Fort Myers Senior AdvisorWhat is the main difference between Medicaid LTC and PACE in Florida?
Medicaid long-term care (SMMC LTC) pays a managed care plan to arrange home, community and nursing home services from many providers, while PACE is a single organization, Hope PACE in Lee County, that employs or contracts the whole care team and replaces the member's Medicare and Medicaid coverage.
In PACE, the doctor, nurse, therapists, social worker and drivers work together from a PACE center. In SMMC LTC a case manager coordinates separate providers, and the member keeps his or her own doctors through Medicare.
Is there a waitlist for Medicaid LTC or PACE in Lee County?
Home and community-based services under SMMC LTC have a statewide waitlist managed through the Area Agency on Aging's screening, while PACE enrollment depends on the program's available slots and does not go through that waitlist.
AHCA's PACE monthly report for August 2026 shows Hope PACE's Lee County program, operating since January 22, 2008, approved for 580 enrollment slots with 475 members enrolled (488 people served that month); its separate Charlotte and Collier programs had 80 and 94 members.
Who is eligible for each program?
Both require nursing home level of care as certified by the state and Medicaid financial eligibility (or, for PACE, private payment of the Medicaid share); SMMC LTC requires age 65 or older or a disability, and PACE requires age 55 or older and residence in the service area.
The financial rules, including the $2,982 monthly income cap and the Qualified Income Trust for those above it, are the same DCF rules for both.
Can each program pay for assisted living in Lee County?
Both can pay for care services in an assisted living facility, and neither pays the room and board, which the resident covers from income, often with Optional State Supplementation.
What matters in practice is whether the ALF is in the plan's network or works with Hope PACE. Ask before signing a lease.
Which program fits which Lee County family?
PACE tends to fit someone who needs frequent medical attention, benefits from a day center and is comfortable changing doctors, while SMMC LTC fits someone who wants to keep current physicians, lives outside a PACE service area or is already in a nursing home.
Call the Elder Helpline at 1-866-413-5337 to be screened for SMMC LTC and ask Hope PACE for an assessment at the same time.
The short version
| PACE is | Medicaid LTC is | |
|---|---|---|
| Structure | One organization delivering all care | A plan coordinating many providers |
| Doctors | PACE's own physicians | The member's own Medicare doctors |
| Access | By available PACE slot | Through the statewide waitlist (unless in a nursing home) |
Built from Chapters 400, 408, 429 and 651 of the Florida Statutes, Fla. Admin. Code chapters 59A-4, 59A-36 and 65A-2, and AHCA, DCF, OIR, Elder Affairs, CMS, VA and CareScout publications cited on the page; see our editorial standards.
