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How To Apply For Florida Medicaid Health Coverage

Updated on March 29, 2013

Often times in a rough economy, many people who might be qualified for state funded services don’t apply either because of embarrassment, or they don’t know what is available to them. One major focus is medical insurance. It seems that everyone needs medical coverage, but in many cases people either aren’t eligible due to their employment status, or simply can’t afford the high cost of premiums. As it turns out there is a wealth of information available regarding these social programs. Since we’re on the topic of health insurance lets talk about Medicaid.

Despite being a Federally funded program, it is up to each state to set the requirements and administer their medicaid program. In Florida, the Medicaid program is handled by DCF, the Department of Children and Families. This program is not to be confused with Medicare, which is a whole different animal.There are three main types of medicaid in the state of Florida, each with unique benefits and requirements. It sounds very complicated, but it really shouldn’t be.


Medicaid for Children

This is probably the most confusing form of medicaid in the state! Also, known as KidCare Medicaid, this category of coverage is the most essential. Lets face it, children are our future right? There are three different categories, each having different income restrictions:

  • Kids Under age 1 with a household income less than 200% of Federal Poverty Level (FPL)
  • Children ages 1 through 5 with household income less than 133% FPL
  • Children ages 6 to 19 with household income less than 100% FPL

Great, so what is the Federal poverty level? Well it changes every year, so most of the rules apply to the percentages so the rules don’t need to be rewritten all the time. Don’t worry though, there is a complete chart of household income levels vs. family size courtesy of the Florida Medicaid Fact sheet link. There is no asset limit for this program. If your eyes haven’t glazed over yet, I’ll show you a much simpler way to see if you may be qualified at the end of the article.

Medicaid for Families

This program essentially covers everyone in the family for their healthcare needs and may also be referred to as “Family-Related Medicaid”,“Low Income Medicaid” or even “Medicaid 1931” (Based on Section 1931 of the Social Security Act which created it.) In order to qualify for this form of medicaid, the family must have at least one child that qualifies for Medicaid services or be pregnant and expecting a child. Don’t worry, if you are a loving Uncle or Aunt that has taken in a nice or nephew, or maybe even a grandparent that is now legally responsible for their grandchild, this may also be considered an acceptable family arrangement. The income requirements are based on a sliding scale which considers the entire size of the family. A complete chart is available in the fact sheet link. In addition, the family must have under $2000 in assets. (Bank accounts, stocks, bonds, pensions, ect.) Interestingly enough, if you own a home, and you are receiving a homestead tax exemption, your home may not be considered an asset. In some cases, if you owe money on a car loan or note, it too may not be considered an asset.


Medically Needy Medicaid

This program is commonly referred to as “Medicaid Share of Cost”. This type of medicaid functions much like family medicaid but with a monthly deductible. Families or individuals that exceed the income restrictions for regular Medicaid may be given this coverage as an alternate. The income restrictions again are on a sliding scale, but so are the asset limitations, making a much greater part of the Florida population potentially eligible for coverage. The income and asset information is is also located at the end of the Fact Sheet link. So how does the program itself work? Basically a mathematical formula is applied, and Medicaid determines just how much money you can afford for your monthly medical expenses. If you exceed that amount in monthly billing, you are covered, but your deductible is reset on a monthly basis. Lets say you have this coverage, and you break your arm in January, you would most likely exceed your share of cost amount meaning the bill would be paid by Medicaid, but in February, you need to seek follow up care for the same or a different injury. Unless you meet your share of cost amount for that month, you may be liable for the charges. It sounds a bit confusing because it truly can be. It’s basically the state’s way of saying that they will only cover you if you really need the medical treatment and you exceed what you can realistically pay out of pocket; almost like a safety net coverage.

So now that you know about the different types of Medicaid coverage, it’s time to see if you actually qualify! Despite all the info we have gone over, you might have even pulled up the Fact Sheet that I have referenced quite a few times, you might still be lost. Medicaid actually as an eligibility calculator! It’s pretty straight forward, just plug in your earnings, family size, and a few other details, and it will tell you if you likely are eligible. Remember, this is only an estimate, and may not always give accurate results, so it’s important to note that if you have any questions, or are in doubt, you really need to just apply for the program to see if you qualify. All you have to lose is a little bit of time filling out the online application, and have a whole wealth of possible health care options to gain. It sounds like a pretty good trade off to me. To apply, checkout the link below.

Remember, I’m not an attorney, legal expert, Medicaid employee, or even an expert in the field, I’m just trying to help people make sense out of a confusing system. This information should not be construed as an endorsement, or medical or legal advice. I take no responsibility for if you actually can or cannot get Medicaid.


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    • RichardPac profile image

      RichardPac 5 years ago from Sunny Florida!

      Thanks! I'm glad you enjoyed it. Many folks don't know where else to turn when thing get rough financially.

    • midget38 profile image

      Michelle Liew 5 years ago from Singapore

      This is really helpful for those who have no idea of the avenues they can use to cut medical expenses. A great write Richard, and I share here.