Who Florida Medicaid Covers

Florida Medicaid covers people in specific groups: children under 19, pregnant people, parents and caretakers of children, people over 65, and people who are blind or disabled. You must be a U.S. citizen or a may have access to immigrant, live in Florida, and meet income and asset limits. The income limit depends on which group you fall into — a parent of two children has a different threshold than a pregnant person or a senior.

Florida did not expand Medicaid under the Affordable Care Act, which means working-age adults without children or disabilities generally do not may have access to, even if their income is very low. This is the single largest gap in Florida's program. If you are an adult without dependents and earn under the federal poverty line, you may still not may have access to for Florida Medicaid.

Key Takeaways

  • Florida Medicaid income limits vary by household size and category — a parent of one child has a different limit than a parent of three.
  • You must be a U.S. citizen, a refugee, an asylee, or a may have access to immigrant with a valid Social Security number or Individual Taxpayer Identification Number.
  • Working-age adults without children or disabilities do not may have access to in Florida, even if their income is very low, because the state did not expand Medicaid.
  • You report your household size, income, citizenship status, and assets to the Florida Department of Children and Families, either online through ACCESS Florida or by mail.
  • The state processes applications within 45 days for most people and 30 days for pregnant people and children.

Income Limits by Household Size and Category

Florida Medicaid income limits are set as a percentage of the federal poverty level and change each year. For parents and caretakers, the limit is currently around 33% of the federal poverty level — roughly $900 per month for a single parent with one child, though this varies. For children, the limit is higher: around 200% of the federal poverty level. For pregnant people, it is around 196% of the federal poverty level. For seniors and people who are blind or disabled, the limit is around 100% of the federal poverty level.

These percentages translate into different dollar amounts depending on your household size. A household of two has a higher income limit than a household of one. The Florida Department of Children and Families publishes current income limits on its website, and they update each January. When you report your income, the state counts gross monthly income before taxes — wages, self-employment income, Social Security, unemployment, child support, and most other regular payments.

Some income does not count: the first $90 of unearned income per month, the first $65 of earned income per month, and certain types of support like Supplemental Security Income (SSI) in some cases. If you are unsure whether a specific income source counts, ask the caseworker when you apply.

Citizenship and Immigration Status Requirements

You must be a U.S. citizen or a may have access to immigrant to receive Florida Medicaid. U.S. citizens include people born in the United States, naturalized citizens, and certain people born abroad to U.S. citizen parents. You will need to provide proof: a birth certificate, passport, naturalization certificate, or a state ID marked as REAL ID compliant.

may have access to immigrants include refugees, asylees, people granted withholding of removal, Cuban or Haitian entrants, and certain other categories. If you are a may have access to immigrant, you will need to show your immigration documents — an I-94, I-131, I-765, or other USCIS paperwork. Undocumented immigrants do not may have access to for Florida Medicaid, though they may be able to use emergency services covered by Medicaid.

Everyone who applies must provide a valid Social Security number or an Individual Taxpayer Identification Number (ITIN). If you do not have one, you can apply for an ITIN through the IRS before you apply for Medicaid.

Asset Limits and What Counts

Florida Medicaid has asset limits that vary by category. For most people — parents, caretakers, and children — the asset limit is $2,000 for a single person and $3,000 for a couple. For seniors and people who are blind or disabled, the limit is also $2,000 for a single person and $3,000 for a couple. Assets include cash, bank accounts, stocks, bonds, and property you own other than your home and one vehicle.

Your home and one car do not count toward the asset limit, no matter their value. Household goods and personal items also do not count. If you are married, the state counts both spouses' assets together. If you are over the limit, you may still be able to spend down assets on medical care, home repairs, or other allowed expenses before you apply.

How to Report Income, Household Size, and Citizenship

You report your information to the Florida Department of Children and Families through ACCESS Florida, the state's online benefits portal. You can create an account at myflorida.gov/accessflorida, fill out the application, upload documents, and track your case status. You will need to provide your name, date of birth, Social Security number, household members' names and dates of birth, monthly income from all sources, asset information, and citizenship or immigration status.

If you cannot apply online, you can mail a paper application to your local Department of Children and Families office or apply in person. Call 1-866-762-2237 to find your local office or to request a paper form. When you apply, have ready: pay stubs or proof of income, a birth certificate or passport, proof of citizenship or immigration status, and bank statements if you have assets near the limit.

The state will contact you within a few days to ask for any missing documents. You have 30 days to send them back. If you do not respond, your application may be denied. Once the state has everything, it processes your case within 45 days for most people and 30 days for pregnant people and children.

What Happens After You Apply

After you submit your application, the Florida Department of Children and Families sends you a notice by mail. If you are found to meet the income, asset, and citizenship requirements, you will receive a notice of approval and your Medicaid card will arrive within two weeks. Your coverage starts on the first day of the month you applied or the first day of the following month, depending on when the state processes your case.

If the state denies your application, the notice will explain why — usually because your income is over the limit, you did not provide proof of citizenship, or you did not respond to a request for documents. You have the right to request a hearing to challenge the decision. You must request the hearing within 90 days of the denial notice. Call 1-866-762-2237 to ask how to file a hearing request.

Once you are approved, you must report changes to your income, household size, or address within 10 days. You can report changes online through ACCESS Florida or by calling your caseworker. If your income increases and you go over the limit, your coverage will end. If your income decreases, you may become newly may be able to access or your coverage may continue.

Special Rules for Pregnant People and Children

Pregnant people have a higher income limit than parents — around 196% of the federal poverty level — and the state processes their applications within 30 days instead of 45. Pregnancy-related care, delivery, and postpartum care are covered for 60 days after the end of pregnancy, even if your income later exceeds the limit. You do not need to be a citizen to receive pregnancy-related Medicaid in Florida; you only need to be a resident.

Children have the highest income limit of any group — around 200% of the federal poverty level — and the state also processes their applications within 30 days. If a child is born to a parent already on Medicaid, the child is automatically enrolled for the first month. After that, you must report the birth to keep the child on the program.

Frequently Asked Questions

What if I earn too much for regular Medicaid but not enough to afford insurance?

If your income is above Florida Medicaid's limit but below 400% of the federal poverty level, you may be able to purchase a plan through the federal health insurance marketplace at healthcare.gov and receive a tax credit to lower your premium. You can also call 1-800-318-2596 to speak with a marketplace representative about your options.

Do I have to report my immigration status if I am undocumented?

No. Undocumented immigrants do not may have access to for regular Medicaid in Florida. However, you may be able to receive emergency Medicaid if you have a medical emergency. You do not have to report your immigration status to receive emergency care.

Can I get Medicaid if I am receiving unemployment benefits?

Yes. Unemployment income counts toward your total household income, so it may affect whether you meet the income limit. Report your unemployment benefits when you apply. If your unemployment ends, report that change within 10 days so the state can recalculate your may be able to access.

What if my household size changes after I am approved?

Report the change within 10 days through ACCESS Florida or by calling your caseworker. If someone moves into your household, your income limit may change. If someone moves out, your limit may increase, which could help you stay may be able to access if your income is close to the limit.

How long does Medicaid coverage last once I am approved?

Coverage typically lasts 12 months. Before your 12 months end, the state will send you a renewal notice asking you to confirm your income and household information. You must respond within 30 days or your coverage will end. After renewal, your coverage continues for another 12 months if you still meet the requirements.