Requirements for Florida Medicaid

The Florida Agency for Health Care Administration is in charge of the state's Medicaid program. Medicaid provides financial coverage of medical expenses for individuals and families who meet certain criteria. The Florida Department of Children and Families determines eligibility based on income and asset factors.

Residency and Citizenship

• U.S. citizenship, proof of Florida residency and a social security number are required to apply for full Medicaid coverage in Florida. Residents without citizenship and/or social security numbers can apply for limited emergency coverage. A health care provider must verify the conditions and dates of the medical emergency in order for assistance to be considered. A noncitizen can receive Medicaid coverage only for the specified emergency.

Families

• Florida parents or guardians and their children under the age of 18 are eligible for Medicaid if they meet certain income requirements. Income limits are based on the number of family members in the household. Families that receive Temporary Cash Assistance (TCA) automatically meet the income requirement. The TCA income rule states that gross income has to be less than 185% of the federal poverty level, according to the Department of Children and Families' TCA website. In addition, families cannot have more than $2,000 in assets.

Children

• Florida parents and guardians can apply for children-only Medicaid coverage. Qualifying children must be under the age of 19. The income of the parent(s) and child will be considered during the eligibility determination. However, guardians and stepparents do not need to report their income. There are no asset limits for children-only Medicaid programs.

Pregnant Women

• Pregnant women can receive Medicaid in Florida through two methods: presumptive Medicaid eligibility or simplified eligibility. Medical care providers, such as health departments, determine if a pregnant woman qualifies for presumptive eligibility. This program's coverage lasts 60 days or less and is used for only prenatal services. The income of the woman and her family--comprised of the baby's father and her other children--is considered during the application process.

  To qualify for simplified eligibility, the woman's family must have a gross income of less than 185% of the federal poverty level and proof of pregnancy must be provided. Simplified eligibility for pregnant women lasts for two months after the baby's birth. Newborns receive Medicaid for up to one year if the mother qualifies for Medicaid at the time of the baby's birth.

Medically Needy

• Residents whose income or assets exceed the eligibility limits can participate in Florida's Medically Needy program. They must meet all other Medicaid requirements to qualify. There is an asset limit based on the household size and family gross income. Those seeking assistance through this program must have a certain amount of monthly medical bills. That amount is based on income and asset levels.