Important Changes to Florida Medicaid in 2026: What You Need to Know

If you or someone you care about might need Medicaid assistance for long-term care in Florida, there are several important updates taking effect in 2026 that could affect your planning. These changes impact asset limits, income thresholds, and other financial considerations for those seeking help with home care, assisted living, nursing facilities, or PACE programs.

The Asset Test Remains at $2,000

The basic asset limit hasn't changed. If you're applying for Medicaid, you can only have $2,000 in what Florida Medicaid considers "countable assets." The good news? Not everything counts toward this limit.

Your primary residence generally doesn't count as a countable asset, though there are some conditions attached. If you're married and applying for Medicaid, there's no limit on your home's value. However, if you're single, that's where the 2026 change comes in.

New Home Equity Limit: $752,000

For single applicants, Florida has increased the home equity limit to $752,000 as of January 1, 2026. This represents the amount of equity you can have in your home and still qualify for Medicaid.

Here's a simple example: If your home is worth $800,000 but you have a $100,000 mortgage, your equity is $700,000. Since this falls below the $752,000 threshold, you're within the acceptable range. However, if you own your home outright and it's worth more than $752,000, you may face some hurdles (though solutions exist to address this situation).

Income Limit Increases to $2,982

Florida Medicaid looks at your total monthly income from all sources—Social Security, pensions, 401(k) distributions, and any other money coming in. As of January 1, 2026, if your combined monthly income exceeds $2,982, you'll need to set up a Qualified Income Trust (QIT).

You might also hear this called a Miller Trust. Some people choose to use a pooled needs trust instead, but the QIT is the most common solution. Whatever you call it, this trust allows you to qualify for Medicaid even when your income is above the limit.

Community Spouse Resource Allowance: $162,660

When one spouse needs Medicaid for long-term care and the other spouse remains healthy and living in the community, Florida law allows the healthy spouse (called the "community spouse") to keep a certain amount of assets.

As of 2026, that amount is $162,660. This means the healthy spouse can have up to $162,660 in their name, while the spouse applying for Medicaid can have an additional $2,000.

Important note: This Community Spouse Resource Allowance (CSRA) only applies during the initial application process. Once the Medicaid applicant gets approved, the community spouse can actually accumulate assets beyond the $162,660 limit without affecting the Medicaid recipient's eligibility. The applicant spouse, however, must continue to maintain less than $2,000 in countable assets each month.

Gift Penalty Divisor Now $10,645

One of the most misunderstood aspects of Medicaid planning involves the five-year lookback period. Medicaid reviews any gifts you've made in the five years before applying, and if you've given away money, it can result in a penalty period.

As of January 1, 2026, the penalty divisor has increased to $10,645. Here's how it works: Medicaid adds up all the gifts you made in the past five years and divides that total by $10,645. The result tells you how many months Medicaid will delay your coverage.

Simple math example: If you gifted exactly $10,645 within the last five years, you'd face a one-month penalty. If you gifted $53,225, that would result in a five-month penalty period ($53,225 ÷ $10,645 = 5 months).

The penalty period doesn't start from when you made the gift. It begins from the date when you would have otherwise been eligible for Medicaid. In other words, Medicaid says, "You would have qualified on this date, but because of these gifts, we're delaying your coverage by X months."

You Have Options

If you've already made gifts or you have too many assets to qualify, don't panic. There are legal and ethical strategies to protect your assets and become eligible for Medicaid without waiting five years. The key is working with someone who knows Florida Medicaid law inside and out.

Sometimes gifts can be returned. Other times, there are ways to get money back to family members in a Medicaid-compliant manner. This is what proper Medicaid planning accomplishes—it's not about hiding anything from anyone. It's about following the rules to protect what you've worked your whole life to build, so you don't have to deplete everything before getting the care you need.

What About Other Medicaid Programs?

While this article focuses on long-term care Medicaid (covering home care, assisted living, and nursing facility care), other Medicaid programs exist with different income and asset requirements. Programs like QMB (Qualified Medicare Beneficiary) have also seen slight adjustments to their thresholds, though those fall outside the scope of what most people need for long-term care planning.

Why These Changes Matter

Every year, Florida adjusts its Medicaid limits to account for inflation and cost-of-living increases. While some of these changes might seem small, they can make a real difference in whether you qualify for assistance and how much you can protect for your spouse or family.

If you're getting close to needing care—or if you're already receiving care and paying out of pocket—these 2026 updates could open new doors for you. The increased home equity limit might mean you no longer need to worry about your home's value. The higher income cap might mean you can avoid setting up a QIT. The increased community spouse resource allowance means your healthy spouse can keep more of what you've built together.

Additional Resources

If you want to go deeper into Florida Medicaid planning, here are some helpful resources:

• Elder Needs Law - Florida Estate Planning & Elder Law: https://elderneedslaw.com
• Medicaid Planning Resources and Information: https://medicaidplanninglawyer.com/
• "How Medicaid Can Pay for Some or All of Your Long-Term Care Expenses" - Available on Amazon: https://www.amazon.com/Medicaid-some-your-long-term-expenses/dp/1513634712

Need Help With Your Situation?

If you're anywhere in Florida and would like to discuss your specific circumstances, consider scheduling a consultation. Every family's situation is different, and getting personalized advice can help you make the best decisions for your future and your loved ones.

The information in this article is current as of January 2026 and applies specifically to Florida Medicaid programs. Laws and limits change regularly, so always verify current requirements when planning.

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