Navigating Florida's Long-Term Care (LTC) Medicaid system can feel overwhelming — especially when a loved one needs care urgently. This guide breaks down how LTC Medicaid works in Florida, which managed care plans are available, and how La Agency Nurse Registry can help you access quality nursing care through your Medicaid benefits.
What is Long-Term Care (LTC) Medicaid in Florida?
Long-Term Care Medicaid is a Florida Medicaid program designed to provide ongoing care for elderly individuals and people with disabilities who need assistance with daily activities over an extended period. Unlike traditional Medicaid, which covers primarily acute care, LTC Medicaid covers services such as:
- In-home nursing care (RN, LPN, CNA, HHA)
- Personal care and assistance with activities of daily living (ADLs)
- Skilled nursing facility care
- Adult day care
- Assisted living facility placement
- Respite care for family caregivers
- Case management
How Florida LTC Medicaid is Managed
Florida administers its LTC Medicaid program through a Managed Care system. This means that Florida contracts with private health plans — called Managed Care Organizations (MCOs) — to coordinate and deliver LTC services to eligible Medicaid recipients.
Once a person is determined eligible for Florida LTC Medicaid, they are enrolled in one of these managed care plans. The plan then coordinates their care, including authorizing home nursing services through providers like La Agency Nurse Registry.
LTC Plans Accepted by La Agency
La Agency Nurse Registry proudly accepts the following Florida LTC Medicaid plans:
Simply Healthcare
Florida-based Medicaid managed care plan with extensive LTC coverage across Miami-Dade and surrounding counties.
Aetna Better Health
National managed care organization providing comprehensive LTC Medicaid services including in-home nursing care.
Integrated Healthcare Systems
Specialized managed care plan focused on coordinated healthcare delivery for LTC Medicaid beneficiaries in Florida.
📋 Important: To receive services through your LTC Medicaid plan, La Agency must be an authorized provider in your plan's network. Contact us at (305) 419-4929 to confirm coverage and begin the authorization process.
Who Qualifies for Florida LTC Medicaid?
To qualify for Florida Long-Term Care Medicaid, an individual generally must:
- Be a Florida resident
- Be a U.S. citizen or qualified non-citizen
- Be 65 years of age or older, OR be an adult with a disability
- Meet functional criteria — typically needing assistance with at least 2–3 Activities of Daily Living (ADLs) such as bathing, dressing, eating, or mobility
- Meet financial eligibility requirements (income and asset limits set by the state)
Eligibility is determined by the Florida Department of Children and Families (DCF) and the Department of Elder Affairs (DOEA). The process can take several weeks, so it is important to begin early.
How to Apply for Florida LTC Medicaid
The application process involves multiple steps and agencies. Here's a simplified overview:
- Apply for Medicaid through the Florida Department of Children and Families (DCF) at myflorida.com/accessflorida or by calling 1-866-762-2237.
- Request a Comprehensive Assessment — A DOEA case manager will assess your functional needs to determine if you meet the clinical criteria for LTC services.
- Enroll in an LTC Managed Care Plan — Once approved, you will choose an MCO (such as Simply Healthcare, Aetna, or IHS) to manage your LTC care.
- Work with Your Plan to Authorize Services — Your MCO care coordinator will help determine what services you are authorized to receive and connect you with providers like La Agency.
- Begin Receiving Care — Once authorized, contact La Agency to begin the referral process and get a qualified nurse matched to your needs.
What Services Can La Agency Provide Under LTC Medicaid?
Through your LTC Medicaid plan, La Agency can refer qualified nurses and aides for the following in-home services (subject to plan authorization):
- Skilled Nursing Visits (RN or LPN)
- Personal Care by Certified Nursing Assistants (CNA)
- Home Health Aide (HHA) services
- Companion and daily living assistance
- Medication reminders and monitoring
- Post-hospital and post-surgical care coordination
Tips for Families Navigating LTC Medicaid
- Start Early: The application and assessment process can take 6–8 weeks or more. Begin as soon as you believe your loved one may qualify.
- Keep Records: Document all medical appointments, diagnoses, and functional limitations. This documentation supports your eligibility determination.
- Understand Your Plan's Benefits: Each MCO has different covered services and provider networks. Review your plan's benefit guide carefully.
- Ask About the Waiver Programs: Florida also has Medicaid waiver programs (like the Statewide Medicaid Managed Care Long-Term Care waiver) that may offer additional home and community-based services.
- Contact a Benefits Counselor: The Florida SHINE program (Serving Health Insurance Needs of Elders) offers free Medicare/Medicaid counseling. Call 1-800-963-5337.
How La Agency Can Help
La Agency Nurse Registry has experience working with Florida's LTC Medicaid managed care plans. If you or your loved one has coverage through Simply Healthcare, Aetna Better Health, or Integrated Healthcare Systems, our team can guide you through the authorization process and refer a qualified caregiver quickly.
Call us at (305) 419-4929 or send us a message to discuss your needs. We are available Monday–Friday 9am–5pm and on-call 24hrs for urgent situations.
Have Medicaid coverage and need nursing care? We can help you navigate the authorization process. Contact La Agency today →