Eligibility for Medicaid in Florida

Medicaid benefits eligibility in Florida is determined by the Department of Children and Families. This governing body sets forth the Medicaid eligibility requirements that Floridians must meet to receive these specific healthcare benefits. The Medicaid eligibility requirements basically revolve around the income levels and citizenship of those in the household of the applicant. Most Floridians can learn how to qualify for Medicaid just by satisfying these two conditions, first. There are also other groups who may have Medicaid benefits eligibility under certain circumstances. Who is eligible for Medicaid? The roster includes: parents, children, guardians of children, pregnant women, individuals formally in foster care, disabled people, senior citizens and those who are not U.S. citizens or residents of Florida that have medical emergencies. To learn more about the Medicaid eligibility requirements review the below topics:

  • Medicaid Benefits Eligibility for Parents, Caretakers and Individuals in Florida
  • Medicaid Eligibility for Children and Pregnant Women in Florida
  • Medicaid Benefits Eligibility for Additional Groups in Florida

Medicaid Benefits Eligibility for Parents, Caretakers and Individuals in Florida

What are the requirements for Medicaid in Florida? To begin, Medicaid benefits eligibility is mainly determined by the household income level of the applicant as it relates to the current Federal Poverty Level, or FPL. Parents and caretakers can have higher income limits on their Medicaid benefits eligibility if they are taking care of one or more children in their households. To satisfy the Medicaid eligibility requirements, parents or caretakers need to have specified relationships with the child/children residing in the household, and the children in the household must be under the age of 21. Download our free guide to read about the specific relationships required between applicants with children who are seeking Florida Medicaid.

What are the income requirements for Medicaid in Florida? A household with one person can have a maximum income amount of $15,800, while a household with two people can have a maximum income amount of $21,307. With each additional person in the household, the maximum income amount increases by $5,533. Also, any individuals that are currently receiving Temporary Cash Assistance from the government may still have Medicaid benefits eligibility for themselves. If they are eligible for Temporary Cash Assistance but are choosing not collect the benefits, then they are eligible for Medicaid, too. Read more about applicants who qualify for Medicaid through other benefit programs by downloading our guide.

Medicaid Eligibility for Children and Pregnant Women in Florida

Medicaid eligibility requirements dictate that children do not have to be living with their adult caretakers to be eligible for Medicaid. Caretakers and parents can follow the steps to fill out Medicaid applications in order for their children to receive these healthcare benefits. Any child who has Medicaid benefits eligibility can also sign up with the Child Health Check-Up Program. This specialized program for children helps with scheduled health checkups, immunizations, dental screenings and lots of other medical services designed for children. The household income of the child still plays a factor into whether he or she has Medicaid benefits eligibility or not. Any income made by the child will not count toward the household income limit if he or she is not required to file a federal tax return. Applicants on behalf of children who do not qualify for Medicaid in Florida should then review the state eligibility requirements for CHIP benefits.

Pregnant women who have a low enough household incomes may have Medicaid benefits eligibility, too. The only stipulation is that the Medicaid benefits last for the duration of the pregnancy and for two months after the baby is delivered. Pregnant women who may be eligible for Medicaid but who have not gotten the benefits yet can receive temporary coverage called Presumptively Eligible Pregnant Women. This coverage only applies to prenatal care only and applicants must get approved for the coverage by a Qualified Designated Provider. If the pregnant woman has a family income too high for Medicaid benefits eligibility, then she may get approved for the Medically Needy Program, another type of coverage plan available. Download our guide to review more information on these alternative health programs for low-income pregnant women.

Medicaid Benefits Eligibility for Additional Groups in Florida

In addition to the above groups, Medicaid benefits eligibility automatically applies to anyone under 26 years of age who used to be in Foster Care. What are the Medicaid application guidelines for former Florida foster children? These applicants must also have been receiving Medicaid after they turned 18 to qualify thereafter. There is no income limit for former foster care individuals who apply for Medicaid under these conditions.

Non-U.S. citizens who have Medicaid benefits eligibility in every other area may be able to receive Emergency Medical Assistance coverage if they are suffering from medical emergencies. Pregnant women who are not citizens can qualify for this coverage because going into labor and delivering a child are both considered emergency situations. As for disabled individuals or those who are over 65 years of age, these applicants are entitled to SSI-Related Medicaid. Basically, their Medicaid eligibility requirements are automatically met if they are receiving Supplemental Security Income from the government. 


What Health Services Are Available in Florida?

Health services are available for a wide variety of Florida residents and the benefits range from low-cost to free health care. However, the claimants and families that are interested in these benefits typically need to submit applications and documents that prove their eligibility for program benefits. Learn about the various health programs available in the state of Florida and find out how to qualify for affordable health care or medical coverage that is free of charge by downloading our guide.

Who Can Receive Florida Health Benefits?

Health service programs in Florida have a variety of eligibility requirements. Some of the factors taken into consideration when evaluating an applicant's eligibility include age and household income. However, even if petitioners do not qualify for health care in one program, they are often eligible for the benefits of another.