Medicaid provides low income Florida families with free or low-cost medical insurance to provide a basic level of medical care to all Florida residents. Applying for Medicaid is a fairly complex process, requiring different steps based upon the manner in which you qualify. Some require the involvement of only the state government, while others involve the federal Social Security Administration. In this article, I break down the process step-by-step to make it simple for you and your family to get Medicaid coverage.
Medicaid EligibilityMedicaid coverage is available to individuals and families who fall into at least one of the following five categories:
- Low income families with children
- Child-only coverage
- Pregnant women
- Non-citizens with medical emergencies
- Aged or disabled individuals
Medicaid Qualifications for Low Income Families with ChildrenFlorida families with children may qualify for Medicaid coverage if they meet the following requirements:
- Family income below the limits for Temporary Cash Assistance (TCA). In 2011, the limit is $364 for a family of four and increases approximately $62 for each additional family member. For more details see the TCA eligibility chart.
- Countable assets less than $2,000 (excluding your homestead)
Medicaid Qualifications for Children OnlyIf your entire family does not qualify for Medicaid coverage, you still may be able to obtain coverage for your children (under 19) only.
- Under age 1 with family income less than 200% of the federal poverty guidelines.
- Ages 1 through 5 with family income less than 133% of the federal poverty guidelines.
- Ages 6 through 18 with family income less than 100% of the federal poverty guidelines.
Medicaid Qualifications for Pregnant WomenPregnant women have several options for receiving Medicaid coverage:
- The quickest way is the Presumptive Medicaid Eligibility for Pregnant Women (PEPW) process. To obtain this coverage, your family income must be less than 185% of the federal poverty guidelines. You apply for this coverage in person at a public hospital, the county health department or state-approved healthcare providers. It is only good for 60 days and is designed to provide you access to care while you apply using the SEPW process.
- You may obtain longer-term coverage using the Simplified Eligibility for Pregnant Women (SEPW) process. You must provide proof that your income is less than 185% of the federal poverty guidelines, that you are a US citizen, and that you are pregnant. To apply for this coverage, fill out the one-page SEPW application.
- You may apply for Medicaid for Low Income Families with Children using the ACCESS Florida online application.