Medically Needy Program in Florida

"What is the Medically Needy Program in Florida?" is a question asked by certain low-income patients who seek government-sponsored health coverage. The Medically Needy Program in Florida is designed for patients whose household incomes are too high to qualify for Medicaid benefits. The Medically Needy Program in Florida helps pay for services that are covered by Medicaid, but it does not pay health coverage in its entirety. Recipients must pay a particular amount of their medical expenses each month, first. Once they reach the limit of how much they must pay, Medicaid will step in and pay the rest of their medical expenses for that month. Medically Needy Program eligibility has different income limits than the regular Medicaid. Aside from income, anyone that qualifies for Medicaid can qualify for the Medically Needy Program in Florida - under certain circumstances. Medically Needy Program eligibility is decided upon by the Florida Department of Children and Families after an application is received. To learn more about how the Medically Needy Program in Florida works, review the below sections:

  • Medically Needy Share of Cost Details in Florida
  • Allowable Expenses for the Medically Needy in Florida
  • How to Apply for Medically Needy Program Benefits in Florida

Medically Needy Share of Cost Details in Florida

The Medically Needy Program in Florida uses a "share of cost" system which is like an insurance deductible that patients must pay on a monthly basis before Medicaid pays for their medical expenses. The Medically Needy share of cost that a recipient must pay is determined by his or her gross monthly income and household size. If a patient has a big family with a small income, his or her share of cost would be considerably less than someone who is living alone that has the same income. The Medically Needy share of cost can be met by those in the household whose needs and incomes make them eligible for Medicaid. The amount of an applicant's medical expenses each month determines how much Medicaid will cover. For example, if the recipient has a Medically Needy share of cost that is $500, he or she would need to have over $500 in allowable medical expenses for the month before Medicaid steps in and pays for anything.

Allowable Expenses for Medically Needy in Florida

The Medically Needy share of cost and the benefits paid only apply to allowable expenses. These are typically the same expenses that Medicaid would handle. These include unpaid medical bills (which have not been counted toward the share of cost before), medical bills paid within the last three months, medical bill copays, health insurance premiums, doctor-prescribed medical services and transportation to get medical treatment. There are other expenses the Medically Needy Program in Florida does not cover, though. Download our free guide to review the specific expenses that the Medically Needy Program in Florida does not cover on behalf of beneficiaries.

How to Apply for Medically Needy Program Benefits in Florida

The Florida Department of Children and Families is what regulates the Medically Needy Program in Florida for all residents. State residents can apply for the Medically Needy Program in Florida through the Florida Department of Children and Families website. The site will direct users to the ACCESS Florida webpage, where applicants can register for an account online and then submit their applications for the Medically Needy Program in Florida so they can be reviewed. This is the same website that walks applicants through the steps to apply for general Medicaid benefits. Most patients who have already tried to apply for Medicaid online will likely have an ACCESS Florida account already established. This same account can be used to apply for the Medically Needy Program in Florida as well. Alternatively, applicants can choose to go down to their local ACCESS service centers in person and fill out the applications for the Medically Needy Program in Florida. In addition, there are other methods of application available, which can be found in our free, downloadable guide.

When approved for the Medically Needy Program in Florida, the recipient of the benefits will have to provide proof to the Department of Children and Families regarding medical expenses for the month. These expenses get reported to the Economic Self-Sufficiency Office by either the Medicaid provider or the recipient. The information about the expenses must include the amount, the date incurred and the amount of any payments made toward the expense, as well as the date of these payments. This proof could come in the form of monthly medical bill statements, payment receipts and canceled checks. This proof should be submitted to the Economic Self-Sufficiency Office for the Medically Needy Program in Florida as soon as possible in order for Medicaid to provide recipients with the maximum coverage possible for the month. Download our guide to review information on how to submit proof of medical expenses to the state properly and timely.

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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.