Florida’s Medicaid long-term-care pathway has a defined sequence: screening, pre-enrollment release, medical certification, financial review, CARES assessment, and managed-care plan enrollment. Skipping ahead to an assisted-living quote can produce a plan that assumes coverage before eligibility and network participation are settled. This guide follows Florida’s actual sequence and separates Medicaid services from facility charges.
The program: SMMC Long-Term Care
The Florida Agency for Health Care Administration operates the Statewide Medicaid Managed Care Long-Term Care program. Eligible members receive long-term services through contracted managed-care plans rather than a universal payment made to any facility they choose.
AHCA’s official service list includes assisted living among the home- and community-based options. Depending on the member’s assessed plan, assisted-living support can include help with housekeeping, bathing, dressing, eating, medication, and social activities.
The presence of a service on the program list does not authorize it for every member. The final package depends on medical and financial eligibility, enrollment, the plan’s assessment, the authorized care plan, and a participating provider.
How Florida’s enrollment sequence works
AHCA’s current eligibility and enrollment page identifies separate agencies and decisions.
1. ADRC screening and the pre-enrollment list
The starting point for community long-term-care services is the local Aging and Disability Resource Center. The ADRC screens the person and, when appropriate, places the person on the SMMC LTC pre-enrollment list. Placement on that list is not Medicaid approval and is not a promise of immediate enrollment.
When AHCA releases a person from the list, the ADRC contacts the person to confirm continued interest and sends the next-step material.
2. Form 3008 medical certification
The released applicant receives Form 3008, the Medical Certification for Medicaid Long-term Care Services and Patient Transfer Form. AHCA says a Florida-licensed physician, advanced practice registered nurse, or physician assistant must complete it. The applicant must return the completed form to the ADRC to continue.
This form supports the medical review; it does not replace the later assessment or the financial application.
3. DCF financial eligibility
The Florida Department of Children and Families determines Medicaid financial eligibility for aged or disabled applicants who are not receiving SSI. The ADRC checks whether the person already has Medicaid and tells the applicant when a DCF application is required.
Submit all requested income, asset, identity, and residency documents to DCF. A CARES approval cannot substitute for an incomplete financial determination.
4. CARES assessment
The Department of Elder Affairs’ Comprehensive Assessment and Review for Long-Term Care Services (CARES) program determines medical eligibility. After the ADRC receives a complete Form 3008, CARES conducts an in-person assessment to decide whether the applicant meets the required level of care.
5. Welcome packet and plan choice
When both financial and medical requirements are satisfied, AHCA sends a welcome packet explaining SMMC and plan selection. The selected managed-care plan then becomes central to service coordination, provider network, and authorization.
Ask the ADRC which step is pending. “On the list,” “released,” “financially eligible,” “medically eligible,” and “enrolled with a plan” are different statuses.
From plan enrollment to an assisted-living authorization
After enrollment, the plan assesses the member and develops the authorized care arrangement. Before choosing a residence, request written confirmation of:
- the services included in the member’s plan;
- the frequency or level authorized;
- whether the proposed facility contracts with that SMMC LTC plan;
- the effective date of authorization; and
- any member responsibility identified by the plan.
Florida plans maintain networks. A state-licensed facility is not automatically in every plan, and a plan contract is not evidence that a room is available or that the facility can meet a particular care need.
What the facility quote must separate
Ask for a resident agreement and itemized estimate that identifies:
- room, meals, and housing services;
- services covered by the SMMC LTC authorization;
- services the facility will charge privately;
- medication assistance, nursing, transportation, and supplies;
- deposits, community fees, and move-in costs;
- any charge tied to a specialty license or higher service level; and
- what happens if plan authorization starts after admission.
Do not describe SMMC LTC as paying the entire assisted-living bill. The plan pays authorized services under its contract; the facility agreement must identify room-and-board and other resident obligations.
Florida licenses and specialty services
AHCA’s Assisted Living Facility licensing page links provider directories, statutes, rules, survey guidance, and application material. It also explains that consumers can search by facility type and, through advanced search, by specialty license.
Florida assisted-living facilities may hold specialty licenses for services such as Extended Congregate Care, Limited Nursing Services, or Limited Mental Health. Those labels matter because a standard license and a specialty license permit different service arrangements. Verify the exact location and specialty status rather than relying on a company-wide description.
Use Florida’s official provider and inspection records to review:
- current license status;
- specialty licenses;
- standard and complaint surveys;
- deficiencies and correction status; and
- sanctions or emergency actions shown in the state record.
AHCA rules also require facilities to make agency inspection reports available to residents and the public. Ask to see the latest report during the tour and compare it with the online record.
Florida-specific planning questions
For the ADRC and CARES process
- Has the person been screened and placed on the pre-enrollment list?
- Has AHCA released the person, and what deadline applies to Form 3008?
- Is the DCF financial application complete?
- Has CARES conducted the in-person assessment and issued its decision?
For the managed-care plan
- Which assisted-living services are authorized for this member?
- Is the facility in network for this plan and service package?
- Does the plan require a separate authorization before move-in?
- Who updates the care plan when needs change?
For the facility
- Which Florida license and specialty licenses apply to this address?
- What portion of the proposed invoice is not paid by the plan?
- Can the facility meet the current assessment without private supplemental care?
- What do its recent AHCA inspection records show?
Official sources
- Florida AHCA: SMMC Long-Term Care program
- Florida AHCA: SMMC Long-Term Care services
- Florida AHCA: Medical and financial eligibility sequence
- Florida AHCA: Assisted Living Facility licensing, directories, and rules
- Florida Department of Elder Affairs: Long-term-care and assisted-living resources
Track the ADRC, DCF, CARES, plan, and facility decisions separately. Compare Florida care options on SLINQ →