A Medicaid waiver in Florida is a special program that lets people receive care at home or in their community instead of in a nursing home or institutional facility. Regular Medicaid covers doctor visits and hospital stays, but waivers go further by paying for services like personal care, home modifications, respite for family caregivers, and daily living support. Florida operates several active waivers, each designed for a different population, from older adults at risk of nursing home placement to children and adults with developmental disabilities.
The term “waiver” comes from the fact that the federal government waives certain Medicaid rules so states can offer these extra services. Without waivers, Medicaid would only cover institutional care for many people who need long-term support. Florida uses this flexibility to keep people in their homes and communities, which is typically less expensive and preferred by the people receiving care.
Florida’s Main Active Waivers
Florida currently runs three primary Medicaid waivers, plus a handful of smaller, specialized ones. Each targets a specific group and offers a different set of services.
Long-Term Care (LTC) Waiver
This is the largest waiver and serves older adults and people with physical disabilities who would otherwise need nursing home care. It operates through the Statewide Medicaid Managed Care program, meaning enrollees receive services through a managed care plan rather than directly from the state. Covered services include personal care, adult day health care, homemaker assistance, attendant care, assisted living, home-delivered meals, home accessibility adaptations, respite care, companion services, and personal emergency response systems. The Department of Elder Affairs determines medical eligibility and the level of care needed, while the Department of Children and Families handles financial eligibility.
iBudget Waiver (Developmental Disabilities)
Run by the Agency for Persons with Disabilities, the iBudget waiver serves people with intellectual and developmental disabilities. To qualify, a person must be diagnosed with a qualifying condition and meet the level of care criteria for placement in an intermediate care facility for individuals with intellectual disabilities. Qualifying diagnoses include an IQ of 59 or below, or an IQ between 60 and 70 combined with a secondary condition such as Down syndrome, cerebral palsy, autism, spina bifida, epilepsy, or Prader-Willi syndrome. People in that 60 to 70 IQ range can also qualify by showing severe functional limitations in at least three major life activities: self-care, learning, mobility, self-direction, language use, or capacity for independent living.
Services under the iBudget waiver include adult day training, personal supports, residential habilitation, supported employment, behavior analysis services, occupational and physical therapy, respite care, companion services, dietitian services, durable medical equipment, environmental accessibility adaptations, personal emergency response systems, and supported living coaching. Each person receives an individualized budget based on their assessed needs.
Familial Dysautonomia Waiver
This is a small, specialized waiver serving people diagnosed with familial dysautonomia, a rare genetic condition affecting the nervous system. It was most recently renewed in December 2024 and runs through the end of 2029. Covered services include respite care and non-residential support services.
Model Waiver
Another smaller program, the Model waiver covers respite care and environmental accessibility adaptations for a limited number of individuals who qualify.
Who Is Financially Eligible
All Florida Medicaid waivers require the applicant to be eligible for Medicaid. Financial eligibility is determined by the Department of Children and Families and depends on household size, income, and countable assets. For 2025, estimated monthly income limits for a single adult under family-related Medicaid start at roughly $1,255, though waiver-specific rules can differ significantly from standard Medicaid. Many waiver programs use institutional-level income and asset standards, which are more generous than regular Medicaid because the alternative would be costly facility placement paid by Medicaid anyway.
The financial rules vary by waiver type. If your income is slightly above the limit, Florida may still offer eligibility through a medically needy pathway or income trust arrangements, depending on the specific program.
The “Level of Care” Requirement
Beyond financial eligibility, every waiver applicant must demonstrate a medical need for the level of care that would normally be provided in an institution. For the Long-Term Care waiver, this means showing you need the kind of daily support a nursing home provides. For the iBudget waiver, it means meeting the criteria for an intermediate care facility for individuals with intellectual disabilities.
This is assessed through a formal evaluation. For elderly and physically disabled applicants, the Comprehensive Assessment and Review for Long-Term Care Services (CARES) team conducts the assessment. For developmental disabilities, the Agency for Persons with Disabilities performs its own evaluation. The purpose is to confirm that without waiver services, the person would likely end up in an institutional setting.
How to Apply
The application process depends on which waiver you need. For the Long-Term Care waiver, the starting point is Florida’s network of Aging and Disability Resource Centers, which are operated by 11 Area Agencies on Aging across the state. These centers serve as a single entry point for anyone seeking long-term care resources. You can reach them by calling 1-800-963-5337 or by contacting your local center directly. They handle screening, help determine eligibility, and connect you with the right programs.
For the iBudget waiver, you apply through the Agency for Persons with Disabilities. The process begins with establishing eligibility under Florida Statute Chapter 393, which requires documentation of a qualifying developmental disability. Once determined eligible, applicants are placed on a waitlist and assigned to a pre-enrollment category based on priority. Florida law sets the priority order, generally placing people with the most urgent needs (such as those in crisis situations or aging out of children’s services) higher on the list.
Waitlists Are Common
One of the most important things to understand about Florida Medicaid waivers is that demand far exceeds available slots, particularly for the iBudget waiver. Funding is set by the state legislature, and enrollment is capped. This means that even after you qualify, you may wait years before receiving services. The iBudget waitlist has historically been one of the longest in the country, with tens of thousands of people waiting at any given time.
The Long-Term Care waiver also has capacity limits, though wait times tend to be shorter because the program is larger and managed through health plans that have contractual obligations to serve enrollees. If you or a family member may need waiver services in the future, applying early is important because the clock starts when you get on the list, not when your needs become urgent.
What These Services Look Like Day to Day
Waiver services are designed to fill the gaps that keep someone from living safely at home. Personal care means a trained aide helps with bathing, dressing, toileting, and eating. Homemaker services cover cooking, cleaning, and laundry when the person can’t manage those tasks independently. Respite care gives family caregivers a break by providing a substitute caregiver for a set number of hours. Environmental accessibility adaptations include things like installing wheelchair ramps, widening doorways, or adding grab bars in bathrooms.
For people with developmental disabilities, the iBudget waiver also covers employment support, behavioral therapy, and supported living coaching to help with skills like budgeting, cooking, and navigating public transportation. Adult day training provides structured daytime activities focused on building life skills and social connections. The goal across all waivers is to maximize independence while keeping the person safe and healthy in a setting they prefer.
Terminated Waivers You May Still See Referenced
If you search online, you’ll find references to several Florida waivers that no longer exist. The Traumatic Brain and Spinal Cord Injury waiver, the Project AIDS Care waiver, the Alzheimer’s Disease Program waiver, the Nursing Home Diversion waiver, and the Assisted Living waiver have all been terminated. Most of their functions were absorbed into the Statewide Managed Care Long-Term Care program when Florida consolidated its waiver system. If you were previously enrolled in one of these programs, your services would have transitioned to the current LTC managed care structure.