Benefits Program

All Goverment Program benefits and Application form, income limits, documents etc.
All Goverment Program benefits and Application form, income limits, documents etc.
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NOTICE

Florida Medicaid Income Limits 2024

Citizens of the state of Florida are required to meet the prescribed income limits for the year 2024 to join the Medicaid program. The income limit has been determined on the basis of family members under the program. Florida Medicaid is the state and Federal partnership that provides health coverage for selected categories of people in Florida with low incomes. Its purpose is to improve the health of people who might otherwise go without medical care for themselves and their children. You have been given information related to Florida Medicaid Income Limits Guidelines in this article.

Florida Medicaid Income Limits Guidelines

As we enter the year 2024, it's essential for Florida residents to stay informed about the latest updates on Medicaid income limits. Medicaid is a crucial government program designed to provide healthcare coverage to low-income individuals and families. Understanding the income thresholds is key to determining eligibility and accessing the necessary medical services. In this article, we will delve into the Florida Medicaid Income Limits for 2024, examining the maximum income levels based on household size.

Florida Medicaid Income Limits For Household Size

To qualify for Medicaid in Florida, individuals and families must meet specific income criteria. The income limits vary based on the size of the household, ensuring that assistance is targeted towards those who need it most. Here are the maximum income levels for 2024:

  • Household Size: 1 - Maximum Income: $19,392 per year
  • Household Size: 2 - Maximum Income: $26,228 per year
  • Household Size: 3 - Maximum Income: $33,064 per year
  • Household Size: 4 - Maximum Income: $39,900 per year
  • Household Size: 5 - Maximum Income: $46,737 per year
  • Household Size: 6 - Maximum Income: $53,573 per year
  • Household Size: 7 - Maximum Income: $60,409 per year
  • Household Size: 8 - Maximum Income: $67,245 per year

Florida Medicaid Income Limits 2024

In order to qualify, you must have an annual household income (before taxes) that is below the following amounts:

Household SizeMaximum Income Level (Per Year)
1$19,392
2$26,228
3$33,064
4$39,900
5$46,737
6$53,573
7$60,409
8$67,245

For households with more than eight people, add $6,836 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

Who is eligible for Florida Medicaid Program?

To be eligible for Florida Medicaid, you must be a resident of the state of Florida, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be one of the following:

  • Pregnant, or
  • Be responsible for a child 18 years of age or younger, or
  • Blind, or
  • Have a disability or a family member in your household with a disability, or
  • Be 65 years of age or older.

How does the federal PHE affect eligibility for Florida Medicaid?

The Families First Coronavirus Response Act requires that states maintain continuous Medicaid coverage for enrollees during the PHE. Florida has allowed individuals to remain on Medicaid throughout the PHE even though their household situation may have changed. As a result of federal legislative changes in the Consolidated Appropriations Act, 2023, the continuous coverage provision will end on March 31, 2023. Once the continuous coverage ends, some Medicaid recipients may no longer be enrolled in Medicaid.

Medicaid Florida Eligibility

Medicaid provides medical coverage to low-income individuals and families. The state and federal government share the cost of the Medicaid program. Medicaid services in Florida are administered by the Agency for Health Care Administration. Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI recipients).

DCF determines Medicaid eligibility for:

Parents and caretaker relatives of children

Parents and other caretaker relatives of children up to age 18 who live with them may be eligible for Medicaid if the family’s countable income does not exceed certain income limits. Individuals who receive Temporary Cash Assistance (TCA) are eligible for Medicaid. Individuals who are eligible for TCA, but choose not to receive it, may still be eligible for Medicaid.

Families who lose Medicaid eligibility due to earned income may be eligible for up to twelve (12) additional months of Medicaid, if they meet certain requirements. Families that lose Medicaid eligibility due to the receipt of alimony may be eligible for four (4) additional months of Medicaid.

Children

Parents and caretakers may apply for Medicaid on behalf of children under age 21 living in their home, if the family income is under the limit for the age of the child.  There is no requirement for a child to reside with an adult caretaker to qualify for Medicaid. Children eligible for Medicaid may enroll in the Child Health Check-up Program. 

This program provides regularly scheduled health checkups, dental screenings, immunizations and other medical services for children. For information on the Child Health Check-up Program, visit the Agency for Health Care Administration’s information page at https://ahca.myflorida.com/ Families may also apply for medical assistance for children through Florida KidCare.

Pregnant Women

A pregnant woman may qualify for Medicaid if her family’s countable income does not exceed income limits.  For pregnant women who do not meet the citizenship requirements for Medicaid, see the information below about Emergency Medical Assistance for Non-Citizens.

Presumptively Eligible Pregnant Women (PEPW) is temporary coverage for prenatal care only and eligibility is determined by Qualified Designated Providers (QDP) based on limited information from the pregnant woman. During the temporary coverage period, the pregnant woman will need to submit an application to have her ongoing Medicaid eligibility determined. Women with family income over the limit for Medicaid may qualify for the Medically Needy Program. 

Former Foster Care Individuals

Individuals who are under age 26 may receive Medicaid if they were in foster care under the responsibility of the State and receiving Florida Medicaid when they aged out of foster care.  There is no income limit for this program.

Non-Citizens with Medical Emergencies

Non-citizens, who are Medicaid eligible except for their citizenship status, may be eligible for Medicaid to cover a serious medical emergency. This includes the emergency labor and delivery of a child. Before Medicaid may be authorized, applicants must provide proof from a medical professional stating the treatment was due to an emergency condition. The proof also must include the date(s) of the emergency.

Aged or Disabled Individuals not Currently Eligible

Medicaid for low-income individuals who are either aged (65 or older) or disabled is called SSI-Related Medicaid. Florida residents who are eligible for Supplemental Security Income (SSI) are automatically eligible for Medicaid coverage from the Social Security Administration. There is no need to file a separate ACCESS Florida Application unless nursing home services are needed.

Individuals may apply for regular Medicaid coverage and other services using the online ACCESS Florida Application and submitting it electronically.  If long-term care services in a nursing home or community setting are needed, the individual must check the box for HCBS/Waivers or Nursing Home on the Benefit Information screen. HCBS/Waiver programs provide in-home or assisted living services that help prevent institutionalization.

Medicare Savings Programs (Medicare Buy-In) help Medicare beneficiaries with limited finances pay their Medicare premiums; and in some instances, deductibles and co-payments. Medicare Buy-In provides different levels of assistance depending on the amount of an individual or couple’s income. Individuals may apply for Medicare Buy-In coverage only by completing a Medicaid/Medicare Buy-In Application. Print the form, complete it and mail or fax it to a local Customer Service Center.

Individuals eligible for Medicaid or a Medicare Savings Program are automatically enrolled in Social Security's Extra Help with Part D (Low Income Subsidy) benefit for the remainder of the year.  An individual may also apply directly with Social Security for the Medicare Extra Help Program.  Individuals who do apply directly for the Medicare Extra Help Program have the option of having the same application consideration for the Medicare Savings Program.

If the individual takes the option of having the Medicare Extra Help Program application considered for the Medicare Savings Program, the Social Security Administration will send information electronically to Florida and the individual will be contacted. More information about Medicaid programs for aged or disabled individuals is available in the SSI-Related Fact Sheets. 

Information for Medicaid providers who need to communicate with DCF about SSI-Related Medicaid eligibility status is contained in the SSI-Related Provider Communication Guide. Income and asset limits may be found on the SSI-Related Programs Financial Eligibility Standards.  Important information for individuals seeking Medicaid for long-term care services in a nursing home or community setting is available in the Qualified Income Trust Fact Sheet.