Medicaid Eligibility

The first step to qualifying is taken by filing a Request or Assistance form with the Florida Department of Children and Families.  This is usually done by the spouse or child of the individual needing nursing home care.  An application can also be filed directly online through the Department of Children and Families ACCESS Florida website. Please note however, that it is very important that all necessary planning steps be finalized before applying for Medicaid ICP.  Applying prior to completing a well thought out asset protection plan could result in disqualification of benefits for the applicant for many months or longer and could cause the applicant to loose substantial assets.

Once a Request for Assistance is filed, a Comprehensive Assessment and Review Examination (CARES) is performed by the Department of Elder Affairs.  A brochure detailing the CARES process with telephone numbers can be found here.  The assessment team must find the applicant is unable to perform three of five activities of daily living, which include:

• walking and standing;

• dressing oneself;

• feeding oneself;

• bathing oneself;

• using the restroom unassisted.

Additionally, the CARES team will conduct objective tests to determine the capacity of the individual and whether that person is in need of skilled nursing home care.  Further definitions of skilled care and intermediate care services can be found in the Florida Administrative Rules at sections R 59G 4.180 and 4.290. 

While the CARES team determines the medical need for an applicant, the Florida Department of Children and Families must verify that all financial criteria are met by the applicant.  The financial rules for Medicaid ICP qualification are covered in detail under the "Asset Rules" and "Income Rules" pages.