ($6,000 for eligible couple)."5
• Married, both applying: the cap is applied to each spouse's own gross income separately, at $2,982/month each, not to a $5,964 pooled total. A couple whose incomes are uneven can have one spouse pass and the other need a QIT. Countable assets are $3,000 for an eligible couple.5
• Married, one applying: the applicant's income only counts toward the $2,982 cap; the applicant's countable assets are capped at $2,000; the community spouse is protected by the CSRA and MMMNA (see below).

Read "countable" before you conclude anything from $2,000. This is the single most common way a Florida family talks itself out of an application it would have won. The same DCF asset chapter that sets the $2,000 figure excludes the two things most households own: "Home property is excluded as an asset, regardless of its value, if it is the individual's principal place of residence. Only one residence can be excluded under this provision," and "One automobile, regardless of value or use, is excluded as an asset." DCF also states that "Home equity is not an asset test," meaning the home-equity standard further down this page is a separate eligibility test rather than part of the $2,000. So a Florida homeowner with a car is not over the ICP asset limit on account of the house and the car. Where a spouse stays in the community, the Community Spouse Resource Allowance is subtracted from the couple's countable assets before the applicant is measured against the $2,000.5

2026 ICP medical (level-of-care) test: Florida calls this the medical eligibility determination, not a functional one. It is a nursing-facility level-of-care finding made by the Florida Department of Elder Affairs (DOEA) Comprehensive Assessment and Review for Long-Term Care Services (CARES) program through a face-to-face assessment. For ICP applicants the assessment happens immediately rather than after a waitlist release.2

What patient responsibility means in ICP. Once approved, the resident pays nearly all of their monthly income to the nursing facility as the patient-responsibility share, keeping only:

• A $160/month Personal Needs Allowance (PNA) for personal items. This is the first of four deductions, not the only one.8
• A diversion to the community spouse up to the MMMNA, or a family-member or dependent's allowance, if applicable.
• Health-insurance premiums (Medicare Part B and any supplemental coverage), along with deductibles, coinsurance, and other uncovered medical expenses.

What is left after those deductions is the patient responsibility, the share of the resident's own income applied to the cost of care; Medicaid pays the balance of the facility's Medicaid rate.5

The $160 is a floor for some residents, not a ceiling. DCF's manual protects three further amounts on top of it, and each is easy to miss. A resident with therapeutic wages keeps half of their gross therapeutic wages, up to $111, in addition to the $160. A resident under a court-ordered child-support obligation gets an additional PNA equal to the court-ordered amount, again in addition to the $160. And a single veteran or surviving spouse in a nursing home who receives the $90 VA pension keeps that $90 too: it is disregarded as income in both the eligibility and the patient-responsibility computations, and the resident is still entitled to the $160 PNA. If a facility's math leaves a veteran with $160 flat, ask DCF to check it.2

Pathway 2: The SMMC Long-Term Care (LTC) Waiver

The SMMC LTC waiver pays for home and community-based services for Florida seniors and adults with disabilities who need nursing-facility level of care but want to stay at home (or in an assisted living facility, adult family care home, or adult day health center) instead. To be eligible you must be a Medicaid recipient who is 65 or older, or 18 or older and eligible for Medicaid by reason of a disability, and CARES must determine that you require nursing facility care as defined in F.S. 409.985(3). One alternative route sits in the same statute and is worth knowing if it applies to your family: hospital level of care qualifies instead, for individuals diagnosed with cystic fibrosis.7

Once you are enrolled, services come from a contracted long-term care managed care plan. The Department of Elder Affairs publishes a 26-service array that every contracted plan must provide at a minimum, including personal care, attendant care, homemaker, adult companion, home-delivered meals, home accessibility adaptation, respite care, a personal emergency response system, adult day health care, assisted living facility services, and nursing facility care. Read that list as a floor rather than a ceiling: a plan may cover more, so a service missing from it is not automatically unavailable from a given plan. Ask the plan.9

The financial test is identical to ICP: $2,982/month income, $2,000 in countable assets with the home and one car excluded, full CSRA/MMMNA protection for the community spouse.1

The medical level-of-care test is also the same: a nursing-facility level-of-care determination by CARES.

The critical difference is structural: the SMMC Long-Term Care waiver is not an entitlement. Enrollment offers are made subject to the availability of funds, and before making them AHCA and the Department of Elderly Affairs must determine that sufficient funds exist to support additional enrollment. DOEA maintains a statewide waitlist, and a priority score sets the order in which people are released from it. Release is frailty-driven, but waiting time is the tie-breaker: where capacity is limited among people with identical priority scores, the person with the oldest date of placement on the list gets priority. Screening is done by certified aging resource center staff, and you must live in an LTC program waiver service area.7

A low priority rank does not put you low on the list. It keeps you off the list entirely. The rule sorts scores into eight ranks across a low range and a high range: Rank 1 is a score of 0 to 15 and Rank 2 is 16 to 29, both low; Ranks 3 through 5 run from 30 up through 46 and above, and Ranks 6, 7 and 8 are Aging Out Referral, Imminent Risk, and Adult Protective Services High Risk Referral. The waitlist is defined as the list of people assigned a high priority rank, meaning rank 3 and above, so someone screened into Rank 1 or Rank 2 receives a notification of ineligibility for waitlist placement and information about community resources instead of a place in line. Families often read that letter as a long wait when it is actually a "no" that has to be worked on.7

Three routes exist past a low rank or a closed list, and no one should be left ignorant of them.7

• Ask for a rescreening. You or your authorized representative may request one because of a significant change. Aging resource centers rescreen high-ranked people annually and may rescreen low-ranked people on request annually, and the statute directs that a low-scoring person be told they can contact the aging resource center for a new assessment at any time if circumstances change. A hospitalization, a fall, or a dementia diagnosis is a change worth calling about the week it happens.
• Request an administrative fair hearing. DOEA's written notice has to include instructions for requesting one under 42 CFR Part 431 Subpart E, F.S. 409.285, and Rule 65-2.042.
• Check whether you can bypass the screening and waitlist altogether. F.S. 409.979(3)(f) gives priority enrollment, with no screening or waitlist process, to three groups: a person aged 18, 19, or 20 with a chronic debilitating disease that makes them dependent on 24-hour-a-day medical, nursing, or health supervision; a nursing facility resident who asks to transition into the community after residing in a Florida-licensed skilled nursing facility for at least 60 consecutive days; and a person referred by the Department of Children and Families under the Adult Protective Services Act as high risk who is temporarily placed in an assisted living facility with DCF funding. That second one matters to a great many families: a parent who has been in a nursing home for two months and wants to come home does not join the queue.

Two 30-day deadlines cost people their place in line. If DOEA cannot reach you to schedule a screening or rescreening, its letter must warn that you have to contact the Department within 30 calendar days of the notice date, and that failing to complete the screening or rescreening ends your place in the screening process and on the waitlist. After you are released from the waitlist, the completed Medical Certification for Medicaid Long-term Care Services and Patient Transfer Form must go back to DOEA within 30 calendar days of the notice date. Losing your spot is not a pause: someone terminated from the list has to start a new request for placement, and any previous priority consideration is disregarded.7

The same $2,982 income cap and the same QIT requirement apply. Most applicants who plan ahead set up the QIT before they even start the financial application, because the QIT must be funded before Medicaid eligibility can begin.1

Pathway 3: MEDS-AD (Regular Medicaid for Aged and Disabled)

For seniors who do not need long-term care but do need help paying for everyday medical care, doctor visits, prescriptions, hospital stays, and durable medical equipment, the right pathway is MEDS-AD. This is full-benefit Medicaid for community-dwelling aged or disabled adults.1

The MEDS-AD income limit sits well below the $2,982 long-term-care cap, on the SSI-related side of the rules. MEDS-AD also applies its own resource (asset) test. We do not print the MEDS-AD income and asset standards here because we do not currently hold a sourced 2026 figure for them, and a wrong number on this line would send the wrong family away; get both from the Florida Department of Children and Families before relying on a specific number. The takeaway that does not change: being under the LTC limit does not mean you are under the MEDS-AD limit, and being over MEDS-AD does not rule out the more generous $2,982 LTC pathway later.1

MEDS-AD is an entitlement, with no waitlist. If you meet the financial test and the disability or age criteria, you are enrolled.

SSI approval is its own route in. For Florida Medicaid, financial eligibility "is determined by the Florida Department of Children and Families or the Social Security Administration," so an SSI approval establishes financial eligibility for the SSI-related categories without a second DCF determination. What that settles is who decides, not which coverage group you land in: MEDS-AD is Florida's own optional group for aged and disabled adults, so if your SSI claim is approved, call DCF to confirm your Medicaid record actually opened rather than assuming the two are the same door.2

The big trap with MEDS-AD: it does not cover long-term-care services. A senior on MEDS-AD has access to Florida's managed-care medical benefits, primary care, prescriptions, hospital, behavioral health, and dental, but not to home-care services, assisted-living-facility services, or adult-family-care-home services. Those are LTC waiver benefits. If your loved one is on MEDS-AD and needs home care, you still have to apply separately for the LTC waiver and join the waitlist.9

Two protective rules to know about for MEDS-AD applicants:

1. The Pickle Amendment. If you once received SSI and lost it solely because a Social Security cost-of-living adjustment (COLA) pushed you over the SSI limit, your Medicaid continues under Pickle protections even though you are no longer SSI-eligible. The test is counterfactual: subtract every COLA received since SSI was lost from your current Social Security check, and if you would still be SSI-eligible, you keep Medicaid. Two details are easy to lose and both work in a family's favor. The COLAs you subtract are not only your own; the regulation counts increases received by a financially responsible spouse or other family member. And if a state's eligibility rules are more restrictive than SSI's, it must still provide Medicaid to Pickle-protected people on the same basis as people still receiving SSI, and must cover someone as categorically needy once they incur enough medical expenses to reduce their income to the categorically-needy standard.10
2. Section 1619(b). If you are a blind or disabled SSI recipient whose earnings push you over the SSI break-even point, Section 1619(b) of the Social Security Act can keep your Medicaid open, so going to work does not automatically cost you your health coverage. It is a conditional protection rather than an automatic one: SSA also checks that you still have the qualifying impairment, that you would still meet every non-earnings SSI rule, and that you actually need Medicaid in order to keep working, and it compares your gross earnings to your state's charted threshold amount. Earning above that charted amount does not by itself end 1619(b). SSA then works out an individualized threshold that adds your own Medicaid and publicly funded attendant-care costs on top, so ask SSA before assuming a raise has ended your coverage. Two boundaries matter for an older reader. Age is not a bar: since May 1, 1991, someone 65 or older can establish 1619(b) eligibility provided they are determined to be blind or disabled. But 1619(b) protects only the working individual. A non-working SSI-eligible spouse has no protection under it and loses Medicaid when their working spouse's earnings end the SSI payment, while a couple who are both working and both lose their payment on combined income keep Medicaid.11

Under 65 and Not Disabled? Florida's Coverage Gap

Every pathway above is built for someone who is 65 or older, blind, disabled, or in need of nursing-facility-level care. If you are a working-age adult (say, 60 to 64, not yet on Medicare, not disabled, and without minor children at home), none of them fit, and there is a policy reason why.

In the 41 states (including the District of Columbia) that adopted the Affordable Care Act Medicaid expansion, a "new adult group" covers adults under 65 who are not pregnant and not on Medicare, generally up to 138% of the federal poverty level (about $1,835 a month, or roughly $22,000 a year, for one person in 2026).12,6 Florida is one of 10 states that did not adopt the expansion.13 So there is no new adult group here, and no general, income-based Medicaid for a non-elderly, non-disabled, non-pregnant adult without dependent children.

That leaves the coverage gap. Because Florida did not expand, an adult below the federal poverty line can earn too much for any Florida Medicaid pathway yet too little to qualify for Marketplace premium subsidies.13 If your income is above the poverty level, the realistic fallback is a subsidized private plan through the federal Marketplace at HealthCare.gov. If it is below, apply through ACCESS Florida anyway, because only the state can rule out a pathway you might still reach as a parent or on the basis of disability.

Two rules shape the narrow MAGI (tax-based) pathways Florida does run, which cover children, pregnant applicants, and parents at a very low income standard. Those groups face no asset test and no income disregards: savings and a car do not count against them.12 Neither the $20 general income exclusion used on the aged track nor the $65 earned-income exclusion applies on the MAGI side.14 And if you have claimed Social Security early, on that MAGI side the benefit counts in full, including the portion that is not taxable, with no amount subtracted.14

The picture changes at 65, though less absolutely than it is usually described. Turning 65 (or becoming entitled to Medicare) does close the under-65 adult group where that group exists, and it moves most people onto the aged, blind, and disabled (ABD) track, Florida's MEDS-AD pathway above, which is SSI-related and does apply a resource test that never existed on the MAGI side. The reference points are the 2026 SSI Federal Benefit Rate of $994 a month and the SSI resource standard of $2,000.1

But turning 65 does not by itself end MAGI eligibility. Federal rules set MAGI methods aside for people 65 and older only when age is a condition of eligibility for the group being tested. Someone 65-plus who qualifies as a parent or caretaker relative, a group with no upper age limit, is still assessed under MAGI, and so faces no asset test. If you are 65-plus and raising a grandchild, raise that with DCF.15

Pathway 4: Medically Needy (Share of Cost), and Why It Doesn't Cover LTC

For seniors whose income is above the MEDS-AD limit but who still face high medical bills, Florida operates a Medically Needy share-of-cost program. Its scope is narrower than many families expect, so it is worth understanding exactly what it covers before relying on it.1

The Medically Needy Income Level (MNIL) is intentionally very low, far below any cost-of-living figure, because the program is designed as a spend-down mechanism rather than a baseline coverage threshold. Confirm the current MNIL with the Florida Department of Children and Families, since it is the target your medical bills must bring you down to.

How spend-down works. Each month, you submit incurred medical bills to the Department of Children and Families. Once the value of those bills brings your remaining income down to the MNIL, you are approved for Medicaid for the rest of that month. The clock resets at the start of the next month, and you do it again.

The critical limitation: Medically Needy does NOT cover long-term-care services.

• Medically Needy will pay for doctor visits, hospital stays, prescriptions, and other acute-care services for the days of a month after spend-down is met.
• Medically Needy will not pay for nursing-home care (ICP), home-care services (LTC waiver), assisted living facility services, adult family care home services, adult day health care, or any other HCBS service. Those are LTC pathways with their own financial tests.

This distinction matters in practice. Adult children sometimes find Medically Needy and conclude they have solved the problem of their parent's home-care need. They have not. For long-term care, Florida's strict income-cap rules apply, and the QIT is the only workaround for over-income applicants.1

Pathway 5: Medicare Savings Programs (MSPs) for Dual Eligibles

If you have Medicare and your income is low, even if it is too high for full Medicaid, you may qualify for one of three Medicare Savings Programs, which use Medicaid dollars to help pay your Medicare premiums and cost-sharing.4

MSPs are an entitlement (with one exception, QI-1, which is funded by an annual federal block grant, first-come, first-served).

The Three MSP Tiers

All three tiers use the 2026 Federal Poverty Level as their income yardstick: 100 percent of the FPL is about $1,330/month for one person and $1,803/month for two, and each tier adds the federal $20 general income disregard from the SSI rules. All three share the same resource limits, $9,950 for an individual and $14,910 for a couple.6,4

QMB (Qualified Medicare Beneficiary), income at or below 100% FPL:6

• Pays: the Medicare Part A and Part B premiums (the Part B premium is $202.90/month in 2026; roughly 99 percent of beneficiaries already have premium-free Part A, so the Part A premium only matters if you are in the small group that owes one), and all Part A and Part B cost-sharing, deductibles, coinsurance, and copays.4
• That covers Medicare's own cost-sharing, not your Part D drug copays. Prescription costs are handled by the separate Part D Extra Help subsidy, which QMB enrollment gets you into automatically (below), and which has its own, higher resource limits.4
• QMB providers are federally prohibited from billing patients for any Medicare cost-sharing. A balance bill sent to a QMB enrollee is a violation that can be reported to the Florida Agency for Health Care Administration or CMS.
• QMB also enrolls you automatically in the federal Part D help with drug costs through auto-deeming, with no separate Part D application required.

SLMB (Specified Low-Income Medicare Beneficiary), income 100–120% FPL:6

• Pays: the Part B premium only ($202.90/month).4
• SLMB also auto-deems you into the same Part D drug-cost help.

QI (Qualifying Individual), income 120–135% FPL:6

• Pays: the Part B premium only.
• QI also auto-deems you into the same Part D drug-cost help.
• QI is first-come, first-served because it is funded by an annual federal block grant. Once the year's allocation is exhausted, no new enrollments are accepted until the next federal fiscal year.

Why MSPs Are Underused

MSPs are among the most underused Medicaid pathways in Florida. A significant share of QMB-eligible seniors are not enrolled, often because they assume their income is over the limit without realizing MSPs use Federal Poverty Level brackets, not the SSI rate. The asset limit is also more generous than the rest of Florida Medicaid: $9,950 in countable assets for an individual, against the $2,000 countable-asset limit on ICP and the LTC waiver. If you have been told your asset count rules you out of Medicaid, check the MSP rules separately. They may not.4,1

The QIT (Miller Trust): Florida's Income-Cap Workaround

Florida is one of a minority of states that operate a strict income cap for institutional and HCBS Medicaid LTC. If your gross monthly income exceeds $2,982, you cannot qualify for ICP or the SMMC LTC waiver, no matter how high your medical expenses are, unless you establish a Qualified Income Trust.1

A QIT (also called a Miller Trust, or under Florida statute an income trust) is an irrevocable trust that solves the income-cap problem by routing the over-cap portion of your income through the trust each month. Here is how it works:16

Critical rule: the QIT must be funded before Medicaid eligibility can begin. There is no retroactive QIT. If you apply for Medicaid first and then try to set up a QIT after the fact, your eligibility start date is delayed.

Cost. Most Florida elder-law attorneys handle QIT setup as a flat-fee service. The fee is almost always recovered in the first month of approved Medicaid coverage versus private-pay care.

Common QIT mistakes include trying to put assets into the trust (it is an income trust, not an asset trust, so assets stay in your or your spouse's name), letting the balance accumulate instead of draining it monthly, naming a spouse or another Medicaid-eligible person as trustee, and skipping the State-of-Florida residual-beneficiary clause, without which the trust is invalid.16

Spousal Protections: CSRA and MMMNA

When the institutionalized spouse needs ICP or SMMC Long-Term Care waiver services and the other spouse remains in the community, Florida applies federally-mandated spousal impoverishment protections so the community spouse is not financially destroyed by the cost of care. There are two, and they cover different things: the CSRA protects the couple's assets, and the MMMNA protects the community spouse's income.3

Community Spouse Resource Allowance (CSRA): Assets

When the institutionalized spouse is determined eligible for LTC Medicaid, the Florida Department of Children and Families takes a snapshot of the couple's countable assets on the first day of the most recent continuous period of institutionalization.

Florida is not a "half the assets" state. Many states let the community spouse keep half the couple's countable assets, capped at the federal maximum. Florida's rule (Fla. Admin. Code R. 65A-1.712) instead sets the allowance equal to the maximum resource allocation standard allowed under 42 U.S.C. §1396r-5, or any court-ordered support, whichever is larger. In 2026 that maximum standard is $162,660. So a couple with $200,000 in countable assets does not protect $100,000: the at-home spouse's allowance is $162,660, and only the countable resources above that allowance are considered available to the applicant, to be compared against the applicant's $2,000 limit. The federal $32,532 minimum is the floor a state may elect up from rather than an amount Florida's rule applies.3,1,5

$162,660 is Florida's starting figure, not a cap. Two routes in the same rule go above it, and neither states a dollar limit of its own. The first is the second half of the sentence quoted above: where a court has entered an order against the institutionalized spouse for the community spouse's support, the court-ordered amount is the one that governs, and Florida does not impose a transfer penalty on a transfer made under such an order. The second is a hearing. Under 65A-1.712(4)(e), if either spouse can verify that the allowance produces income that does not raise the community spouse's income to Florida's minimum monthly maintenance income allowance, the resource allowance may be revised through the fair hearing process to an amount adequate to provide such additional income as determined by the hearing officer.1

The hearing route is narrower than it sounds, and the limit sits in the same paragraph: since November 1, 2007, Florida's hearing officers must consider all of the community spouse's income and all of the institutionalized spouse's income that could be made available to a community spouse.1 If diverted income already closes the community spouse's shortfall, the hearing has nothing left to award. Where it does apply, the officer works from what a single premium lifetime annuity would cost to generate the missing income, and the community spouse does not have to actually buy the annuity. See the Florida spousal impoverishment guide for the full walkthrough.

Anything above the CSRA must be spent down or, more typically, restructured through legitimate Medicaid planning before the institutionalized spouse can qualify. Allowable spend-down strategies include paying off debt, prepaying funeral expenses, making home improvements, purchasing exempt assets, and in some cases purchasing a Medicaid-compliant immediate annuity for the community spouse's benefit. A Florida elder-law attorney is essential for couples with assets above the CSRA.

Minimum Monthly Maintenance Needs Allowance (MMMNA): Income

When LTC Medicaid starts paying, the institutionalized spouse's income is mostly redirected to their cost of care (the patient-responsibility share). Florida lets them divert some of that income to the community spouse if the community spouse's own income is below the MMMNA. The allowance is calculated for each couple: it starts at a floor of $2,705.00/month (effective 7/1/2026 through 6/30/2027) and rises with an excess-shelter allowance to a standard maximum of $4,066.50/month in 2026.3

So if the community spouse's own income falls short of their calculated MMMNA, the institutionalized spouse's income makes up the gap before any of it flows to the nursing facility or LTC plan. These figures re-index based on the federal Spousal Impoverishment Standards, so a case that crosses an update boundary will see the second period's figure shift slightly.

The $4,066.50 is not the last word either. Under 42 U.S.C. §1396r-5(e)(2)(B), if either spouse establishes that the community spouse needs income above the level the minimum monthly maintenance needs allowance otherwise provides, due to exceptional circumstances resulting in significant financial duress, an amount adequate to provide that additional income is substituted for the standard allowance.3 That is an evidence-backed request at a hearing, not a box on the application, so bring it to an elder-law attorney rather than assuming DCF's calculated figure is fixed.

The Home Equity Exemption

Your primary residence is exempt as a countable asset for LTC Medicaid purposes if any of the following is true:

• You have intent to return (Florida applies a permissive standard, even bedridden nursing-home residents can have intent to return).
• A community spouse lives there.
• A dependent relative lives there (a minor child, blind/disabled child, or otherwise dependent relative).

The 2026 home equity limit is $752,000, the federal minimum that Florida adopts. Equity above this disqualifies the applicant for nursing-facility and other long-term-care services unless a qualifying spouse, a minor child, or a blind or permanently and totally disabled child is lawfully residing in the home. That is a complete disapplication of the equity test rather than a reduction of it, so where such a relative lives in the home, equity of any amount does not by itself disqualify the applicant. Florida's constitutional homestead protection is broader than this for creditor purposes, but for Medicaid eligibility the federal equity limit controls.16,1,5

Being over the equity limit is also not a permanent bar. Federal law says nothing in the equity rule prevents you from using a reverse mortgage or a home equity loan to reduce your total equity interest in the home, so the equity can be brought below the limit. Separately, the Secretary must maintain a process waiving the equity limit in a demonstrated hardship.16

After Death: Estate Recovery

When a Medicaid LTC member dies, Florida's Medicaid Estate Recovery Program (MERP) under Fla. Stat. §409.9101 recovers by filing a statement of claim against the deceased's probate estate. Accepting Medicaid creates a debt to the Agency for Health Care Administration for the total medical assistance paid on the recipient's behalf after they reached age 55; benefits paid before age 55 create no debt.

Two Florida provisions limit that debt. Under §409.9101(6) it is not enforced if the recipient is survived by a spouse, by a child under 21, or by a child who is blind or permanently and totally disabled. Under §409.9101(7) it cannot be enforced against property exempt from creditors under Florida law, and the constitutional homestead exemption is one such exemption, which is why §409.9101(10) directs that what gets sold is nonexempt property that is not protected homestead. Protected homestead is therefore shielded inside probate.

Be careful with the common claim that Florida recovery is probate-only. Federal law lets a state define the recoverable estate to include assets passing by joint tenancy, survivorship, life estate, or living trust, and §409.9101 is silent on whether Florida made that election. We cannot source the proposition that a joint account, a payable-on-death designation, or a living trust is beyond AHCA's reach, so do not treat a specific asset as protected without asking a Florida elder-law attorney about that asset.17

The Five-Year Look-Back

Any uncompensated transfer (gift) of assets in the 60 months before an LTC Medicaid application triggers a transfer penalty period, a span during which the applicant is otherwise eligible but ineligible for paid LTC services. The 60-month look-back and the divide-by-the-state-cost penalty formula are federal rules under 42 U.S.C. §1396p(c).16

The math:

• The penalty is the uncompensated value of the transfers divided by Florida's average monthly private-pay nursing-home rate, and the result is the number of months of ineligibility.5,16
• That divisor is a state figure that is reset periodically, and we do not publish a current Florida number here rather than risk giving you a stale one. Ask DCF or a Florida elder-law attorney for the divisor in effect on your application date; a divisor that is off by a few hundred dollars changes the penalty by weeks.
• The penalty period starts on the later of the transfer date or the date the applicant is otherwise eligible and receiving institutional-level care, which in practice means it starts once Medicaid would otherwise begin paying, not on the date of the gift and not on the date you file. A gift made two years before applying does not serve out its penalty during those two years. Plan on the clock starting after approval, not at application.16
• Federal law does allow an undue-hardship waiver where imposing the penalty would deprive the applicant of medical care or the necessities of life. It is not automatic and it has to be requested, but a family facing a penalty they cannot survive should ask DCF about it rather than assume the penalty is final.16

What counts as a transfer: any uncompensated transfer of assets, gifting cash, transferring real estate to a child, adding a non-spouse to a bank account, or creating an irrevocable trust funded with applicant assets, is presumed a disqualifying transfer unless the applicant proves it was made for a non-Medicaid-planning purpose.

What does not count (exempt transfers):

• Transfers between spouses, which are unlimited.
• Transfers to a blind or disabled child of any age.
• Transfers of the home to a caregiver child, an adult son or daughter who lived in the home for at least two years immediately before the parent was institutionalized and provided care that allowed the parent to stay home rather than enter a facility. The two-years-of-in-home-care condition is strict, and the state decides whether the care met it. On the estate-recovery side, that residency condition is not the only thing standing between a family and a claim: federal law bars recovery until after the death of a surviving spouse, and then only where there is no surviving child under 21 and no blind or permanently and totally disabled child. Those conditions are joined to the residency conditions by "and," not "or," so a family whose protected child has moved out is not automatically exposed. Federal law separately requires every state to have a procedure waiving recovery that would work an undue hardship, and federal guidance points to homesteads of modest value and income-producing property such as farms or family businesses essential to surviving family members.16
• Transfers to a first-party special needs trust for the sole benefit of a disabled person under age 65, provided the trust is established by the individual, a parent, grandparent, legal guardian, or a court and names the state to receive whatever remains, up to the total Medicaid paid, at the beneficiary's death. The payback language has to do specific work: SSA requires the state or states to be listed as the first payee with priority over other debts and administrative expenses, requires reimbursement of any state that provided medical assistance rather than one named state, and does not allow the payback to be limited to a particular period of time. "Sole benefit" is read strictly too, so provisions that give benefits to anyone else during the beneficiary's lifetime can disqualify the trust. A trust set up before the beneficiary turns 65 keeps working after they turn 65, but additions made after 65 do not qualify.16

Look-back planning is one of the most consequential decisions a family makes about their assets, and the area where well-meaning DIY planning most often goes wrong. Talk to a Florida elder-law attorney before making large gifts in the five years preceding any anticipated need for LTC Medicaid.

Can You Spend Down to Qualify for Florida LTC Medicaid?

Some states operate a medically needy LTC pathway where applicants whose income is over the LTC limit can spend down their excess income on medical bills each month and qualify for long-term-care Medicaid. Florida does not.1

Florida's Medically Needy program exists, but it is acute-care only. For long-term care, Florida is a strict income-cap state, and the QIT is the only workaround for an over-income applicant. This is one of the most-misunderstood differences between Florida Medicaid and the programs in nearby states. If you are researching cross-state options for an aging parent, the income-cap-versus-medically-needy distinction is one of the most important variables.1

Where to Get Help With Florida Medicaid

Florida splits a Medicaid application across three agencies: the Department of Children and Families runs the financial determination, the Department of Elder Affairs and its CARES program run the medical level-of-care determination for long-term care, and the Agency for Health Care Administration enrolls approved applicants into a managed-care plan. Start with the contacts below.2

Learn More

Find personalized help comparing your Florida Medicaid pathways at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.