Statewide Medicaid Managed Care (SMMC) is managed by the Health Care Administration Agency in Florida. SMMC provides low-income families and individuals with access to free or low-cost health care and helps the elderly and disabled with the costs of nursing facilities and other medical and long-term care costs. Other benefits include physician’s services, inpatient and outpatient hospital services, durable medical equipment and hearing, vision and dental services. Individuals who are eligible for Supplemental Security Income (SSI) automatically qualify for Medicaid in Florida.
In order to be eligible for this program, individuals must be:
- A resident of the state of Florida
- A U.S. citizen, permanent resident or legal alien
- Proven to have low income
- Blind, disabled or at least 65 years of age
- Single with a monthly income below $891 and countable assets at $5,000 or less
- Married with a monthly income below $1,208 and countable assets at $6,000 or less
Countable assets include cash, stocks, bonds, investments, savings and checking accounts and real estate the individual doesn’t reside in.
The
Statewide Medicaid Managed Care Long-Term Care Program (SMMC LTC) provides services to individuals who require long-term care support. SMMC LTC is designed to delay or prevent premature institutionalization while individuals maintain stable health at home or in an assisted living facility.
SMMC LTC provides many services, including:
- Assistive care services
- Assisted living
- Medical equipment and supplies
- Medication management
- Personal emergency response system
- Occupational, physical, respiratory and speech therapies
- Nonemergency transportation
Through this program, Medicaid reimburses over two dozen home and community services and nursing facilities. This waiver is a capitated, managed care program, which means it pays a fixed amount of money to health care service providers; however, room and board costs aren’t covered.
Medicaid participants are required to be enrolled in the
Long-Term Care program if they:
- Are age 18 and older and need nursing facility level of care
- Are In Hospice
- Are In institutional care
- Meet Florida Medicaid financial requirements
Counselors are available to help residents of Port Charlotte and surrounding cities choose from
three LTC plans that best meet their needs, including Humana, Sunshine and United. Depending on which plan seniors choose, additional benefits may be provided, such as cellular phone service, dental services, hearing evaluation and over-the-counter medications and supplies.
SMMC LTC limits the number of people who can receive assistance, and waiting lists for some of these services are possible in areas across the state.
For more information about SMMC and SMMC LTC, please contact the
Area Agency on Aging for Southwest Florida at (866) 413-5337 or apply for benefits online through the
ACCESS system.