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Florida Medicaid

What You Need To Know

Medicaid helps to cater to the healthcare needs of people with low incomes. Its health coverage helps to provide for those people who are unable to take medical care of themselves. This helps to improve the health of the residents of the state. It is a program that has been administered by the Centers for Medicare & Medicaid Services.

The average amount of people that are eligible for Medicaid can be estimated at 3.8 million. Therefore, they are further broken into categories. Amongst these there is

  • Age by Assistance Category
  • Age by County
  • Age by Gender

Medicaid covers services according to the age of the beneficiary as well as the type of the program. The services may include:

  • Doctor
  • Hospital
  • Family planning i.e. birth control, pregnancy, and birth care.
  • Home health care
  • Nursing home
  • Hospice
  • Transportation
  • Dental and visual
  • Prescriptions
  • Community behavioral health
  • Any other similar services.

In case the individual who wishes to apply has both Medicare and Medicaid, the program covers:

  • Medicare deductible. This is the amount a person pays before Medicare starts to pay.
  • A portion of Medicare co-payment and co-insurance. This is the cost a person shares with Medicare.
  • Premiums paid for Medicare coverage
  • Some services that Medicare does not cover.

There are certain other programs that eligible applicants can consider too. These include Qualified Medicare Beneficiaries (QMB), Qualifying Individuals 1 (QI-1) and Special Low-Income Medicare Beneficiaries (SLMB).

Are You Eligible?

There are certain requirements involving this program. Amongst these, the applicant must make sure that he or she is:

  • A resident of the state of Florida
  • In need of health coverage
  • Has a financial situation which can be described as low income or very low income.
  • A U.S. national, citizen or has a satisfactory immigration status

These are basic requirements for the applicant who wishes to benefit from this program. Along with this, there are certain factors including the fact that the person must:

  • Be above the age of 64
  • Be pregnant or a parent of a child under 18
  • Be blind or disabled
  • Have a family member who is blind or disabled. This can be a child, parent or spouse in the household.
  • Recipients of Supplemental Security Income

Once these requirements are met, then the income and asset requirements of the person are considered. The household income of the applicant is also taken into account. Their earnings before tax deductions are considered. The amount is either be less than or equal to:

Size Of Household Maximum Annual Income Level ($)
1 16,612
2 22,491
3 28,369
4 34,248
5 40,127
6 46,005
7 51,884
8 57,762

Some houses may have more than eight residents. In these instances, an additional amount of $5,878 s added per person. To ensure that you are in line with the most recent and accurate guidelines, a managing agency must be approached.

How To Apply

The application process for Medicaid can begin with the help of the Department of Children and Families. A toll-free number is also available:


Certain people move from other states to Florida. In these cases, if the person had Medicaid in their previous state, they must apply for it in Florida. If they receive SSI then they should contact the appropriate Social Security through their toll-free number



Medicaid is also available for children. Families who wish to apply for it must submit a Florida KidCare application. There is a toll-free number available for such purposes as well. It is:


The qualified candidates receive all health care services except long-term care from a managed care plan. This helps you to choose among the various plans of your area. It is dependent on the providers of the individual’s plan. There is a choice counselor present who helps to make sure that the best plan is selected. It suits the needs of the person completely.

For Further Information?


A Florida Medicaid website has been set up to cater to the queries of potential applicants. This helps people to easily access the information they require.

There also Medicaid offices set up to help out the residents of the state. A local office can be found through the website which can be visited whenever it is possible. In case further information is required by the applicant concerning eligibility, there is a page available too.

In case the application has been denied or terminated. The person can also request a hearing through telephone. This includes any information you require if your benefits have been reduced or terminated. The DCF is available to answer such questions.


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