Florida Medicaid Programs
Florida Medicaid is administered by AHCA and accessed through the Department of Children and Families. Florida has not expanded Medicaid under the ACA, so adult coverage is more limited than in expansion states.
Florida Medicaid (Traditional)
Florida Medicaid covers approximately 5 million residents, primarily children, pregnant women, seniors, and disabled adults.
What it provides: Health coverage for eligible low-income Floridians
Assistance: Doctor visits, hospital care, prescriptions, and long-term care for eligible categories.
Eligibility: Income limits vary by category; adults without dependents generally not eligible unless disabled or pregnant.
Who may qualify:
- Pregnant women, children, seniors, and people with disabilities
- Parents and caretaker relatives meeting income limits
- Recipients of SSI
Requirements:
- Application through ACCESS Florida
- Proof of identity, residency, and income
- Immigration status verification for non-citizens
How to apply: Apply online at myflorida.com/accessflorida, by phone, or at local DCF office.
Official source: Florida Medicaid
Florida Medicaid for Pregnant Women
Pregnant women receive presumptive eligibility at many Florida clinics while full application is processed.
What it provides: Pregnancy-related Medicaid coverage
Assistance: Prenatal care, delivery, postpartum care, and newborn coverage.
Eligibility: Coverage from application through 60 days postpartum (extended coverage may apply).
Who may qualify:
- Pregnant women in Florida meeting income guidelines
- Income up to 196% of federal poverty level
- Women needing prenatal through postpartum care
Requirements:
- Pregnancy verification
- Income documentation
- Application through ACCESS Florida
How to apply: Apply immediately upon learning of pregnancy through ACCESS Florida for expedited processing.
Official source: Medicaid Pregnancy
Medicaid Long-Term Care (Florida)
Florida operates managed long-term care programs through statewide and regional managed care organizations.
What it provides: Nursing home and home-based long-term care coverage
Assistance: Nursing facility care, HCBS waivers, and managed long-term care.
Eligibility: Strict income and asset limits; spousal impoverishment protections apply.
Who may qualify:
- Florida seniors and disabled individuals needing long-term care
- Nursing home residents meeting income and asset limits
- Recipients of home and community-based waiver services
Requirements:
- Level-of-care assessment
- Income and asset documentation
- Application through DCF or Aging and Disability Resource Center
How to apply: Contact your local Aging and Disability Resource Center (ADRC) for application assistance.
Official source: Florida LTC Medicaid