Medicaid for low-income individuals who are either aged (65 or older) or disabled is called SSI-Related Medicaid.
Florida residents who are eligible for Supplemental Security Income (SSI) are automatically eligible for Medicaid coverage from the Social Security Administration. There is no need to file a separate ACCESS Florida application unless nursing home services are needed.
Individuals may apply for full Medicaid coverage and other services using the online ACCESS Florida Application and submitting it electronically. If long-term care services in a nursing home or community setting are needed, the individual must check the box for HCBS/Waivers or Nursing Home on the Benefits Information screen. HCBS/Waiver programs provide in-home or assisted living services that help prevent institutionalization.
Medicare Savings Programs (Medicare Buy-In) help Medicare beneficiaries with limited finances pay their Medicare premiums; and in some instances, deductibles and co-payments. Medicare Buy-In provides different levels of assistance depending on the amount of an individual or couple’s income. Individuals may apply for Medicare Buy-In coverage only by completing a Medicaid/Medicare Buy-In Application.
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The State of Florida offers The Medicaid Institutional Care Program that helps people in nursing facilities pay for the cost of their care plus provides general medical coverage. There are several requirements for qualification.
There is also a Medicaid Diversion Program which provides home-based community services such as personal care, homemaker services, adult day care, meal preparation, and assistance with errands to name a few. If you or your loved one requires Assisted Living (ALF), the Home Based Community Services Program (HBCS) can provide that alternative. A Comprehensive Assessment and Review for Long term Care Services (CARES) is conducted by the Department of Elder Affairs to assess you or your loved one’s eligibility for the program.
Both Medicaid programs for Older Persons have been combined into a Medicaid Managed Care Program. There are four Managed Care Organizations (MCOs) that are part of this pilot program implemented in this area first. Those on the program will have to stay within their provider network. For additional information, please contact the Senior Resource Specialist.
Both programs require an online Medicaid application. There are strict income guidelines that can require professional assistance to meet these guidelines.
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When you need advice on senior services, senior living options, home health services, elder law, hospice, adult day care and more, please call us. Orlando Senior Help Desk is here to help you navigate the senior maze.
407-678-9363 for more information.