Florida Medicaid applicants apply through the MyACCESS portal at myaccess.myflfamilies.com, and once approved, most are automatically enrolled in Statewide Medicaid Managed Care (SMMC), the system that assigns members to a private health plan for their actual medical, long-term care, or dental services. Approval and managed care enrollment are two separate steps: the state decides if you qualify for Medicaid, then a second process, run through Florida's enrollment broker, decides which managed care plan handles your care. This guide walks through both steps for 2026, including income limits, the nine SMMC regions, and how to pick or switch a plan.
Florida Medicaid Income Limits 2026
Florida did not expand Medicaid under the Affordable Care Act, so eligibility depends heavily on which category you fall into: parent or caretaker relative, pregnant woman, child, or aged/disabled adult. There is no general low-income adult category. The table below uses the 2026 federal poverty guidelines ($15,960 for one person, adding approximately $5,680 per additional household member).
| Household Size | Parents/Caretaker Relatives (~27% FPL) | Pregnant Women (196% FPL) | Children Ages 6-18 (138% FPL) | Children Under 6 (206% FPL) |
|---|
| 1 | ~$4,309/year | ~$31,282/year | ~$22,025/year | ~$32,878/year |
| 2 | ~$5,843/year | ~$42,414/year | ~$29,863/year | ~$44,578/year |
| 3 | ~$7,376/year | ~$53,547/year | ~$37,702/year | ~$56,279/year |
| 4 | ~$8,910/year | ~$64,680/year | ~$45,540/year | ~$67,980/year |
These figures are approximate and reflect gross income before certain MAGI deductions. Elderly and disabled applicants (age 65+, blind, or disabled) generally qualify with income near 100% of the federal poverty level ($1,330/month for an individual in 2026) and countable assets under $2,000, with different rules applying to institutional and home and community based services cases.
The Coverage Gap
Because Florida has not expanded Medicaid, adults without dependent children generally do not qualify regardless of how low their income is, unless they are pregnant, disabled, or 65 or older. Parents only qualify at extremely low income levels, around 27% of the federal poverty level. This leaves an estimated 300,000 to 400,000 Floridians in a coverage gap: too much income for Medicaid, but often still below the threshold to qualify for Affordable Care Act marketplace subsidies in prior years (though enhanced subsidies have narrowed this gap for many). If you fall into this gap, check whether you qualify for a $0 or low-cost marketplace plan through Healthcare.gov.
How to Apply for Florida Medicaid
- Gather documents. Proof of identity, Florida residency, Social Security numbers for household members, proof of income (pay stubs, tax return, or benefit award letters), and if applying for long-term care, asset documentation.
- Apply online at MyACCESS. Go to myaccess.myflfamilies.com and create an account, or apply by phone at 1-866-762-2237. Paper applications are also accepted at local Department of Children and Families (DCF) service centers.
- Complete the interview if requested. Some cases require a phone interview with a DCF caseworker, particularly for aged, blind, or disabled applicants.
- Wait for a determination. DCF generally has 45 days to process a standard application, or 90 days if a disability determination is required.
- Receive your eligibility notice. If approved, you will get a Medicaid gold card and, in most cases, information on selecting a managed care plan.
Children applying through Florida KidCare use the same MyACCESS portal or floridakidcare.org, with a phone line at 1-888-540-5437 for KidCare-specific questions.
What Is Statewide Medicaid Managed Care (SMMC)?
Once DCF approves Medicaid eligibility, the Florida Agency for Health Care Administration (AHCA) enrolls most recipients into Statewide Medicaid Managed Care. SMMC has three components:
| Program | Who It Covers | What It Covers |
|---|
| Managed Medical Assistance (MMA) | Most Medicaid enrollees, including children, pregnant women, and adults | Doctor visits, hospital care, prescriptions, behavioral health |
| Long-Term Care (LTC) | Aged and disabled individuals needing nursing home level care | Nursing facility care, assisted living, in-home personal care |
| Statewide Prepaid Dental | Most Medicaid enrollees | Dental exams, cleanings, fillings, extractions |
In February 2025, Florida launched SMMC 3.0, a new round of managed care contracts running through 2030. The state reorganized its service areas from 11 numbered regions into 9 lettered regions, A through I, each served by a specific set of health plans. Because plan availability differs by region, the plan choices shown to a Miami-Dade resident (Region K under the old system, now folded into the new lettered map) will differ from those shown to someone in the Panhandle or Central Florida.
How SMMC Enrollment Works
Medicaid eligibility and managed care plan selection are handled by different systems, so expect a second set of instructions after your Medicaid approval letter.
- You get a plan selection packet. After DCF approves your case, AHCA's enrollment broker mails information on the managed care plans available in your region.
- You have a window to choose a plan. New enrollees typically get roughly 30 days to actively select an MMA or LTC plan. If no selection is made, the state auto-assigns a plan based on factors like existing provider relationships.
- Get free help from Choice Counseling. Florida's enrollment broker offers neutral, no-cost help comparing plans by phone at 1-877-711-3662 or online at flmedicaidmanagedcare.com. This is not a private insurance broker call, it is a state-contracted service.
- You can switch plans in the first 120 days. After initial enrollment, members may change their MMA or LTC plan without cause during the first 120 days of enrollment in that plan.
- After 120 days, changes require open enrollment or good cause. Once the 120-day window closes, switching plans requires waiting for the annual open enrollment period or documenting a state-approved good cause reason, such as moving out of the plan's service area or losing access to a needed provider.
Long-Term Care Program Enrollment
The SMMC Long-Term Care program works differently from MMA. It serves people who need nursing-facility level care but often wish to stay at home or in an assisted living facility through home and community based services. For 2026, the income limit for an LTC applicant is approximately $2,982 per month in gross income (roughly 300% of the SSI federal benefit rate), with a countable asset limit of $2,000 for an individual. Unlike MMA, the LTC program has enrollment slots that are limited, and many regions maintain a waitlist. Applicants should contact the Elder Helpline at 1-800-963-5337 as early as possible, since waitlist position and urgency of need affect how quickly a slot opens up.
Who Is Exempt from Managed Care Enrollment
A small number of Medicaid recipients are not required to enroll in an SMMC plan and instead remain in fee-for-service Medicaid. This generally includes people enrolled in the Family Planning Waiver, those with limited benefit packages, and certain individuals dually eligible for Medicaid and Medicare who are enrolled in specific integrated care programs. If you believe you should be exempt, contact DCF or the choice counseling line to confirm your status before a plan is auto-assigned.
Florida Medicaid and Medicare Together
Floridians who qualify for both Medicare and Medicaid (dual eligibles) may be enrolled in a Medicare-Medicaid coordinated plan or remain in separate MMA and Medicare coverage depending on their needs. The SHINE program (Serving Health Insurance Needs of Elders) offers free, unbiased counseling on how Medicare and Medicaid interact, reachable at 1-800-963-5337.
For a full breakdown of every benefit program available to Florida residents, visit our Florida state benefits guide.
Frequently Asked Questions
Do I have to apply for SMMC separately from Medicaid?
No. You apply for Medicaid once through MyACCESS or DCF. If approved, the state automatically routes you into the Statewide Medicaid Managed Care enrollment process and mails you information on choosing a plan. There is no separate SMMC application.
What happens if I don't pick a Florida Medicaid managed care plan?
If you do not choose a plan within the selection window, generally about 30 days, AHCA's enrollment broker automatically assigns you to a plan operating in your region. You can still switch during the first 120 days without needing a special reason.
Can I change my Florida Medicaid managed care plan?
Yes. You can switch plans without cause during your first 120 days of enrollment in a plan. After that, changes are limited to the annual open enrollment period or a state-approved good cause reason, such as a move or a provider network issue.
What is the difference between MMA and LTC in Florida Medicaid?
Managed Medical Assistance (MMA) covers routine medical care like doctor visits, hospital stays, and prescriptions for most Medicaid enrollees. Long-Term Care (LTC) is a separate program for people who need nursing-facility level care, covering nursing homes, assisted living, and in-home personal care services, and it has a more limited number of enrollment slots.
How long does it take to get approved for Florida Medicaid?
The Department of Children and Families generally has 45 days to process a standard Medicaid application, or up to 90 days if the case requires a disability determination.
Is Florida a Medicaid expansion state?
No. Florida is one of 10 states that has not expanded Medicaid under the Affordable Care Act. This means adults without dependent children generally cannot qualify for Medicaid regardless of income, and parents qualify only at very low income levels.
Who do I call for help choosing a Florida Medicaid managed care plan?
Florida's Choice Counseling line at 1-877-711-3662 provides free, neutral help comparing MMA and LTC plans by region. You can also compare plans online at flmedicaidmanagedcare.com.
