Florida Statewide Medicaid Managed Care

Florida Statewide Medicaid Managed Care, or SMMC, is the system Florida uses to deliver most Medicaid services through private managed care plans rather than traditional fee-for-service Medicaid. If you or a loved one qualifies for long-term care Medicaid, you receive those benefits through the program's Long-Term Care component, known as SMMC-LTC. As of February 2025, the program runs under a new contract cycle called SMMC 3.0, which reorganized the state from eleven regions into nine and awarded new plan contracts that run through 2030. What this means for a recipient is straightforward. You will choose a long-term care plan in your region, or the state will assign one if you do not pick within your enrollment window, and that plan coordinates and pays for your covered services. Nursing facility care has no waitlist, while home and community based care generally does.

What Is the SMMC Long-Term Care Program?

Medicaid recipients who live in a nursing facility or who receive home and community based services must enroll in the Statewide Medicaid Managed Care Long-Term Care Program, or SMMC-LTC. To qualify, a person must meet the financial criteria determined by the Department of Children and Families and the nursing-home level of care criteria determined by CARES, the state's screening program. Once enrolled, if a plan denies a needed service, the recipient can appeal through the plan's grievance process or through the state Fair Hearing process. The program is authorized under the Florida Medicaid managed care statutes at Sections 409.962 through 409.985, Florida Statutes, and Florida operates it through federal waivers that permit a managed care model for long-term services.

There is no waiting list for nursing facility services under the program. There is, however, a waitlist for home and community based care, sometimes called the Florida Medicaid Waiver program, where priority is assigned by level of need. While the program charges no co-pays, many enrollees owe a monthly patient responsibility amount toward their nursing facility or home and community based services.

The Nine SMMC Regions Since 2025

For more than a decade, Florida divided the program into eleven regions. Under Senate Bill 1950, passed in the 2022 legislative session, the state consolidated those into nine regions, effective with the 2025 contract cycle. The number of plan contracts the state must award did not shrink, so recipients still have multiple plans to choose from in every region. The older eleven-region map, including the former Region 10 for Broward and Region 11 for Miami-Dade and Monroe, no longer reflects how the program is organized.

Skilled nursing facilities must contract with every long-term care plan operating in their region, and a facility cannot discharge a resident because of that resident's plan choice. It must work with the resident's chosen plan to arrange payment. Assisted living facilities are different. They are not required to contract with the plans in their region, so a resident has to confirm that their chosen facility participates with their long-term care plan. If it does not, the resident either changes plans, finds a participating facility, or disenrolls. Assisted living facilities are reimbursed only for home and community based services, never for room and board.

Which Long-Term Care Plans Can I Choose in 2026?

The current plan lineup changed substantially with SMMC 3.0. Florida law requires at least two long-term care plan choices in every region, and the specific plans available depend on where you live. As of 2026, the long-term care plans contracted statewide or regionally include Florida Community Care and Humana, which operate across all nine regions, along with Aetna, Simply Healthcare, Sunshine State, and UnitedHealthcare, which operate in selected regions. Molina offers long-term care coverage in Miami-Dade and Monroe. Plans that appeared on older versions of this list, including several that have since merged or exited, are no longer accurate, and AmeriHealth Caritas left the program on February 1, 2025.

Because each region carries a different mix of plans and benefits, comparing the available options before you choose matters. If you do not actively select a plan within roughly 30 days of your welcome packet, the state assigns one for you, and an auto-assigned plan may not include your preferred providers. Recipients who want help choosing can name an authorized representative to assist with the selection.

One point that reassures many families is that enrolling in a Florida managed care plan does not force you to give up a preferred Medicare Advantage or Medicare Supplement plan. Medicaid and your Medicare coverage can work alongside each other.

What Services Does the Program Cover?

Every long-term care plan must provide a core set of covered services. For a fuller breakdown of what Florida long-term care Medicaid covers, the minimum services each plan is required to offer include the following.

• Adult companion care, adult day care, and assistive care services
• Attendant nursing care, intermittent and skilled nursing, and nursing facility care
• Behavioral management and care coordination or case management
• Caregiver training and home accessibility adaptations
• Home-delivered meals, homemaker services, and personal care
• Hospice services and respite care
• Medical equipment and supplies, medication administration, and medication management
• Nutritional assessment and personal emergency response systems
• Occupational, physical, respiratory, and speech therapies
• Non-emergency transportation

Beyond these required services, plans compete by offering expanded benefits, which is a reason to compare them closely. Expanded benefits offered by various plans have included dental services, over-the-counter medications and supplies, vision and hearing evaluations, a bed hold for assisted living, cell phone service, non-medical transportation, and emergency financial assistance. The exact mix varies by plan and can change each contract year.

Choosing Your Own Caregivers Through the Participant Direction Option

Long-term care plans provide personal care services for those who qualify when the enrollee's plan of care calls for them, including homemaker, companion, chore, and home-delivered meal services. Through the Participant Direction Option, a participant can sometimes choose who delivers their services, which may include family members or friends. The long-term care plans set the pay rates for these participant-directed services.

What If a Recipient at Home Suddenly Needs Nursing Care?

If a recipient living at home or in an assisted living facility is already enrolled with a long-term care plan and is later determined to need a higher level of care, the plan works with a nursing facility in its network to arrange admission to skilled nursing. Enrollment in the plan is what makes that transition smoother, since the plan already coordinates the recipient's care.

The Role of the Area Agencies on Aging

Local Area Agencies on Aging help recipients throughout the process. They provide education about the Florida Medicaid long-term care programs and help recipients choose one that fits their needs, they screen individuals for the home and community based services waitlist and contact them when funding becomes available, and they assist with completing the medical and financial eligibility steps. For a closer look at how the waitlist works, the priority score system for the Medicaid waiver waitlist explains how the state ranks who receives services first.

Key Takeaways

• SMMC is how Florida delivers most Medicaid, and long-term care benefits come through its SMMC-LTC component.
• Since February 2025, the program runs under SMMC 3.0, a 2025 to 2030 contract cycle, with the state reorganized from eleven regions into nine.
• Florida Statutes require at least two long-term care plan choices in every region; if you do not choose within your window, the state assigns one.
• Nursing facility services have no waitlist, but home and community based care generally does, with priority set by level of need.
• Enrolling in a Medicaid managed care plan does not require giving up a preferred Medicare Advantage or Supplement plan.

Frequently Asked Questions

Q. What is SMMC-LTC in Florida?

A. It is the Long-Term Care component of Florida Statewide Medicaid Managed Care. Recipients who live in a nursing facility or receive home and community based services enroll in a long-term care plan that coordinates and pays for their covered services, authorized under Sections 409.962 through 409.985, Florida Statutes.

Q. How many regions does Florida Medicaid managed care have now?

A. Nine. Under Senate Bill 1950 from the 2022 legislative session, Florida consolidated its former eleven regions into nine, effective with the 2025 contract cycle known as SMMC 3.0. The older Region 10 and Region 11 labels are no longer used.

Q. Do I have to choose a long-term care plan, or is one assigned?

A. You can choose. If you do not select a plan within roughly 30 days of receiving your welcome packet, the state auto-assigns one, which may not include your preferred providers. Florida law requires at least two plan choices in every region.

Q. Is there a waitlist for long-term care Medicaid?

A. There is no waitlist for nursing facility services. There is a waitlist for home and community based care, and priority is assigned based on each person's level of need rather than first come, first served.

Q. Will I lose my Medicare plan if I enroll in a Florida Medicaid managed care plan?

A. No. Enrolling in a Florida Medicaid managed care plan does not require giving up a preferred Medicare Advantage or Medicare Supplement plan. Your Medicare and Medicaid coverage can work together.

Getting Help Choosing and Qualifying

Choosing among plan options is only part of the picture, since qualifying financially for long-term care Medicaid is often the harder step. A good next move is to gather a current list of the recipient's income sources and account balances, then talk with a Florida Medicaid planning attorney who can confirm eligibility and help you compare the plans available in your region. Bring one document to that first meeting, a recent statement for every account, since accurate balances are what let an attorney build a reliable plan. Doing this early means care gets approved sooner and your family keeps more of what it has built.

Because plan lineups and eligibility figures shift with each contract year, it also helps to check the latest Florida elder law updates before relying on any single detail when you plan..