Delray Beach · Boca Raton · Boynton Beach
Florida Medicaid long-term care planning is the work of understanding how the state may help pay for ongoing care when someone needs help with daily life for months or years, and then making decisions based on the actual rules instead of rumors. Long-term care means help with bathing, dressing, eating, moving safely or supervision because of memory loss, delivered in a nursing home, an assisted living facility or the person’s own home. Palm Beach County families usually meet this question at a hard moment: after a hospital stay, when a parent can no longer live safely alone, or when one spouse is wearing out caring for the other.
Long-term care Medicaid is not Medicare. Medicare is health insurance. After a medically necessary inpatient hospital stay of at least three days in a row, Medicare may cover up to 100 days of skilled nursing facility care in a benefit period, and in 2026 the patient pays a daily coinsurance of $217 for days 21 through 100 (Medicare.gov). Time spent "under observation" does not count toward those three days.
Medicare does not pay for custodial care: the long, ordinary months of help with daily living after rehab ends. That is where families start asking who pays the monthly nursing home bill. For a sense of scale, the average monthly nursing home cost Florida uses to figure transfer penalties is $10,645 in the current DCF standards (Florida DCF, Appendix A-9).
It is also not the same thing as the Medicaid card someone may already use for doctor visits. The programs that pay for long-term care have their own rules about income, countable assets and the level of care a person needs. Having one kind of Medicaid, or having very little in a checking account, does not by itself answer the long-term care question.
Florida families usually hear about two main paths:
Program names and procedures change, and a waiver is not an open door. A consultation matches the person's actual care setting to a program that exists today, not to an old handout.
“Planning” means looking at those rules before money moves, while there is still a choice about what to do. Applying is a later step, filed through ACCESS Florida with the Department of Children and Families (DCF) once the care and the facts support it. Planning is not a promise that a person will qualify. It is not a calculator, and it is not a way to hide assets. Florida Medicaid reviews gifts and transfers, and a transfer made so that someone looks eligible can delay coverage for months. Lawful planning works with the rules: knowing what counts, what doesn’t, and what the law itself allows.
Every long-term care program asks two separate questions: 1. Medical need: does the person need the level of care the program covers? For SMMC LTC, Florida’s CARES unit decides whether the person needs nursing-facility level care. 2. Finances: do income and countable assets fit that program’s 2026 limits? A family can be clear on one question and stuck on the other. A first meeting is mostly about sorting the two apart.
This page will not tell you to deed the house, gift an account, or spend down to a particular dollar figure. Those choices depend on facts this website doesn’t have, and the figures quoted here change every year, some in January, some in April and some in July. If a page online hands you a transfer to copy, close it and call.
2026 numbers
These are the main Florida Medicaid long-term care figures for 2026, taken from the Department of Children and Families (DCF) standards used for nursing home (ICP) and SMMC Long-Term Care eligibility. They help you follow a conversation. They don't decide whether anyone qualifies, because how each figure applies depends on the person's facts, the program and the month.
SSI federal benefit rate
$994 a month
The basic federal SSI payment for one person. Florida uses it to set the income cap below.
January 1, with the Social Security cost-of-living adjustment
Income cap (ICP and long-term care programs)
$2,982 a month
Gross monthly income limit for one applicant, which is 300% of the SSI rate. Income above it usually calls for a Qualified Income Trust.
January 1
Countable asset limit
$2,000 (one applicant); $3,000 (a couple who both apply)
The most an applicant may have in countable assets, such as cash and investments. The home, one car and some burial funds are treated differently.
Not indexed each year. Check each new DCF edition.
Personal needs allowance (nursing home)
$160 a month
The income a nursing home resident on Medicaid keeps for personal costs. Most of the rest goes toward the cost of care.
When Florida updates the DCF standards
Community Spouse Resource Allowance (CSRA)
Up to $162,660
Countable assets the spouse who stays at home may generally keep, in addition to the home and other excluded property.
January 1
Minimum Monthly Maintenance Needs Allowance (MMMNA)
$2,705 a month
The income floor for the at-home spouse. If that spouse's own income is lower, part of the other spouse's income may be shifted to them.
July 1
Maximum spousal income allowance
$4,067 a month
The usual ceiling on the at-home spouse's total protected income, including any housing-cost adjustment.
January 1
Excess shelter standard
$812 a month
Housing costs (rent or mortgage, taxes, insurance, condo fees, utilities) above this amount can raise the at-home spouse's allowance.
July 1
Home equity limit
$752,000
Above this much equity, long-term care coverage is generally unavailable. The limit doesn't apply if a spouse, a child under 21, or a blind or disabled child lives in the home.
January 1
Transfer penalty divisor
$10,645
The state's average monthly nursing home cost. DCF divides the uncompensated amount of a gift by this figure to set the length of a penalty in months.
Periodically. The current figure has been in effect since April 1, 2025.
Look-back period
60 months
The five years before an application during which gifts and transfers below fair value are reviewed.
Set by federal law; not adjusted each year
| Figure | 2026 amount | What it means | When it changes |
|---|---|---|---|
| SSI federal benefit rate | $994 a month | The basic federal SSI payment for one person. Florida uses it to set the income cap below. | January 1, with the Social Security cost-of-living adjustment |
| Income cap (ICP and long-term care programs) | $2,982 a month | Gross monthly income limit for one applicant, which is 300% of the SSI rate. Income above it usually calls for a Qualified Income Trust. | January 1 |
| Countable asset limit | $2,000 (one applicant); $3,000 (a couple who both apply) | The most an applicant may have in countable assets, such as cash and investments. The home, one car and some burial funds are treated differently. | Not indexed each year. Check each new DCF edition. |
| Personal needs allowance (nursing home) | $160 a month | The income a nursing home resident on Medicaid keeps for personal costs. Most of the rest goes toward the cost of care. | When Florida updates the DCF standards |
| Community Spouse Resource Allowance (CSRA) | Up to $162,660 | Countable assets the spouse who stays at home may generally keep, in addition to the home and other excluded property. | January 1 |
| Minimum Monthly Maintenance Needs Allowance (MMMNA) | $2,705 a month | The income floor for the at-home spouse. If that spouse's own income is lower, part of the other spouse's income may be shifted to them. | July 1 |
| Maximum spousal income allowance | $4,067 a month | The usual ceiling on the at-home spouse's total protected income, including any housing-cost adjustment. | January 1 |
| Excess shelter standard | $812 a month | Housing costs (rent or mortgage, taxes, insurance, condo fees, utilities) above this amount can raise the at-home spouse's allowance. | July 1 |
| Home equity limit | $752,000 | Above this much equity, long-term care coverage is generally unavailable. The limit doesn't apply if a spouse, a child under 21, or a blind or disabled child lives in the home. | January 1 |
| Transfer penalty divisor | $10,645 | The state's average monthly nursing home cost. DCF divides the uncompensated amount of a gift by this figure to set the length of a penalty in months. | Periodically. The current figure has been in effect since April 1, 2025. |
| Look-back period | 60 months | The five years before an application during which gifts and transfers below fair value are reviewed. | Set by federal law; not adjusted each year |
Sources: Florida DCF, ESS Policy Manual Appendix A-9, SSI-Related Medicaid Financial Eligibility Standards (July 2026); look-back period: 42 U.S.C. 1396p(c); penalty method: DCF Appendix A-8.
Figures checked: November 6, 2026
Most calls come from adult children, from a husband or wife, or from someone trying to figure out whether this is a crisis or a chance to plan ahead. Care managers, discharge planners and financial advisors in Palm Beach County also use this page to explain the basics to families before a referral.
You're the one collecting bank statements, talking to the rehab unit, and trying to make sense of what the discharge planner just said. You may live in Delray Beach, or you may be managing things from another state while your parent lives in Boca Raton or Boynton Beach.
A useful first step is a clear picture of three things: the care your parent needs now, the date coverage is expected to end, and whether anyone has legal authority to sign for your parent. That is worth more than a stack of advice from group chats.
One of you may need a nursing home, assisted living or help at home. The other still has a house, groceries and a life that has to go on. Florida applies federal "spousal impoverishment" rules that protect part of a couple's savings and income for the spouse who stays home, called the community spouse.
In 2026, the community spouse may generally keep up to $162,660 in countable assets (the Community Spouse Resource Allowance), plus the home and other excluded property (Florida DCF, Appendix A-9). Those rules are technical. They are also the reason a couple should not empty an account just to look poor.
Someone is in the hospital or a rehab bed, and the family has been told Medicare coverage is ending. Starting earlier would have been calmer, but a crisis is still a good time to learn which Florida program fits the care, who has authority to sign, and which facts are still missing.
It is not the time to give property away because a neighbor said a transfer would help. Gifts made within the 60-month look-back can create a penalty period, and that penalty starts only once the person is otherwise eligible. In other words, it starts when the family needs help most.
Everyone can still talk, sign and choose. That is the least stressful kind of meeting. You can write down wishes, sign a durable power of attorney that allows Medicaid planning, review how the house and accounts are titled, and learn how long-term care benefits work before a fall sets the calendar.
Planning ahead also gives the 60-month look-back time to run, if a family decides, with advice, that any lifetime gifts fit their goals. Planning ahead is not a promise that anyone will qualify later.
These are general corrections, not instructions for your situation. The rules change, and a deed, a beneficiary form or a pension can change the answer completely. Nothing below describes a result the firm obtained for any particular person.
What people say.
"We have to sell the house before Florida Medicaid will help pay for care."
A clearer picture.
Often not. Florida does not count a homestead (the person's principal home) as an asset of any value while the person lives there, intends to return, or has a spouse or qualifying relative living there. There is a separate home equity limit for long-term care coverage, $752,000 in 2026. It does not apply when a spouse, a child under 21, or a blind or disabled child lives in the home (Florida DCF, Appendix A-9; ESS Policy Manual, Chapter 1600).
Things get more complicated when the house is rented out, owned with someone else, already in a trust, or empty with no realistic plan to return. A Lady Bird deed (enhanced life estate deed: the owner keeps full control and can still sell, and the home passes to named people at death) is treated by Florida Medicaid like other real property the owner holds, and signing one is not counted as a transfer (ESS Policy Manual, 1640.0613.01). Whether it fits your family is a separate question. List the facts before anyone lists the property or signs a deed.
What people say.
"We have to spend almost everything before we can even ask about Medicaid."
A clearer picture.
"Spend-down" means reducing countable assets to the program limit by paying for things of fair value. In 2026 that limit is $2,000 for a single applicant in the nursing home and long-term care programs (Florida DCF, Appendix A-9). The rules are about which resources count, which spending is ordinary, and which gifts create a delay.
Paying for care, a mortgage, home repairs, a car or prepaid funeral arrangements is a different kind of act from handing an account to a child. A married couple's picture is also different, because of the community spouse allowance. Giving assets away because someone at the facility suggested it can postpone help. Doing nothing because the topic feels overwhelming has its own cost too. Planning is a review of income, assets and timing, with no promise that anyone will qualify.
What people say.
"Once someone is in the nursing home, planning is over."
A clearer picture.
Earlier is calmer, but a nursing home admission doesn't end the conversation. During a crisis, families can still get an accurate explanation, gather documents, set up a Qualified Income Trust if income is over the cap, and see which lawful steps remain, including protections for a spouse at home.
Crisis planning and advance planning are different conversations, and neither comes with a guaranteed result. What usually makes the week harder is trying every rumor first (a new deed, a large gift, a closed account) and only then asking what the rules actually say.
A useful meeting looks at the care first, then the money, then the documents already signed. It is not a script for moving assets. The sections below are the topics families should expect to cover, with the 2026 Florida figures where they help. They are not steps to copy at the kitchen table.
If no one has authority to speak for a parent, read the estate planning guide alongside this page. The benefits question and the “who can sign” question often arrive together. Wills, powers of attorney, and health care directives are part of the same planning, not a separate errand for later.
Where is the person now, and where are they likely to be next month? A nursing home, assisted living and home care fall under different programs. Nursing home care usually means the Institutional Care Program. Home and assisted living care usually mean SMMC LTC and its waitlist.
The medical question (does this person need the level of care the program covers?) is separate from the financial one. A plan starts with the care, because applying under the wrong program wastes weeks.
Families usually list Social Security, pensions, required withdrawals from retirement accounts, annuity payments and wages. For nursing home and long-term care Medicaid in 2026, an applicant's gross monthly income (before Medicare premiums or taxes are taken out) must be at or below $2,982, which is 300% of the $994 SSI federal benefit rate (Florida DCF, Appendix A-9).
Income over that cap does not automatically disqualify someone. Florida allows a Qualified Income Trust (also called a Miller trust): an irrevocable trust and bank account that holds only the person's income. Enough income must be deposited each month to bring the income outside the trust under the cap. At death, the state is repaid from what is left in the trust, up to what Medicaid paid. A missed or short deposit can cost that month's coverage (DCF Qualified Income Trust information sheet).
Once someone qualifies, most of their income still goes toward the cost of care. A nursing home resident keeps a personal needs allowance of $160 a month in 2026. Bring award letters and recent deposit records, and don't rearrange direct deposits before anyone has explained the rule that applies.
An inventory usually covers the home, bank and investment accounts, retirement funds, life insurance, cars, prepaid funeral arrangements, and anything owned jointly with another person. How something is titled matters as much as the balance.
Florida treats some property as countable (most cash and investments) and some as excluded, such as the homestead within the rules above, one car, and certain burial funds and contracts. A single applicant's countable assets generally must be at or below $2,000 in 2026 (Florida DCF, Appendix A-9). The inventory shows what the program is likely to ask about. It is not a worksheet for moving balances around.
The look-back period is the 60 months (five years) before a Medicaid application during which Florida reviews gifts and other transfers for less than fair value (42 U.S.C. 1396p(c)). It applies to nursing home Medicaid and to the home and community-based programs.
If DCF finds a transfer without fair compensation, it presumes the transfer was made to qualify and imposes a penalty: a period of months when Medicaid will not pay for long-term care. Florida generally figures the length by dividing the uncompensated amount by a state average monthly cost, $10,645 in the current Appendix A-9. The penalty starts only once the person is otherwise eligible, not on the date of the gift (DCF Appendix A-8). As a hypothetical, a $53,000 gift could mean roughly five months without coverage at exactly the time care is needed. The actual result depends on the facts.
Federal law does allow some transfers, for example to a spouse, or to a trust for a disabled child or for a disabled person under 65. A personal care contract (a written, fair-value agreement to pay a family member for future care) is another tool that DCF reviews for fair compensation. That is why a gift to a child, a new deed, or an account retitled "just in case" belongs in a legal conversation before it happens. This page does not explain how to structure a transfer.
If a parent can still understand and sign, they should be part of the meeting. If they can't, the family needs to know whether a Florida durable power of attorney already exists and what it actually says.
Under Chapter 709 of the Florida Statutes, an agent may make gifts, create or change a trust, or change beneficiary designations only if the parent signed or initialed next to each of those specific powers (Fla. Stat. 709.2202). An older or generic form may not allow the steps a Medicaid plan needs. Without valid authority, an application can stall, and the remaining option may be a court guardianship. That question often belongs with estate planning, not just with the application.
When one spouse needs long-term care and the other stays in the community, federal and Florida rules protect some assets and income for the spouse at home. The 2026 Florida figures (Florida DCF, Appendix A-9):
Hypothetically, a husband entering a Boynton Beach nursing home might have a wife at home whose only income is a small Social Security check. The rules may let part of his income go to her each month instead of all of it going to the facility. These figures change each year and depend on the facts. The idea is simple: the well spouse is not supposed to be left with nothing, and the couple shouldn't guess the allowance by emptying accounts.
The order is: a consultation, then the facts, then a plan, then an application if the plan calls for one. Some families arrive with an ACCESS Florida application already started. Even then, the plan comes before more signatures.
How do you talk to aging parents about money? is about the person who needs care, where they are, who is helping, and what the family is afraid of getting wrong. You do not need a finished spreadsheet. You need the facts you know today, including any deadline a hospital or facility has given you.
Next come the documents: income award letters, five years of statements for major accounts (because of the 60-month look-back), the deed, retirement accounts, life insurance, prepaid funeral contracts, and any will, trust or power of attorney you already have.
Gather them, but don't move money to "get ready" while you're still collecting. Missing pages are normal. Guessed balances aren't useful.
Brandon explains which Florida long-term care program fits situations like yours, what the rules allow and don't allow, which documents may need updating, and which rumors you can stop worrying about. The plan is written so a tired family can follow it.
It applies general rules to your facts. It is still not a prediction of eligibility, and it is not a script for transferring assets.
If you choose to go forward, the work can include preparing what DCF asks for through ACCESS Florida, setting up a Qualified Income Trust when income is over the cap, answering requests for verification, and staying with the file while DCF reviews it.
Some families aren't ready to apply yet. Others are applying because a bed is already waiting. Either way, the application follows the plan. It doesn't replace it.
Questions families ask
Short answers to questions families in Delray Beach, Boca Raton and Boynton Beach often ask once a nursing home or assisted living is on the table. Each answer is general education. Your family's answer depends on your facts.
Yes. Florida applies the same 60-month transfer review to home and community-based care, including the Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program that can help in assisted living, as it does to nursing home coverage under the Institutional Care Program (ICP) (DCF Appendix A-8). The difference is in the rest of the process. SMMC LTC also requires a medical finding of nursing-facility level of care and, in most cases, a release from the state's waitlist. In assisted living, Medicaid generally helps pay for care services, while the resident's income usually covers room and board. A gift that is a problem for one program is usually a problem for the other.
You can, but a gift made within 60 months before applying may delay long-term care Medicaid. When DCF finds a transfer without fair compensation, it presumes the purpose was to qualify and sets a penalty period. Under the current standards, that period is roughly one month without coverage for every $10,645 given away, and it starts only once the person is otherwise eligible (DCF Appendix A-8). The IRS's $19,000 annual gift tax exclusion doesn't protect a gift from this Medicaid rule. Some transfers, such as gifts to a spouse or to a trust for a disabled child, are treated differently. Talk it through before any money moves.
Waiting usually means paying privately for longer, and Florida generally won't cover the months before you apply. For adults 21 and older who aren't pregnant, Florida Medicaid coverage starts no earlier than the first day of the month the application is received (AHCA). Waiting can also mean that a parent loses the capacity to sign a power of attorney, or that a Qualified Income Trust isn't funded in time. On the other hand, applying before the facts are ready can lead to a denial. The useful question is whether the facts support applying now, not simply whether to wait.
Federal rules give the state up to 45 days to decide most applications, or 90 days when eligibility is based on disability (42 CFR 435.912). The clock can stretch when DCF asks for more documents and they're slow to arrive, which is common when bank statements, trust papers or deeds are missing. For SMMC LTC, financial approval is only one step. The medical assessment and a waitlist release can add time. Applications filed through ACCESS Florida move faster when income records, five years of major account statements and any power of attorney are gathered first.
Often yes, if the arrangement is a genuine, fair-value agreement and not a gift. DCF treats purchases of care contracts as possible transfers and checks whether the parent received fair compensation. It looks at the fair market value of the services and how often and how long they are provided, and it asks for a copy of the agreement or a statement describing the services (ESS Policy Manual, 1640.0609.01 and 1640.0614.04). In practice, a written personal care agreement signed before the care starts, with local market pay rates and logs of the work done, is easier to support. Informal payments, or a large lump sum for "future care," draw more scrutiny. The payments are also taxable income to the caregiver.
A Medicaid-compliant annuity turns a lump sum into a stream of income. Florida doesn't count it as an asset or treat it as a transfer if it meets strict rules (DCF Appendix A-34):
The monthly payments count as income. Couples sometimes consider one when the at-home spouse needs income, but whether it helps depends on the facts.
Call or request a consultation. You do not need a finished plan before the first call. Solkoff Legal, P.A. · (561) 733-4242 · 2605 West Atlantic Avenue, Suite A-103, Delray Beach, FL 33445. A call or an email does not by itself create an attorney-client relationship, and nothing on this page is a promise of eligibility.
Solkoff Legal, P.A. · (561) 733-4242
