Health Insurance for Low-Income Families in Florida

According to the National Conference of State Legislatures, the average annual health insurance premium for a single individual enrolled in an employer's group health insurance plan was $4,488 in 2009 -- up from $3,936 in 2008. Individuals who have spouses and dependents enrolled in their health insurance plans pay even more, and the rising costs have many low-income families in search of affordable health insurance. Florida's Medicaid enrollment ranks as the fourth-largest in the U.S., according to the Florida Agency for Healthcare Administration, and provides much-needed assistance for low-income households.

Florida Medicaid

• The federal government initiated the Medicaid program in the 1960s to help low-income families and individuals afford health coverage. Though the government does not mandate that states participate in the program, all U.S. states offer some degree of Medicaid and abide by federal coverage guidelines. Florida's Agency for Health Care Administration regulates and administers the federally and state- subsidized Medicaid program in the state, and also determines the eligibility guidelines by which applicants may qualify for the program.

Coverage

• All states that participate in the Medicaid program must provide benefits for a list of federally required health services including but not limited to family planning, hospital care, diagnostic services, physician services and medical transportation services. However, Florida goes above the mandated coverage requirements to also offer its enrollees benefits for optional services, such as dental, chiropractic, vision and hearing care, as well as coverage for hospice, prescription drugs and podiatry services.

Qualifications

• Children under age 18 along with their parents or caretakers, as well as pregnant women from low-income households, may qualify for state Medicaid if their household meets the state income eligibility guidelines and the household's assets do not exceed $2,000. Children under age 1 enjoy the most liberal income guidelines -- qualifying for coverage with household incomes as high as 200 percent of the federal poverty level, or FPL. At age 1, the maximum income cannot exceed 133 percent of the FPL until age 6, when the state only accepts children from households with 100 percent or less of the FPL. Pregnant women, on the other hand, receive maternity benefits and comprehensive health coverage throughout pregnancy and immediately following the birth of a child with a household income of 185 percent or less of the FPL.

Considerations

• Children who do not qualify for Medicaid because their household's income is too high may still be able to qualify for affordable state-sponsored health insurance through the Children's Health Insurance Program, or CHIP. Known as KidCare in the state, CHIP is a part of the Medicaid program that requires parents to pay a monthly premium that usually does not exceed $15 to $20 per month for most families. Additionally, families may have to pay small co-payments for certain medical claims. Children enrolled in KidCare receive many health benefits, including coverage for prescriptions, well-child visits, diagnostic care, immunizations, dental exams and treatments, vision and emergency care.