Florida Medicaid Eligibility 2026
Last updated: February 2026
Disclaimer: This guide provides general information about Florida Medicaid and is not legal or financial advice. Eligibility rules can change, and individual circumstances vary. Always verify current requirements with the Florida Department of Children and Families (DCF) before applying.
Understanding Florida Medicaid eligibility can feel complicated, especially since the rules here differ significantly from most other states. If you or your family needs health coverage, knowing where you stand is the first step toward getting help.
Here is the bottom line: Florida has not expanded Medicaid under the Affordable Care Act, making it one of just 10 states with very limited adult coverage. Adults without dependent children generally do not qualify for Medicaid in Florida regardless of how low their income is. Parents with children face extremely strict income limits of just 26 to 30 percent of the federal poverty level, which works out to roughly $688 to $794 per month for a family of four. Children, pregnant women, seniors, and people with disabilities have more accessible pathways to coverage.
This guide breaks down exactly who qualifies for Florida Medicaid in 2026, what the income limits are for each category, and how to apply if you think you might be eligible.
Why Florida Medicaid Rules Are Different
Florida is one of 10 states that chose not to expand Medicaid under the Affordable Care Act. This decision has significant consequences for residents seeking health coverage.
In expansion states, adults with incomes up to 138 percent of the federal poverty level (about $21,597 per year for a single person) qualify for Medicaid. In Florida, the rules are far more restrictive. About 388,000 Floridians fall into what is called the "coverage gap," meaning they earn too much for Florida Medicaid but too little to qualify for subsidies on the ACA marketplace.
The Agency for Health Care Administration (AHCA) and the Department of Children and Families (DCF) administer Florida Medicaid together. Understanding which category you fall into is essential because income limits vary dramatically.
Who Qualifies for Florida Medicaid in 2026
Florida Medicaid eligibility depends primarily on your household composition, age, and special circumstances. Let's look at each category.
Children (Birth to Age 18)
Children have the most accessible Medicaid eligibility in Florida. The income limits are based on the child's age and are significantly higher than limits for adults.
| Age Group | Income Limit (% FPL) | Monthly Income (Family of 4) |
|---|---|---|
| Infants (0 to 1 year) | 211% FPL | ~$5,583 |
| Children ages 1 to 5 | 140% FPL | ~$3,702 |
| Children ages 6 to 18 | 133 to 138% FPL | ~$3,517 to $3,649 |
A family of four earning up to approximately $67,837 per year could have an infant qualify for Medicaid. For older children, the threshold is lower but still reasonable compared to adult limits.
If your children's income exceeds Medicaid limits, Florida KidCare offers additional coverage options with low monthly premiums starting at $15 to $20 for families between 138 and 200 percent FPL.
Pregnant Women
Pregnant women qualify for Florida Medicaid at income levels up to 196 percent of the federal poverty level. For a family of four, that translates to approximately $5,186 per month or about $63,014 per year.
Coverage continues for 12 months after giving birth, regardless of income changes during that period. This extended postpartum coverage was implemented to improve maternal health outcomes.
Parents and Caretaker Relatives
This is where Florida's restrictive rules become most apparent. Parents with dependent children in the household face extremely low income limits.
Adults caring for children qualify only if their income falls below 26 to 30 percent of the federal poverty level. For a family of four, that means earning less than approximately $688 to $794 per month, or roughly $8,256 to $9,645 per year.
To put this in perspective, a parent working just 15 hours per week at minimum wage would likely exceed this threshold. These limits are among the lowest in the nation.
Adults Without Dependent Children
If you are an adult without children in your household, you generally do not qualify for Florida Medicaid regardless of your income. This is the most significant consequence of Florida not expanding Medicaid.
The exceptions are narrow:
- Adults receiving Supplemental Security Income (SSI) automatically qualify
- Adults with qualifying disabilities may be eligible
- Adults age 65 and older may qualify through different pathways
Seniors and People with Disabilities
Floridians who receive SSI automatically qualify for Medicaid. Additionally, various Medicaid programs exist for seniors needing long term care, including nursing home coverage and home and community based services.
The Statewide Medicaid Managed Care Long Term Care program serves seniors and adults with disabilities who need help with daily activities. Income and asset limits apply and vary by program.
Florida Medicaid Income Limits 2026
Here is a complete breakdown of income limits by household size for the main eligibility categories:
Parents with Dependent Children (26 to 30% FPL)
| Household Size | Monthly Income | Annual Income |
|---|---|---|
| 2 | ~$440 to $529 | ~$5,299 to $6,345 |
| 3 | ~$555 to $666 | ~$6,663 to $7,995 |
| 4 | ~$688 to $794 | ~$8,256 to $9,645 |
| 5 | ~$816 to $940 | ~$9,789 to $11,295 |
| 6 | ~$935 to $1,078 | ~$11,219 to $12,945 |
Children's Medicaid (Varies by Age)
| Household Size | Infants (211% FPL) | Ages 1 to 5 (140% FPL) | Ages 6 to 18 (133% FPL) |
|---|---|---|---|
| 2 | $44,627 | $29,610 | $28,130 |
| 3 | $56,232 | $37,310 | $35,445 |
| 4 | $67,837 | $45,010 | $42,760 |
| 5 | $79,442 | $52,710 | $50,075 |
Pregnant Women (196% FPL)
| Household Size | Monthly Income | Annual Income |
|---|---|---|
| 1 | $2,556 | $30,674 |
| 2 | $3,455 | $41,454 |
| 3 | $4,353 | $52,234 |
| 4 | $5,251 | $63,014 |
The Florida Coverage Gap Explained
Approximately 388,000 Florida residents find themselves in a difficult situation called the coverage gap. Understanding this gap is crucial if you are trying to find affordable health coverage.
The coverage gap exists because ACA marketplace subsidies begin at 100 percent of the federal poverty level, assuming that anyone below that threshold would qualify for Medicaid in their state. Since Florida did not expand Medicaid, many adults fall between two programs with no affordable option.
If you earn between roughly 30 percent FPL (the top of Florida Medicaid for parents) and 100 percent FPL (the start of ACA subsidies), you may find yourself in this gap. For a single adult, this means earning between roughly $4,695 and $15,650 per year.
Options for people in the coverage gap include:
- Community health centers that offer sliding scale fees
- Hospital charity care programs
- Free clinics in your area
- Short term health plans (though coverage is limited)
Dial 211 to connect with local resources that may help.
How to Apply for Florida Medicaid
If you believe you or your family members qualify, applying is straightforward. Florida uses a single portal called MyACCESS for most public benefits including Medicaid, SNAP, and cash assistance.
Online Application
The fastest way to apply is online at MyACCESS Florida. You can complete the application in about 30 to 45 minutes if you have your documents ready.
By Phone
Call the DCF Customer Call Center at 1-866-762-2237. Representatives can help you start an application or answer questions about your eligibility.
In Person
Visit your local DCF office to apply in person. Bring identification, proof of income, and proof of Florida residency.
Documents You Will Need
Gather these documents before applying:
- Proof of identity (driver's license, state ID, or passport)
- Social Security numbers for all household members
- Proof of income (pay stubs, tax returns, or employer statement)
- Proof of Florida residency (utility bill, lease, or mail)
- Proof of citizenship or immigration status
Processing Time
Most Medicaid applications are processed within 45 days. If you have a disability, processing may take up to 90 days while medical information is verified. Emergency Medicaid for qualifying situations can be approved much faster.
Check Your Eligibility
Given Florida's complex Medicaid rules, checking your eligibility before applying can save time and help you understand what programs you might qualify for.
A free eligibility screening tool can help you see which benefits you may qualify for based on your household size, income, and circumstances. Benefits USA checks eligibility for Medicaid and 10 other programs in about 5 minutes. The screening is not an official application but helps you understand your options before starting paperwork.
If Medicaid is not available to you, the screener can identify other programs that might help, including SNAP food assistance, utility assistance through LIHEAP, and tax credits like the Earned Income Tax Credit.
What If You Do Not Qualify for Medicaid?
Many Florida adults do not qualify for Medicaid but still need affordable health coverage. Here are alternatives to explore.
Florida KidCare
If your children do not qualify for Medicaid, Florida KidCare provides health coverage for children from birth to age 18. Premiums start at $15 to $20 per month for families between 138 and 200 percent FPL. Apply at floridakidcare.org or call 1-888-540-5437.
ACA Marketplace Plans
If your income is above 100 percent FPL, you may qualify for subsidized health insurance through Healthcare.gov. Open enrollment typically runs from November 1 through January 15, though special enrollment periods are available for qualifying life events like job loss or having a baby.
Community Health Centers
Federally Qualified Health Centers provide care on a sliding fee scale based on your income. Find locations at findahealthcenter.hrsa.gov.
Frequently Asked Questions
Can adults without children get Medicaid in Florida? Generally no. Florida has not expanded Medicaid, so adults without dependent children are not eligible regardless of income. The main exceptions are pregnant women, people who are disabled, and seniors on SSI.
What is the income limit for Florida Medicaid for a family of 4? For parents with children, the income limit is extremely low at about 26 to 30 percent of the federal poverty level, which is roughly $688 to $794 per month for a family of four. Children have much higher limits at 133 to 211 percent FPL depending on age.
How do I apply for Medicaid in Florida? Apply online through MyACCESS Florida at myaccess.myflfamilies.com, by phone at 1-866-762-2237, or in person at your local DCF office. Processing typically takes 45 days for most applications.
What is the Florida Medicaid coverage gap? The coverage gap affects about 388,000 Floridians who earn too much for Medicaid but too little for ACA marketplace subsidies. This gap exists because Florida did not expand Medicaid and ACA subsidies start at 100 percent FPL.
Are children easier to qualify for Medicaid in Florida? Yes. Children have significantly higher income limits than adults. Infants qualify at up to 211 percent FPL, children ages 1 to 5 at 140 percent FPL, and children ages 6 to 18 at 133 to 138 percent FPL. Florida KidCare extends coverage even higher.
Does receiving Medicaid affect my immigration status? Receiving Medicaid does not make you a public charge under current immigration rules for most applicants. However, immigration rules are complex and can change. If you have concerns about your specific situation, consult an immigration attorney before applying.
Next Steps
Florida Medicaid has strict eligibility requirements, especially for adults. Children, pregnant women, and people receiving SSI have clearer pathways to coverage. If you are a parent, your children may qualify even if you do not.
Start by checking your eligibility for Medicaid and other benefit programs. Many Florida families qualify for multiple programs including SNAP, utility assistance, and tax credits that can provide thousands of dollars in annual support.
If you think you might qualify, gather your documents and apply through MyACCESS Florida. The application checks eligibility for multiple programs at once, so even if you do not qualify for Medicaid, you may be approved for other assistance.
