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What is in the ACCESS Florida Medicaid Application

What is in the ACCESS Florida Medicaid Application
Medicaid Planning
Jason Neufeld
September 1, 2019

First – there is no requirement that you hire a Medicaid attorney to apply for Medicaid benefits. The Medicaid application can be filled out online (, a printable paper copy of the 18 page Medicaid application (“Form CF-ES 2337”), including Medicaid application and Medicaid-application instructions, can also be accessed. Medicaid applicants can call 1-866-762-2237 for more information as well: this number provides general program information(option 1), health care provider options (option 2), medicaid (option 3 - to change address, get a new Medicaid card, find out health plan options); EDT information (option 4), etc… 

Prior to filling out the Medicaid application, many individuals who do not already qualify, will seek the advice of a Medicaid lawyer for help with the Medicaid application. It is important to consult with a Medicaid lawyer (also known as an elder law attorney) prior to applying (whether or not you intend of filling out the Medicaid application yourself or having the lawyer do it) because if you apply prior to being eligible, you will undoubtedly be denied.

What is in the Florida Medicaid Application?

The first two pages provide some basic information about the Florida Medicaid application process. 

The first preliminary page mostly informs about Medicaid’s food assistance programs. Remember that Medicaid is a general term for a number of programs. A list of common Medicaid programs can be found at the link. 

The next page warns against engaging in Medicaid fraud. The Medicaid applicant is also advised that their answers will be verified through their Income and Eligibility Verification System (IEVS) and that any changes in circumstances must be reported within 10 days. In case you are denied Medicaid benefits or are not approved for a sufficient level of benefits, page 2 of the Medicaid application also explains that you have the right to request a “fair hearing” by writing, calling the customer call center (1-866-762-2237), or coming into an Medicaid office within 90 days of receiving notice of the adverse action you wish to challenge. The Medicaid application can be mailed to ACCESS Central Mail Center, PO Box 1770, Ocala, Florida, 33478-1770 or faxed to a local DCF service center.

What information does the Medicaid application require?

Page 1 of actual Medicaid application actually begins on the third page of the 18 page application packet. It starts by asking which program you are applying for. While my elder law attorney office primarily assists clients with Medicaid Waiver / Home & Community Based Services and Nursing Home Care Medicaid benefits, the application can also be used for Food Assistance, Cash Assistance, Relative Caregiver Assistance, Medical, Hospice, and OSS / Optional State Supplementation programs. 

The application will also ask for basic contact information(home address, phone numbers, email address), whether it is difficult to come into the office for an interview (i.e. for reasons of illness, lack of transportation, living in a rural area, or need to remain home to care for a sick or disabled household member). 

The Medicaid application will have you acknowledge that DCF will verify statements made and may consult with other state/federal agencies for that purpose. You provide DCF permission to consult with prior employers,review any pertinent medical records, etc.. You also agree, under penalty of perjury, to provide accurate information to the best of your knowledge. 

Page 2 starts with information if the Medicaid applicant is seeking expedited food assistance. Below is Section A, which involves entering all household member information. For nursing home or ALF residents, you only list yourself, your spouse and dependents (if any). 

Page 3, Section B, lists children living in the Medicaid applicant’s home. Section C involves listing absent parents (obviously not relevant for Nursing Home or HCBS/Waiver applicants). 

Page 4, Section D involves criminal activity, employment status, residency, special residential situations (i.e. living in homeless shelter, drug treatment center, nursing home, ALF, etc…), whether anyone in the household has been deemed disabled by social security or the State of Florida and more. 

Page 5, Section E – Assets. Must list all assets here(vehicles, bank accounts, tax-sheltered accounts, CDs, mortgages, promissory notes, loans, IRAs, annuities, stocks, bonds, burial contracts, CCRC or life care community contracts, life insurance. You will list the asset, describe the asset, how much equity you have if real property or a vehicle, location of asset (e.g. bank name and address), account number or insurance ID, and the asset’s value. 

You will also verify whether any assets have been given away in the last five years. This portion of the medicaid application is concerned with the five-year look back period and whether any assets are jointly owned with someone that does not live in the household. 

Interestingly, at the bottom of page 5 of the Medicaid application, you can also register to vote. 

Page 6, Section F – Income. Must list all income sources (wages, tips, SSI, disability, VA income, unemployment, child support, alimony,dividends, interest, retirement income, etc…) The rest of page 6 involves how income taxes are filed, whether Income or Miller Trusts have been utilized, employer and health insurance information. 

Page 7, Section G – Expenses. Must list rent, mortgage,property taxes, homeowner’s insurance, condo/maintenance fees, gas, electric,fuel, medical bills (prescriptions, glasses, transportation, doctor’s visits,dental, health aides, hospitalizations, nursing home bills, health insurance/Medicare premiums, telephone etc…. 

Section H – Health Insurance Coverage. What health insurance(Medicaid/Medicare, VA, employer based, TriCare, etc…and whether any health insurance was voluntarily cancelled (for a variety of enumerated reasons). 

Page 8. If the Medicaid applicant wants to apply for reduced telephone rates through the Lifeline Program (more info on Lifeline through Office of Public Counsel,and through Assurance Wireless). 

Section I. For American Indian or Alaska Native Americans. 

On Page 8 you can also designate an authorized representative  (any trusted person:family member, friend or Medicaid-planning attorney). 

Pages 10 and 11 list your rights and responsibilities. 

The following 5 pages are The Florida Department of Children and Families Notice of Privacy Practices. 

Medicaid Lawyer – Final Thoughts on the Medicaid Application

While you can fill out this application yourself, issues can arise when information is entered incorrectly or insufficiently. Not fully understanding what DCF is requesting can result in unnecessary delays and denials that can cost the Medicaid applicant significant sums of money – especially when nursing homes are involved. 

But the choice is yours. Certainly, for those who are not currently eligible for Medicaid, but would like to be, we charge for the legal strategies necessary for Medicaid qualification. We would then charge an additional amount if the client wanted us to apply on their behalf (and handle the routine correspondence with DCF, answer their questions, and correct any errors made on their end, etc…). Clients come to us for one, the other, or both.

For those who wish to try handling the Florida long term care medicaid application themselves, here is an article that discussed some Common Mistakes Found on Medicaid Applications.

Jason Neufeld

Jason Neufeld is the Founder and Managing Partner of Elder Needs Law, a Florida estate planning and elder law firm he created in 2017. With more than 15 years of experience practicing law, he represents clients in a wide range of legal matters, including Medicaid planning, estate planning, elder law, probate, Medicare, and life insurance.

Jason received his Juris Doctor from the University of Miami — School of Law and is a member of the Florida Bar and the Broward County Bar Association. He has received numerous accolades for his work, including being named a Rising Star and Super Lawyer by Super Lawyers and among the Florida Legal Elite by Florida Trend in 2024.

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