Florida Medicaid HCBS Waiver Programs Guide

Who it serves: Individuals of any age (generally 3 and older) with intellectual or developmental disabilities (I/DD) — including intellectual disability, cerebral palsy, spina bifida, autism spectrum disorder, Prader-Willi syndrome, and Phelan-McDermid syndrome — who need home- and community-based services as an alternative to institutional care. Eligibility includes an I/DD diagnosis with onset before age 18 and documentation that the disability is expected to continue indefinitely. APD determines eligibility — confirm your specific diagnosis and eligibility criteria with your local APD district office.

How to apply: Contact your local APD District Office or call the APD main line at 1-866-APD-CARES (1-866-273-2273) to request eligibility determination. APD will conduct a records review and may require a psychological evaluation documenting the qualifying disability. Once APD determines eligibility, they develop an iBudget allocation based on assessed support needs. The iBudget amount determines which HCBS services the individual can self-direct or access through APD-enrolled providers. Apply through the APD iConnect portal or contact your district office for paper-based intake.

Note: Florida has historically maintained waiting lists for iBudget services. APD publishes data on the Developmental Disabilities Waitlist (also called the Medicaid Waiver Waiting List) at apdcares.org — confirm current wait times and slot availability with your APD district office. Some individuals receive limited services while on the waitlist through APD's pre-waiver support framework.

Who it serves: Adults with early-onset Alzheimer's disease (age limits apply — confirm current eligibility criteria and age limits with APD) who have a diagnosis of Familial Alzheimer's Disease (FAD) — a genetically-linked form of early-onset Alzheimer's — whose care needs require home- and community-based services as an alternative to nursing facility placement. FALD is a smaller, targeted waiver separate from iBudget. Eligibility requires medical documentation of FAD and functional impairment — confirm current eligibility criteria and slot availability with APD.

How to apply: Contact your local APD District Office at apdcares.org or call 1-866-APD-CARES to request FALD intake. Medical documentation of the FAD diagnosis from a physician or neurologist is required, along with functional assessment showing the need for HCBS. FALD is a limited-slot waiver — slot availability varies; confirm current status with APD before making plans based on historical information.

Note: FALD is a narrowly targeted waiver with limited statewide slots. It is distinct from iBudget and from SMMC LTSS. Not all APD offices process FALD applications routinely — call your district office to confirm they serve FALD applicants and ask for the correct intake contact.

Who it serves: Aged adults (65 and older) and adults under 65 with physical disabilities who meet a nursing-facility level of care and are enrolled in Florida Medicaid managed care. SMMC LTSS is the primary pathway for HCBS services for individuals who are NOT in the I/DD population and do not qualify for APD waivers. SMMC LTSS operates through Florida's managed care plans, which deliver HCBS benefits including personal care, home health aide services, adult day care, and care coordination. AHCA determines level of care — confirm eligibility with your Managed Long-Term Care (MLTC) plan or AHCA.

How to apply: Enroll in Florida Medicaid through the ACCESS Florida portal at myflorida.com/accessflorida or call 1-866-762-2237. Once enrolled, contact your assigned managed care plan to request LTSS enrollment and a level-of-care assessment. AHCA's Comprehensive Assessment and Review for Long-Term Care Services (CARES) program conducts the nursing-facility level-of-care screening. Your managed care plan's care coordinator can guide the CARES referral and LTSS enrollment process. Confirm which managed care plan serves your county — plans vary by region.

Note: SMMC LTSS operates through multiple private managed care plans under contract with AHCA. Plan availability, service arrays, and provider networks vary by county. If you are currently enrolled in a managed care plan for regular Medicaid benefits, LTSS services are a separate enrollment — contact your plan to initiate the LTSS assessment process. Confirm current plan options in your county with AHCA's Managed Care Help Line at 1-877-254-1055.

Who it serves: Children (under age 19) with significant disabilities or chronic medical conditions who need a level of care equivalent to an institutional setting but who live at home. The Katie Beckett / TEFRA option allows children to qualify for Florida Medicaid based on the child's own income and resources — parental income and assets are not counted. This is not an HCBS waiver itself, but it often provides the Medicaid coverage base that then enables access to Florida's HCBS waiver services, including APD waiver services for children with I/DD. AHCA determines eligibility — confirm the current process with your regional Medicaid office.

How to apply: Contact AHCA's Medicaid eligibility unit or the DCF ACCESS Florida program to request the TEFRA/Katie Beckett Medicaid eligibility determination. Provide medical documentation showing the child needs an institutional level of care and is being cared for at home. Once Katie Beckett/TEFRA Medicaid is established, contact APD (if the child has I/DD) or the child's managed care plan (for other complex medical needs) to access appropriate HCBS services. Confirm the current intake pathway and required documentation with AHCA or your DCF caseworker.

Note: Katie Beckett / TEFRA eligibility does not automatically enroll a child in an HCBS waiver — it establishes Medicaid coverage eligibility. The family must then separately apply to the appropriate HCBS program (APD for I/DD; SMMC LTSS through AHCA for other disabilities). Waitlists and slot availability for APD waiver services apply regardless of Katie Beckett/TEFRA status.