Florida Medicaid Income Limits for 2020

The Florida Medicaid program provides medical coverage to low-income individuals and families. Medicaid also helps elderly and disabled people with the cost of nursing facility care and other health care expenses. In this post, we will review the eligibility standards for Medicaid in Florida, including the Florida Medicaid income limits.

Eligibility for Medicaid is usually based on the family’s or individual’s income. To learn more about how to qualify for Medicaid in Florida and the income limits, please keep reading this post below.

"Florida Medicaid Income Limits"

This article on Florida Medicaid eligibility will cover:

  • Medicaid in Florida
  • Who Can Get Medicaid in Florida?
  • Florida Medicaid Expansion
  • 2020 Florida Medicaid Income Limit
  • What is Counted as Income for Medicaid?
  • Long Term Care Eligibility for Seniors
  • How to Apply for Medicaid in Florida

Medicaid in Florida

Medicaid provides healthcare coverage to almost 3.6 million people in Florida, including 2.4 million children.

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

However, eligibility for Medicaid in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI recipients).

Florida KidCare is Florida’s name for CHIP, which provides health insurance to children whose families earn too much to qualify for Medicaid.

Who Can Get Medicaid in Florida?

You should apply for Medicaid if your income is low and you match one of the descriptions below:

  • You think you are pregnant
  • The parent or caretaker of a child and/or teenager under the age of 19.
  • You are a child or teenager age 18 or under.
  • An adult age 65 or older.
  • You are legally blind.
  • Living with a disability or disabled.
  • You are in need of nursing home care.

Florida Medicaid Expansion

Florida is one of the 14 states that have not expanded Medicaid coverage to low-income adults without dependents.

As a result, about 445,000 adults with low income who would otherwise be covered by Medicaid expansion are left without coverage.

2020 Florida Medicaid Income Limit

Like most states, Florida has multiple Medicaid programs based on categories.

To be approved for Medicaid, you have to know the income limit for the eligibility category you fall under.

Here are the main eligibility categories:

  • Children Ages 0-1
  • Children Ages 1-5
  • Children Ages 6-18
  • Children – CHIP
  • Pregnant Women
  • Parent & Caretaker Relatives
  • Seniors & People w/ Disabilities
  • Adults – Medicaid Expansion

How the Florida Medicaid Income Limit is Calculated

The Florida Medicaid Income limit is calculated as a Percent of the Federal Poverty Level.

Here is the Medicaid income limit for Florida based on the percentage of the Federal Poverty Level.

Florida Medicaid Eligibility Levels (as a % of Federal Poverty Level)

Children Ages 0-1 206%
Children Ages 1-5 140%
Children Ages 6-18 133%
Children – CHIP 210%
Pregnant Women 191%
Parent & Caretaker Relatives 28%
Seniors & People w/ Disabilities 88%
Adults – Medicaid Expansion No Expansion

Here is the 2020 Federal Poverty Level information, based on Household Size as released by the US Department of Health and Human Services.

Federal poverty levels in 2020
Household Size Poverty Guideline
1 $12,490
2 $16,910
3 $21,330
4 $25,750
5 $30,170
6 $34,590
7 $39,010
8 $43,430
Over 8 people Add $4,420 per extra person

The federal poverty level in Alaska ranges from $15,600 (for one person) to $54,310 (for eight people). The federal poverty level in Hawaii ranges from $14,380 (for one person) to $49,940 (for eight people).

The Florida Medicaid Income Limit for 2020

Based on the Federal Poverty Level numbers above and the Medicaid Income Category Chart above, here are the 2020 Florida Medicaid Income limits.

For simplicity, the chart is broken down by Children and Adults.

Florida Medicaid for Children covers Ages 0-1, 1-5, and 6-18.

Children whose household income is too high to qualify for traditional Medicaid in Florida may qualify for CHIP (Florida KidCare).

Florida Medicaid Income Limit 2020 – Children
Children Medicaid Ages 0-1 Children Medicaid Ages 1-5 Children Medicaid Ages 6-18 Children Separate CHIP
% FPL 100% 206% 140% 133% 210%
Household Size
1 $12,490 $25,729 $17,486 $16,612 $26,229
2 $16,910 $34,835 $23,674 $22,490 $35,511
3 $21,330 $43,940 $29,862 $28,369 $44,793
4 $25,750 $53,045 $36,050 $34,248 $54,075
5 $30,170 $62,150 $42,238 $40,126 $63,357
6 $34,590 $71,255 $48,426 $46,005 $72,639
7 $39,010 $80,361 $54,614 $51,883 $81,921
8 $43,430 $89,466 $60,802 $57,762 $91,203

Here is the chart for adults, which includes Pregnant Women, Parents or Caretakers of Children under 19, Seniors, and people with Disabilities.

Note that since Florida did not expand Medicaid to adults without dependents, that category is not populated.

Florida Medicaid Income Limit 2020 – Adults
Pregnant Women Medicaid Adults (Medicaid) Parent/ Caretaker Seniors & People w/ Disabilities (Medicaid) Adults (Medicaid) Expansion to Adults
% FPL 100% 191% 28% 88% NO
Household Size
1 $12,490 $23,856 $3,497 $10,991 N/A
2 $16,910 $32,298 $4,735 $14,881 N/A
3 $21,330 $40,740 $5,972 $18,770 N/A
4 $25,750 $49,183 $7,210 $22,660 N/A
5 $30,170 $57,625 $8,448 $26,550 N/A
6 $34,590 $66,067 $9,685 $30,439 N/A
7 $39,010 $74,509 $10,923 $34,329 N/A
8 $43,430 $82,951 $12,160 $38,218 N/A

What is Counted as Income for Medicaid?

For Medicaid application purposes, income is all money, earned or unearned, cash or any type of support received from any source by you or your household that can be used to meet basic needs for food, clothing or shelter.

Income eligibility is determined by your modified adjusted gross income (MAGI), which is your taxable income, plus certain deductions.

However, for most people, MAGI is identical or very close to your adjusted taxable income, which you can find on your tax return.

Non-taxable income is excluded in the eligibility determination based on federal rules.

Excluded Income

Some examples of excluded income are adoption assistance payments, earnings from the Census Bureau, Child Support, Veteran’s Benefits, and Supplement Security Income (SSI).

In addition, Earned Income Tax Credits, Disaster relief assistance, and TANF (formerly AFDC) benefits are also excluded.

Also, Income is considered on a monthly basis and is used to determine financial eligibility and benefit level.

Whether your income level qualifies you or your family for Medicaid depends on the size of your family and the Medicaid program for which you are applying.

How Can I Verify My Income?

Income verification can be provided in a variety of ways, including:

  • Pay stubs covering at least the past four weeks.
  • Copy of check reflecting gross income.
  • Form 809 – Wage Verification form.

How to Calculate MAGI for Medicaid Eligibility

Follow the steps below, to calculate your MAGI for Medicaid Eligibility. Please note that this includes estimating any future income that may impact your MAGI.

Step 1

Calculate your household’s adjusted gross income (AGI) by using your most recent federal income tax return. Additionally, you can find your AGI on line 7 of IRS Form 1040.

Step 2

Second, add the following types of income (if applicable) to your AGI:

  • Tax-exempt foreign income
  • Eligible Tax-exempt Social Security benefits (including tier 1 railroad retirement benefits)
  • Any Tax-exempt interest

Do not include Supplemental Security Income (SSI).

Step 3

Lastly, adjust your estimate for any changes you expect.

Be sure to consider things future changes or adjustments for all members of your household, such as:

  • Expected raises
  • New jobs or other employment changes, including changes to your work schedule or self-employment income
  • Include changes to income from other sources, like Social Security or investments
  • Changes in your household, like gaining or losing dependents. Gaining or losing a dependent can have a big impact on your savings.

In conclusion, you now have successfully calculated your MAGI. Additionally, you should have an estimate of your expected income.

Exemptions from Income Limits

Not all Medicaid applications are required to meet the income limit. The following groups do not have to meet the Medicaid Income limit:

  • Supplemental Security Recipients (SSI)
  • Breast and cervical cancer treatment and prevention program beneficiaries
  • Children for whom an adoption assistance agreement is in effect under title IV-E of the Social Security Act are automatically eligible.
  • Young adults who meet the requirements for eligibility as a former foster care recipient are also eligible at any income level.

2020 Florida Medicaid Long Term Care Eligibility for Seniors

Your assets come into play when it comes to Long-Term Services and Supports (LTSS), the part of Medicaid that pays for long-term care and nursing home for Seniors.

Here are the income and asset (resources) limits for the Seniors applying for long-term care under Medicaid in Florida.

Single Person Applying for Florida Medicaid Benefits

Type of Medicaid Single
Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid $2,349 / month $2,000 Nursing Home
Home and Community-Based Services $2,349 / month $2,000 Nursing Home
Regular Medicaid / Aged Blind and Disabled $961 / month $5,000 None

Married Couple if Both are Applying for Florida Medicaid Benefits

Type of Medicaid Married (both spouses applying)
Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid $4,698 / month (Each spouse can have income up to $2,349 / month) $3,000 Nursing Home
Home and Community-Based Services $4,698 / month (Each spouse can have income up to $2,349 / month) $3,000 Nursing Home
Regular Medicaid / Aged Blind and Disabled $1,261 / month $6,000 None

Married Couple if Only One Needs to Apply for Florida Medicaid Benefits

Type of Medicaid Married (one spouse applying)
Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid $2,349 / month for applicant $2,000 for applicant & $128,640 for non-applicant Nursing Home
Home and Community-Based Services $2,349 / month for applicant $2,000 for applicant & $128,640 for non-applicant Nursing Home
Regular Medicaid / Aged Blind and Disabled $1,261 / month $6,000 None

Here is a list of assets counted during eligibility determination:

  • Cash
  • Checking accounts
  • Savings accounts and certificates
  • Christmas or vacation clubs
  • Stocks and bonds
  • Some trust funds
  • Life insurance
  • Vehicles
  • Revocable burial funds
  • Non-resident property

Examples of resources not counted in determining eligibility include:

  • Your home
  • Revocable and irrevocable burial reserves subject to specified limits
  • Burial space and marker
  • One motor vehicle

How to Apply for Medicaid in Florida

There are 3 ways you can apply for Medicaid in Florida.

Option 1 – Apply online

To apply online, please visit the ACCESS Florida online application portal.

You may also find out if you qualify and apply online through the Healthcare.gov Marketplace.

Option 2 – Apply at DCF Office Near You

You can apply in person at the Department of Children and Families (DCF) office near you, also known as ACCESS Service Centers.

To locate and ACCESS Service Center (Florida DCF Office) near you, click here.

Option 3 – Download Florida Medicaid Application

You can download an application, complete it and mail it to your county DCF office or submit it in person.

Note that there are two types of Medicaid applications on the page:

There is the Family-Related Medicaid Application.

Use this application if you are pregnant or have children who are 20 or under living with you and you only want to apply for Medicaid.

The other application is the ACCESS Florida Application, this is for those who want to apply for Medicaid and other benefits.

Use this application if you want to apply for:

  • Food or Cash Assistance
  • Family-related Medical assistance
  • Relative Caregiver
  • Optional State Supplementation or medical assistance for Age 65 or over
  • Blind or Disabled
  • Medicaid Waiver/Home and Community Based Services
  • Hospice or Nursing Home Care

Florida DCF Application Processing Video

This video from the Florida DCF does a great job of explaining what happens after you submit an application for benefits to the DCF, including Medicaid application.

Documents you need to apply

Here are the documents you are going to need to apply for Medicaid in Florida:

    • A copy of your birth certificate or other proof of identity and citizenship or immigration status
    • ID cards issued by federal, state or local government agencies or entities either containing a picture or identifying information, such as name, date of birth, sex, height, eye color and address to confirm identity
    • Social Security numbers, for each person requesting Medical Assistance
    • Paycheck stubs, payroll records or recent W-2 forms covering at least the past four weeks
    • Letters or forms that show your income from Social Security, SSI, Veterans Administration, retirement, pensions, unemployment, worker’s compensation or all sources of income
    • Current health insurance policies, health insurance cards, or other health insurance information
    • Life insurance policies
    • Recent bank statements or bank books, and/or most recent tax return
    • Information about property you own (such as land, or stocks and bonds)

Florida Medicaid Income Limits Summary

We hope this post on the Florida Medicaid Eligibility was helpful.

If you have further questions about Florida Medicaid benefits, please let us know in the comments section below.

Be sure to check out our other articles on Florida Benefits, including how to get 50% OFF Amazon Prime Membership with Florida EBT Card and FREE Museums for EBT Cardholders and how to check Florida EBT Card Balance.  

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