The rules
DCF's Economic Self-Sufficiency (ESS) policy manual sets MEDS-AD's rules (sections 2040.0813.01 to .05):
- Age or disability: 65 or older, or disabled under SSI rules.
- Income: at or below 88% of the federal poverty level.
- Assets: at or below the Medically Needy asset limit. DCF lists the current dollar standards in Appendix A-9.
- Other requirements: Florida residency, citizenship or noncitizen status rules, and applying for other benefits you may qualify for.
- Medicare: you must not be receiving Medicare, or, if you are, you must also be receiving institutional (nursing home), hospice or home and community-based services.
"Home and community-based services" here means you're enrolled in Medicaid's long-term care services at home and meet the level of care set by the state's CARES program, or you're enrolled in PACE.
Why this matters if you have Medicare
Many Floridians on Medicare with low income expect MEDS-AD and are surprised by a denial. For someone with Medicare who lives at home without long-term care services, MEDS-AD isn't available, whatever their income. The usual routes to help are:
| Program | What it does |
|---|---|
| QMB | Income up to about 100% of poverty: pays Medicare premiums, deductibles and coinsurance |
| SLMB or QI-1 | Income up to about 120% or 135% of poverty: pays the Part B premium |
| Medically Needy | Full Medicaid in months when your medical bills reach your share of cost |
| SSI | SSI recipients are eligible for Medicaid; Social Security decides |
All of these also give you Extra Help with Part D costs. See Medicare Savings Programs in Florida.
When MEDS-AD does apply with Medicare
If you enter a nursing home, choose hospice, start home and community-based services through the Long-Term Care program, or join PACE, MEDS-AD becomes possible again, if your income is within 88% of poverty. People with higher income may qualify for long-term care through the Institutional Care Program's income cap or a Qualified Income Trust. See Florida Medicaid long-term care.
To apply, use ACCESS Florida online at MyACCESS or call DCF at (850) 300-4323. Coverage starts the first day of the month you apply if you qualify for that month (ESS 2040.0813.04). To review Medicare plan options, you can request a call from a licensed insurance agent.
Related questions
Can I have Medicare and Medicaid in Florida?
The two ways to have both.
What is the SMMC Long-Term Care program?
Nursing homes, assisted living and care at home.
How do I renew my Medicaid on ACCESS Florida?
Keep your coverage at renewal time.
Sources
- Florida DCF — ESS Policy Manual, Chapter 2000, Coverage Groups (MEDS-AD 2040.0813)
- Florida DCF — Appendix A-9, SSI-Related Medicaid Financial Eligibility Standards (July 2026)
- Florida DCF — Public Assistance (ACCESS Florida)
- Fla. Admin. Code 65A-1.713, SSI-related Medicaid income rules
- Medicare.gov — Medicare Savings Programs
More questions in this guide
- Do I have to join a Medicaid managed care plan if I have Medicare in Florida?
- Can I have Medicare and Medicaid at the same time in Florida?
- Can permanent residents get Florida Medicaid?
- How do I renew my Florida Medicaid on ACCESS Florida?
- What is a dual eligible special needs plan (D-SNP) in Florida?
- What is a FIDE SNP in Florida?
- What is the Florida Medicaid Long-Term Care program (SMMC LTC)?
Part of the guide: Florida Medicaid and Medicare together · All questions
Frequently asked questions
What does MEDS-AD stand for?
Medicaid Designated by SOBRA for the Aged and Disabled. SOBRA refers to the federal Sixth Omnibus Budget Reconciliation Act of 1986.
I'm on Medicare and was denied MEDS-AD. What can I apply for instead?
A Medicare Savings Program (QMB, SLMB or QI-1), which pays Medicare premiums and, with QMB, cost sharing; Medically Needy, if you have high medical bills; or SSI through Social Security. DCF considers them on the same application.
What does MEDS-AD cover?
People in MEDS-AD get all Medicaid benefits. With Medicare, Medicaid pays after Medicare for what it covers.
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