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

If you or a loved one may need Medicaid assistance for long-term care in Florida, 2026 brings several changes that directly affect eligibility and planning strategies. These updates impact asset limits, income thresholds, home equity rules, and gift penalties for applicants seeking coverage for home care, assisted living, nursing homes, or PACE programs.

Understanding these numbers matters. Planning around them can mean the difference between qualifying smoothly and paying out of pocket far longer than necessary.

Asset Limit Still $2,000

Florida Medicaid’s core asset rule remains unchanged. Applicants are limited to $2,000 in countable assets. However, not everything you own is counted.

Your primary residence is typically excluded from the asset test, subject to certain conditions. Married applicants face no home value cap. Single applicants, however, must pay attention to the updated equity limit.

New Home Equity Limit: $752,000

As of January 1, 2026, single Medicaid applicants may retain up to $752,000 in home equity and still qualify.

Example:

• Home value: $800,000

• Mortgage balance: $100,000

• Equity: $700,000

Since $700,000 is below the $752,000 limit, Medicaid eligibility remains intact.

If you own a home outright and its equity exceeds the limit, eligibility becomes more complicated—but not impossible. Planning tools exist to address this issue when handled correctly.

Monthly Income Limit Increased to $2,982

Medicaid evaluates gross monthly income from all sources, including Social Security, pensions, and retirement distributions.

For 2026, the income cap is $2,982 per month. If your income exceeds this amount, Medicaid requires the use of a Qualified Income Trust (QIT), commonly known as a Miller Trust.

The QIT allows applicants over the income limit to remain eligible. While alternatives exist, this remains the most widely used and accepted solution in Florida.

Community Spouse Resource Allowance Now $162,660

When one spouse requires Medicaid-covered long-term care and the other remains at home, Florida protects the healthy spouse through the Community Spouse Resource Allowance (CSRA).

In 2026, the community spouse may keep up to $162,660 in assets. The Medicaid applicant is still limited to $2,000.

Critical distinction:

• The CSRA applies only during the application phase.

• After approval, the community spouse may accumulate additional assets without affecting Medicaid eligibility.

• The applicant spouse must remain under the $2,000 limit on an ongoing basis.

Gift Penalty Divisor Increased to $10,645

Medicaid enforces a five-year lookback period for asset transfers. Gifts made during this window can trigger a penalty delay in coverage.

For 2026, the penalty divisor is $10,645.

How it works:

• Total gifts made in the last five years are added together.

• That amount is divided by $10,645.

• The result equals the number of months Medicaid coverage is delayed.

Examples:

• $10,645 gifted = 1-month penalty

• $53,225 gifted = 5-month penalty

The penalty does not start when the gift was made. It begins when you would otherwise have qualified for Medicaid. Coverage is delayed—not denied.

If You’re Over the Limits, You Still Have Options

Exceeding Medicaid limits does not automatically mean waiting five years or spending everything down. Florida Medicaid planning allows for legal, compliant strategies to restore eligibility.

Depending on the situation:

• Gifts may be returned

• Assets may be repositioned

• Funds may be structured to benefit family without violating Medicaid rules

This is not about hiding assets. It’s about using the rules correctly to avoid unnecessary financial loss.

Other Medicaid Programs Have Different Rules

This overview focuses on long-term care Medicaid. Other programs—such as QMB and Medicare Savings Programs—use different income and asset limits. While some of those thresholds changed in 2026, they do not impact most long-term care planning scenarios.

Why the 2026 Changes Matter

Florida adjusts Medicaid limits annually to reflect inflation and rising care costs. Even modest increases can significantly affect eligibility outcomes.

For 2026:

• Higher home equity limits protect homeowners

• Higher income thresholds reduce trust requirements

• A larger CSRA protects healthy spouses more effectively

If you are nearing the need for care—or already paying privately—these updates may improve your options. The key is understanding the rules before mistakes are made, not after.

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Disclaimer

This information was provided by the Agency for Healthcare Administration (AHCA). The "Ask Medicaid Florida" website is intended for informational purposes only. "Ask Medicaid Florida" is not associated with any state agency including Medicaid Florida. Find all AHCA archived alerts here. Please feel free to read our full disclaimer here.