Florida Medicaid Waiver Guide

Florida's Medicaid waiver services for people with intellectual and developmental disabilities are run by the Agency for Persons with Disabilities (APD) through the iBudget Florida waiver. iBudget helps eligible Floridians live in their own home, with family, or in the community — instead of in an institution — by giving each enrolled person an individual budget to purchase approved supports. Families usually start by applying for Medicaid through the Department of Children and Families (DCF) and requesting an APD eligibility determination. Because iBudget has more eligible people than funding, most families are found eligible and then wait on “pre-enrollment” — so applying as early as age 3 matters. Florida also runs the IDD Comprehensive Managed Care (ICMC) program, a voluntary managed-care alternative that has been open statewide since October 1, 2025 and bundles iBudget-style supports with medical care.

To receive iBudget waiver services, a person must be at least 3 years old, have a qualifying developmental disability that began before age 18, meet an ICF/IID level of care, be eligible for Florida Medicaid, and be a Florida resident. Because the waiver has a waiting list, meeting eligibility does not guarantee immediate enrollment — APD enrolls people by crisis status and statutory priority category, and within Categories 3–7 by the date eligibility was determined.

Florida calls this “pre-enrollment” (formerly the waiting list). APD moves people from pre-enrollment into the iBudget waiver based on crisis status and seven statutory priority categories (s. 393.065(5), F.S.) as funding allows.

Type

Pre-enrollment (formerly the waiting list)

Typical timeline

Waits vary by category and funding and can span years. Within Categories 3–7, APD enrolls people in the order of the date they were determined eligible, so your eligibility date matters as much as your category. Ask APD for the current pre-enrollment count and where you sit.

How to check status

Contact your APD regional office or call APD CARES (1-866-273-2273) to confirm your status and priority category.

1. Apply for Florida Medicaid

   Apply for Medicaid through DCF's MyACCESS portal.

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2. Request APD eligibility

   Contact your APD regional office to apply for services and a developmental disability eligibility determination.

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3. Complete the assessment

   APD reviews your diagnosis and evaluation records and confirms the required level of care.

4. Go onto pre-enrollment

   If eligible, you're placed on pre-enrollment (Florida's term for the waiting list) and assigned one of seven priority categories. Tell APD right away if your situation changes — a new caregiver age, a crisis, or an upcoming graduation can move your category.

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5. Consider ICMC while you wait

   ICMC is a voluntary managed-care alternative open statewide to anyone in a pre-enrollment category, with limited spots. Enrolling in ICMC takes your name off the iBudget pre-enrollment list, so weigh it carefully. Questions: 1-877-711-3662, option 4.

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6. Enroll and choose providers

   When enrolled, a waiver support coordinator helps you build a support plan and select providers.

• The person's age, diagnosis, and county of residence.
• Medicaid status or whether you still need to apply.
• Current supports, urgent needs, and living situation.
• School, medical, evaluation, or eligibility documents.
• Questions about waitlists, timelines, and next steps.

Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.

Florida offers Consumer-Directed Care Plus (CDC+), letting participants and families direct their own iBudget services and budget, including hiring and managing their own workers.

1. Birth to age 3 — Early Steps

   APD does not serve children under 3. Florida's Early Steps program handles early intervention for infants and toddlers with delays. Call 1-800-218-0001 to make a referral.

   Learn more
2. Age 3 — apply to APD

   Age 3 is the earliest you can apply to APD, and applying early matters: within Categories 3–7 people are enrolled in order of their eligibility determination date, so an early date is worth having even while you wait.

   Learn more
3. School age (3–21)

   The school district provides special education under an IEP. APD services are separate from and in addition to what school provides — being on pre-enrollment does not affect IEP rights.

4. Graduation & aging out

   Students expected to graduate within 12 months who need employment or postsecondary support fall in Category 5. Tell your APD worker before graduation, and connect with Vocational Rehabilitation for employment services.

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5. Adulthood

   At 18, Medicaid eligibility is redetermined on the person's own income rather than the family's, which changes financial eligibility for many. Consider whether guardianship, a guardian advocate, or supported decision-making fits before the birthday.

If APD or Medicaid denies, reduces, or terminates services, you have the right to request a Medicaid fair hearing — usually within 90 days of the notice. Disability Rights Florida can help you understand and exercise your rights.

APD

Agency for Persons with Disabilities — the Florida agency that determines developmental disability eligibility and runs the iBudget waiver.

iBudget

Florida's HCBS waiver for people with developmental disabilities. Each enrolled person gets an individual budget to purchase approved supports.

Pre-enrollment

Florida's current term for the iBudget waiting list. You are found eligible and assigned a priority category, then wait for funding.

WSC (Waiver Support Coordinator)

The person you choose to help you find services, coordinate providers, maintain records, and advocate for you. You select your own WSC and can change them.

QSI

Questionnaire for Situational Information — the assessment APD uses to measure the support a person needs. It is redone about every three years and feeds the algorithm that sets your budget amount.

CDC+

Consumer-Directed Care Plus — Florida's self-direction option, letting you manage your own budget and hire your own workers instead of using agency providers.

ICMC

IDD Comprehensive Managed Care — a voluntary managed-care alternative that bundles medical care with iBudget-style supports. Joining removes you from iBudget pre-enrollment.

ICF/IID

Intermediate Care Facility for Individuals with Intellectual Disabilities — the institutional level of care you must be found to need in order to qualify for the waiver.

DCF

Department of Children and Families — determines Medicaid financial eligibility through the MyACCESS portal. Separate from APD's disability determination.