How to Qualify for Medicaid in Florida (2025 Guide)
7.5 min read
For many Floridians, Medicaid is more than just a health insurance program — it's a vital safety net that provides access to essential care when money is tight. But figuring out if you qualify can be confusing, especially in a state like Florida that has not expanded Medicaid under the Affordable Care Act (ACA).
This guide breaks down the key Medicaid eligibility rules in Florida for 2025 — including income limits, who qualifies, how to apply, and what to do if you don’t meet the requirements. Whether you’re a parent caring for a child, a senior with a fixed income, or someone navigating health challenges, this resource is here to help you understand your options.
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Key Takeaways:
Florida Medicaid eligibility is limited to specific groups, including low-income children, pregnant women, seniors, people with disabilities, and very low-income parents.
Income and asset limits vary by program, with stricter thresholds for long-term care coverage.
Florida has not expanded Medicaid, so most adults without dependents do not qualify regardless of income.
Applications can be submitted online, by phone, by mail, or in person through the ACCESS Florida system.
If you don’t qualify, consider alternatives like Florida Healthy Kids, ACA Marketplace plans, or the Medically Needy program.
Asset protection and Medicaid planning are essential if you’re preparing for long-term care; consult a qualified attorney if needed.
Medicaid benefits must be renewed annually, so stay on top of updates to avoid coverage gaps.
Who qualifies for Medicaid in Florida?
Florida Medicaid is available only to individuals who meet specific income and categorical eligibility rules. Unlike states that expanded Medicaid under the ACA, Florida restricts access for low-income adults who don’t fall into one of the following groups:
You May Qualify if You Are:
A child under 19 in a low-income household.
A pregnant woman with income below 196% of the federal poverty level (FPL).
A parent or caretaker relative of a minor with very low household income.
A senior aged 65 or older, or an adult with a disability who meets SSI-level income and asset thresholds.
For most non-disabled adults without dependent children, Medicaid is not available, no matter how little you earn. This remains one of the biggest gaps in Florida’s healthcare system.
What are the 2025 Medicaid income and asset limits?
Florida Medicaid uses both monthly income and total countable assets to determine eligibility, and these thresholds vary depending on the program and household size.
Standard Medicaid (Non–Long-Term Care)
These limits apply to those seeking regular Medicaid coverage for doctor visits, hospital stays, and basic care:
Single adult: Income below ~$1,084/month; assets under $5,000.
Married couple: Income below ~$1,460/month; assets under $6,000.
Long-Term Care Medicaid
For those seeking nursing home care or in-home assistance under Medicaid:
Single adult: Income must be under $2,742/month; assets under $2,000.
Married couples: Combined asset limits of $3,000 (for applicant).
Community spouse (non-applicant): May retain up to $154,140 in assets.
Exempt assets typically include your primary home, one vehicle, and personal belongings. Everything else — including savings accounts, stocks, or property other than your main home — counts toward the limit.
If you're unsure how your assets might affect eligibility, consult a Medicaid planning expert or elder law attorney for a review of your situation.
How to qualify for Medicaid in Florida
Applying for Medicaid is free and can be done at any time of the year. The Florida Department of Children and Families (DCF) manages the application process, and you can submit your application in several ways.
Ways to Apply:
Online: Start at the ACCESS Florida portal — the fastest and most convenient option.
Phone: Call 1-850-300-4323 if you prefer to apply with the help of a representative.
In-person: Visit a local DCF service center or community partner.
Mail: Download the paper application and send it to the appropriate DCF address.
You’ll Need to Provide Documentation, Including:
Proof of income (pay stubs, benefit letters, etc.).
Bank statements and records of assets.
Proof of identity (driver’s license or state ID).
Social Security numbers for all household members.
Proof of Florida residency (utility bill, lease, or similar).
After applying, your caseworker may request additional documents. Be sure to check your ACCESS Florida account regularly to track your application and submit any follow-up information.
What if you don’t qualify?
If you’re turned down for Medicaid, don’t give up — there are other options to explore, especially for children and those facing high medical expenses.
Alternatives to Medicaid:
Florida Healthy Kids: A state program offering affordable health insurance for children under 19 whose families earn too much to qualify for Medicaid but still need help affording coverage.
ACA Marketplace Plans: If your income is above Medicaid limits but still low, you might qualify for subsidized insurance through HealthCare.gov.
Medically Needy (Share of Cost): This option allows people with high incomes and medical bills to still access Medicaid coverage once they “spend down” a portion of their monthly income on healthcare expenses.
For example, if your income is too high, but you have monthly prescriptions, therapy, or doctor visits that eat up most of it, the Share of Cost program may help you qualify.
Planning ahead: protecting assets for long-term care
If you or a loved one needs long-term care, such as nursing home services, Medicaid can be a critical lifeline. But qualifying isn’t always simple. Florida enforces a 5-year look-back rule on financial transfers — meaning any assets you give away or move out of your name within five years before applying could result in a penalty.
To Prepare Responsibly:
Spend down excess assets on legitimate needs (e.g., home repairs, medical debt).
Create a Medicaid Asset Protection Trust (MAPT) if planning ahead more than five years.
Consult a qualified elder law attorney who understands Florida’s Medicaid laws.
How to keep your Medicaid benefits
Once approved, your Medicaid eligibility is reviewed annually. The state will send you a notice before your renewal date — usually by mail or through your ACCESS Florida account. You’ll need to update your income, household information, and any changes in assets.
Tip: Always respond promptly to renewal notices. Delays or missing documents can result in a temporary loss of coverage.
Need help? You’re not alone
Applying for Medicaid or understanding your options can feel overwhelming. Fortunately, free and low-cost help is available.
Where to Get Help:
ACCESS Florida Customer Call Center: 1-850-300-4323.
Community-based organizations: Many nonprofits and local agencies offer Medicaid enrollment assistance.
Legal aid or elder law attorneys: Especially helpful for seniors or those with complex financial situations.
If you're navigating Medicaid for the first time, take advantage of free resources and don’t hesitate to ask for help. You don’t have to figure it all out alone.
Unlock the present to build a brighter future
Medicaid in Florida is a vital program for low-income individuals, families, seniors, and those with disabilities. While the state’s eligibility rules can be strict — especially for adults without children — knowing the qualifications, preparing the right documents, and applying correctly can make all the difference.
At BenefitKarma, we’re committed to making benefits more accessible. Whether you're just starting your Medicaid journey or exploring alternative programs, we’re here to help you understand what’s available and how to get the care you need.