|  | Healthcare Industry | Medicaid

Eligibility Rules for Florida's Medicaid Program

Medicaid is a national program that provides health care coverage for low income individuals and families. To make the care available to these people, state and federal government shares the costs of the program. In Florida, Medicaid services are administered by the Agency for Health Care Administration. Candidates for Medicaid are determined either by the Department of Children and Families (DCF) or the Social Security Administration.

  1. Medicaid for Low Income Families With Children

    • Children under age 18 and their parents may be eligible for Medicaid if the family's total income does not exceed income limits and household assets are not above $2,000. The Florida Department of Children and Families has an online chart listing these cutoff limits. The cutoff for a family with two children between the ages of six and 18 is $1,215 per month as of 2010. Another way to qualify for Medicaid is through the Temporary Cash Assistance (TCA) program. Even if you qualify for TCA but choose not to receive it, you may still be eligible for Medicaid. For more information about TCA in Florida, visit the Florida Department of Children and Families website

    Medicaid for Children Only

    • Parents and legal caretakers can apply for Medicaid on behalf of children under age 19 who live in their home if the total family household income is under the prescribed limit based on the number of children and their ages. Again, these income limits can be found on the Florida Department of Children and Families website.

    Medicaid for Pregnant Women

    • There are three ways to qualify for Medicaid when pregnant.

      1. Presumptive Eligibility for Pregnant Women (PEPW): This program offers temporary coverage for prenatal care by local clinics. An application for PEPW will also be automatically considered for full Medicaid determination. Eligibility for PEPW status must be made by the County Health Department (CHD) or a Regional Perinatal Intensive Care Center (RPICC).

      2. Simplified Eligibility for Pregnant Women (SEPW): This designation covers pregnant women throughout their pregnancy plus two extra months. Qualification is based solely on income which must be less than 185 percent of the federal poverty level, which was $22,000 for a family of four in 2009. An online application is available on the Florida Department of Children and Families website.

      3. ACCESS application: This is the same application used for regular Medicaid which is also available on the Florida Department of Children and Families website. This program offers additional resources, such as cash assistance or food stamps. The income requirement is the same as for the SEPW program.

    Medicaid for Seniors and the Disabled

    • Low income seniors and the disabled are eligible for Supplemental Security Income (SSI) Medicaid. Florida residents who qualify for SSI are automatically eligible for Medicaid through the Social Security Administration. There is no need to file a separate application unless nursing home services are needed.

Medicaid - Related Articles