Florida-specific Medicaid spend-down rules
Florida administers Medicaid eligibility through the Department of Children and Families (DCF) area offices. Long-term care applications usually start at a local ACCESS site or by phone in counties like Miami-Dade, Hillsborough, Orange, and Duval.
The Institutional Care Program (ICP) covers nursing facility care. Statewide Medicaid Managed Care Long Term Care (SMMC LTC) plans handle many waiver slots, but asset tests still follow the same $2,000 resource standard for the applicant.
Florida does not offer a medically needy income spend-down for nursing home cases the way Pennsylvania does. Families above the $2,982 monthly gross income cap must assign excess funds to a Qualified Income Trust, also called a Miller Trust, with a Florida trustee.
Community spouses may keep the greater of the CSRA calculation or certain income protections under spousal impoverishment rules. The state uses the federal maximum home equity cap of $713,000 in 2026 unless a spouse or dependent child still lives in the house.
Burial spaces, one vehicle, and up to $2,500 per person in a designated burial fund can be excluded if titled correctly. Prepaid funeral contracts follow separate DCF ESS policy sections.
Look-back reviews cover asset transfers made within 60 months before application. Penalty length equals the uncompensated transfer amount divided by the average monthly nursing home cost published by Florida AHCA.
Applicants in Naples and Pensacola follow the same resource test as families in Tampa Bay. Waiver interest lists vary by region, but the $2,000 asset cap does not.
DCF requires bank statements covering the look-back window plus proof of every account closure. Families in Broward and Palm Beach counties often file through the same regional office, so document packets should list every financial institution by name and account number.
A QIT agreement must reach DCF Regional Legal Counsel before deposits count. Trustees deposit enough gross income each month to bring countable income below $2,982. Missed deposits can void coverage for that month even when assets already qualify.
Common mistake: Assuming Florida exempts a second home because it is "in the family." Non-homestead real estate counts unless occupied by a spouse or dependent child under DCF rules. Budget property taxes and sale costs before you rely on an appraisal.