Florida Medicaid Eligibility: What You Should Know

Florida Medicaid is designed to help people with low income, including families, seniors, pregnant women, and those with disabilities. The program covers essential medical services such as hospital care and doctor visits.

If you’re looking to get Medicaid, it’s important to understand the eligibility requirements. This guide explains who qualifies for Florida Medicaid, the income limits you need to meet, and how to apply for coverage.

Who Qualifies for Florida Medicaid

Florida Medicaid is available to various groups of people who meet income and other eligibility requirements. Here are some of the main groups that qualify:

• Low-income families: Families who don’t earn a lot of money can get Medicaid.
• Pregnant women: Expecting mothers qualify for Medicaid, and this coverage continues for a year after giving birth.
• Children: Kids under 19 can qualify for Medicaid depending on their family’s income.
• Seniors: Seniors aged 65 and older might qualify, especially if they need long-term care.
• People with disabilities: If you have a disability, you may qualify for Florida Medicaid, even if you don’t get Supplemental Security Income (SSI). It’s also possible to qualify through programs that help with long-term care or high medical costs.
• Other special groups: This includes people who are medically needy or need long-term care.

Florida Medicaid Eligibility Requirements

To qualify for Florida Medicaid, you need to meet certain important requirements. Here’s a breakdown of the requirements:

Residency and Citizenship

You must live in Florida and have the right immigration status to apply for Medicaid. For most Medicaid programs, you typically need to be a U.S. citizen or a qualified non-citizen. If you’re a non-citizen, you may qualify for emergency Medicaid services in certain situations.

Income Limits

The income limits for Medicaid vary depending on the number of people in your household and the type of coverage you need. Here are some current monthly income limits:

• Children: Kids under 1 year old qualify for Medicaid at up to 200% of the Federal Poverty Level (FPL), while children ages 1-18 qualify at up to 138% of FPL. Children whose families have incomes between 138% and 200% of FPL might be eligible for other programs like Florida Healthy Kids. Keep in mind that this program requires you to pay a monthly premium.
• Pregnant women: Expecting mothers can qualify for Medicaid if their income is up to 196% of FPL.
• Adults with minor children: Parents and caregivers of children under 18 can get Medicaid if their income is below 26% of FPL.
• Long-term care applicants: Seniors and people who need nursing home care or home-based support must have an income below $2,901 per month (for a single applicant in 2025).

If you qualify for SSI, you are automatically eligible for Medicaid in Florida, so you don’t need to apply separately.

Asset Limits

Some groups, such as seniors and people with disabilities, have limits on savings and property to qualify for Florida Medicaid. In most cases:

• If you’re single, you can have up to $2,000 in countable assets.
• If you’re married and applying together with your spouse, you can have up to $3,000 combined.
• If only one spouse is applying, the community spouse (the one not applying) can keep up to $157,920 in assets.

Some things, like your personal belongings, don’t count toward this limit. Other assets that may also not count include:

• Your home (as long as its equity is under $731,000 in 2025)
• One vehicle

Age and Disability Requirements

Some groups must meet specific age or disability criteria to qualify for Medicaid:

• Seniors: You can qualify for Medicaid if you are 65 or older, especially if you need long-term care at home or in a nursing facility. Keep in mind that you also need to meet income and asset limits.
• People with disabilities: If you have a disability that prevents you from working, you may qualify for Medicaid. In many cases, eligibility is based on Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). However, some people with high medical expenses may qualify under other Medicaid programs.

Level of Care Requirement

For long-term care services, Medicaid considers how much help you need with the tasks you perform daily, like bathing, dressing, or eating. If the program determines that you need help to stay in your own home or you need full-time care in a nursing home, you will likely qualify for one of Medicaid’s long-term care programs.

If you’re unsure about your eligibility, you can apply and let Medicaid review your situation. Even if your income or assets seem too high, there may still be options to help with medical costs.

How to Apply for Florida Medicaid

Step 1: Check If You Qualify

Before you apply, it’s helpful to know if you are eligible for Medicaid. You can visit the Department of Children and Families (DCF) website to see if you qualify.

Step 2: Gather Your Documents

To apply for Medicaid, you’ll need to get the right documents ready. These usually include:

• Proof of identity (driver’s license, birth certificate, or passport)
• Proof of income (pay stubs, tax returns, or Social Security statements)
• Proof of residency (utility bill or lease agreement)
• Proof of citizenship or immigration status (passport, birth certificate, or immigration documents)
• Proof of household composition (birth certificates for children, marriage or divorce certificates)

Step 3: Submit Your Application

There are three ways to apply for Medicaid in Florida:

1. Online: The easiest way is through the ACCESS Florida portal.
2. In-person: If you prefer to apply face-to-face, you can visit a local DCF office.
3. By mail: You can also send your application through the mail.

Step 4: Wait for a Decision

The processing time for an application is usually about 45 days, but it can take longer if they need to review a disability claim.

You can log into your MyACCESS Account anytime to check your application status. To stay informed about the progress, be sure to sign up for email updates.

Conclusion

Florida Medicaid can make a big difference in the lives of families and individuals who need help with healthcare costs. If you believe you meet the eligibility requirements, don’t hesitate to check your eligibility and start your application as soon as possible.

Need help understanding Medicaid-covered services? Abby Care is here to help. Contact us today to learn more about how we can support you or your loved one.

Sources

https://www.medicaidplanningassistance.org/medicaid-eligibility-florida/

https://www.aetnabetterhealth.com/florida/medicaid-eligibility-qualifications.html

https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/become-eligible-for-medicaid

https://www.coveringcfl.net/florida-medicaid-income-limits-and-eligibility/?form=MG0AV3&form=MG0AV3
https://www.chcfl.org/patient-info/florida-medicaid-information-application-and-eligibility/