Notice About Medicare Information
Why We Share This Info
- To help you learn how Medicare works
- To guide you on where to find official help
Where to Get Help
- Visit the official Medicare website: Medicare.gov
- Call Medicare at
1-800-MEDICARE
- TDD users can call
1-877-486-2048
Medicaid
Official Directories
Official Directories
To find out if you qualify for long-term care coverage through Medicaid Call your State Medical Assistance (Medicaid) office.
1-877-711-3662, TDD 1-866-467-4970
Official Directories
Official Directories
Official Directories
Independent Brokers
Medicare vs. Medicaid
Medicare vs. Medicaid
Professionals who live in Southwest Florida understand local medical networks like Lee Health and can check if your specific local doctors and prescriptions are covered.
Medicare vs. Medicaid
Medicare vs. Medicaid
Medicare vs. Medicaid
Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for certain low-income people, families and children, pregnant women, the elderly, and people with disabilities.
Scammers: Medicare/Medicaid
An unexpected call from Medicare or Medicaid is a scam. Government
workers from these programs do not cold-call people to ask for private details.
Rules for Medicare and Medicaid Calls
- No cold calls: They never call out of the blue.
- No personal data requests: They never ask for your Medicare number, Social Security number, or bank details over the phone.
- No threats or fees: They will never threaten to cancel your coverage or ask for money to issue a new card.
- The only exception: They will only call you back if you called them first or left an official message asking for a return call.
What You Should Do
- Hang up immediately: Do not press any buttons or talk to the person.
- Do not share details: Never give out private numbers or passwords.
- Report the call: Contact 1-800-MEDICARE or file a report with the Federal Trade Commission.
Site Content
Can a Medicaid Waiver Help Pay for Assisted Living
From our research, we have learned that it is very difficult and competitive for residents in Florida to get approved for the Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) waiver for assisted living because of strict financial caps, functional requirements, and a prioritized waitlist.
*This is for informational purposes only. Please contact Medicaid or an attorney for assistance.*
Key Challenges in the Approval Process
- The Waitlist Is Not First-Come, First-Served: The waiver is not an entitlement program like nursing home Medicaid. Florida funds a limited number of slots, meaning applicants are placed on a waitlist ranked by frailty and priority scores (ranging from 1 to 7) determined during a screening interview.
- Long Wait Times: If an applicant receives a lower priority score (Scores 1–4), the wait can stretch from over a year to multiple years. Only high-priority or crisis-level applicants (Score 5 or imminent risk) get fast-tracked within a few months.
- Strict Financial Limits: Applicants must meet strict income and asset caps (for example, a strict individual asset limit of $2,000, though a primary home and certain other assets may be exempt up to equity limits). A 5-year look-back period applies to any asset transfers or gifting, which triggers immediate penalties and denials.
- Finding a Facility: Even with waiver approval, Medicaid does not cover room and board costs at an assisted living facility—it only covers the care services. Furthermore, not all assisted living facilities accept Medicaid, and those that do may have limited slots or specific managed care plan requirements.
As discussed on platforms like Reddit (agreement level=mixed opinions), families often face hurdles finding open spots in participating facilities or managing the required co-pays for room and board. Many people use elder law attorneys or contact their local Aging and Disability Resource Center (ADRC) to navigate the screening and priority score process accurately.
It serves as the designated Aging and Disability Resource Center (ADRC) for your local region in Florida. https://aaaswfl.org
