Florida Medicaid is a State and Federal collaboration that offers health care to eligible specified categories of people in Florida.

It aims to improve the health of deserving people and their children who cannot afford medical care.

In Florida, several people may qualify under Medicaid for medical care or home care programs. Such individuals are typically in a lower-income class and may have conditions such as disabilities or age that prohibit them from working.

If you’d like to learn more about Medicaid the qualifying process in Florida, we explain the basics in this.

An old couple looking at a table as they learn if they qualify for medicaid in Florida

Do I qualify for Medicaid in Florida?

Florida’s Department of Children and Families and the Social Security Administration for Supplemental Security Income (SSI) recipients decide Medicaid eligibility in the State of Florida.

Requirements

You must be a resident of the state of Florida, in need of health care/insurance aid, and whose financial condition can be characterized as low income or extremely low income to apply for this benefit program.

You must either be a national, citizen of the United States or have acceptable immigration status.

According to the U.S. government, to qualify for Medicaid in Florida you have to:

  •   Be older than 64 years of age; or
  •   Be pregnant or have a child 18 or under; or
  •   Be disabled or blind; or
  •   Have a family member (child, spouse or parent) in your household who is blind or disabled[i]

If the person qualifies under the Institutional Care Program (ICP) for Medicaid coverage, the State must pay the difference between the individual’s monthly income and the nursing home’s monthly fee.

The Florida Medicaid program is administered by the Florida Agency for Health Care Administration.

How to qualify for Medicaid in Florida?

There are several Medicaid care programs that people in Florida can be eligible for. Some programs have somewhat different criteria for qualifications and benefits.

An individual must meet the financial and health conditions of the State to qualify for Medicaid in Florida. Medicaid covers a wide variety of healthcare expenses, including visits and prescriptions from doctors, but seniors may get extra benefits.

Medicaid can apply to rehabilitation, skilled nursing care, personal assistance, and long-term care for eligible seniors with low-income status.

By default, Medicaid would cover all forms of long-term care for adults aged 65 years old and above, including assisted living and adult daycare.

To qualify for Medicaid in Florida, other eligibility requirements are required to be met apart from the 64-year-old age standard which includes:

1. Medicaid eligibility Health requirements

To qualify for a long-term Medicaid care policy, an individual must meet the health requirements of the program. It depends on what level of care a person needs. Medicaid demands to know whether a person requires care 24/7, or whether they can survive without much assistance and if so to what degree.

An individual must demonstrate a nursing home level of care to qualify, meaning that they need constant supervision and assistance to complete their daily living activities. Some seniors gladly chose to agree to care which Medicaid won’t cover.

And if a person requires Medicaid’s assistance to pay for their long-term care, they must undergo a health screening to validate their medical and healthcare needs.

2. Medicaid eligibility for financial requirements

The financial requirement criteria to qualify for Medicaid in Florida requires that an individual must not have sufficient assets or income to pay for the expenses of their healthcare.

Medicaid evaluates the capacity of an individual to pay by looking at the monetary value of his / her resources.

If an individual makes too much money per month or their assets are too valuable in compliance with the requirements of Medicaid, they must participate in a spend-down period with Medicaid or pay privately for their healthcare. Medicaid independently measures assets and income when determining a person’s financial requirements.

3. Income requirements

In addition to assets, Medicaid considers a person’s monthly income when determining their eligibility for benefits. Medicaid describes income as any funds earned on a regular, month-to-month basis by the applicant.

To Medicaid applicants, Florida has an income cap of $2,349 which an individual cannot exceed if they wish to receive benefits.

Married applicants with a community partner can, however, maintain part of their income without it being counted against their income cap.

Medicaid Planning

Before applying for Medicaid, many families opt to build a plan to protect their assets and improve their qualifying process. Without Medicaid planning, people are at risk of being entirely penalized or refused coverage.

Fortunately, there are ways in which seniors should plan their assets and income before applying for Medicaid so that they do not incur fines or risk their eligibility.

Our law firm deals with clients applying for Medicaid and helps them qualify for the benefits. 

Medicaid will pay for several benefits, like home nursing, assisted living, and home care. The Medicaid long-term care program has a variety of rules and regulations and the process of applying is seldom, if ever, straightforward with expert advice.

Speak to an attorney at the Finity Law Firm before applying for Medicaid in Florida.

References

  1. Florida Medicaid | Benefits.gov

Contact us today

Download Your Free Estate Planning Guide

Learn how to protect your family, your assets, and your legacy.

Download Now

Free Consultations

Our Orlando attorneys are standing by to provide you with services you can trust and depend on. We offer free consultations because we know each case is unique.

Book Now
Visit Us
Contact Us

Subscribe to our free newsletter

Sign up for our newsletter to get in-depth legal content, updates to laws and regulations, and free tips to help you navigate the legal landscape, all delivered straight to your inbox. Just enter the information on the form to get started. 

* We respect and take your privacy very seriously. Please review our Privacy Policy.