Florida Medicaid Office

Florida Medicaid offices (AHCA and DCF)

Florida Medicaid is run by two agencies. The Agency for Health Care Administration (AHCA) administers the program and sets policy. The Department of Children and Families (DCF) determines eligibility for most categories — children, families, pregnant women, and most aged or disabled adults. The Social Security Administration handles SSI-related eligibility. Day-to-day enrollment and renewals happen through DCF's MyACCESS portal.

How to reach Florida Medicaid

• AHCA Medicaid Help Line — 1-877-254-1055. For Fee-For-Service Medicaid recipients, plan-enrollment questions, and general program assistance.
• DCF benefits and eligibility — apply, renew, report changes, and check status at myaccess.myflfamilies.com. Find your local DCF Customer Service Center at familyresourcecenter.myflfamilies.com.
• Florida KidCare — children's coverage above Medicaid limits. Apply at floridakidcare.org.
• SMMC Choice Counseling — for help choosing a managed care plan, call the SMMC Helpline number listed on plan-enrollment letters or visit flmedicaidmanagedcare.com.
• Children's Medical Services (CMS) Health Plan — 1-855-901-5390 (nurse line for children with special health care needs).
• Aging and long-term care eligibility — Department of Elder Affairs decides medical eligibility for LTC; DCF decides financial eligibility. Start at elderaffairs.org or call the Elder Helpline at 1-800-963-5337.

AHCA does not run county walk-in offices for Medicaid. Recipients apply, renew, and report changes through MyACCESS — DCF approved Community Partners across the state also help with applications free of charge. AHCA's mailing address is 2727 Mahan Drive, Tallahassee, FL 32308.

Who qualifies for Florida Medicaid?

Florida has not adopted the ACA Medicaid expansion. Childless adults under 65 who are not disabled generally cannot qualify for Florida Medicaid. Parents and other adult caretakers can qualify, but at very low income limits. Children, pregnant women, former foster youth, and people with disabilities have separate pathways.

Who qualifies for Florida Medicaid?

• Parents and other related caretakers of children — must care for a Medicaid-enrolled child under 18 (or 18 if in school full-time); subject to family-related income limits set by DCF. Transitional Medicaid extends coverage up to 12 additional months when earned income causes a family to lose eligibility.
• Children under 21 — qualify at higher income limits depending on age. Children under 19 keep coverage for up to 12 months after their last eligibility review under continuous-eligibility rules.
• Pregnant women — once eligible, coverage stays in place throughout pregnancy and 12 months postpartum regardless of later income changes. Presumptively Eligible Pregnant Women (PEPW) get temporary prenatal coverage through Qualified Designated Providers before completing a full application.
• Former foster youth (through age 26) — eligible without an income test if they were in Florida foster care and on Medicaid when they aged out.
• Aged (65+), blind, or disabled adults — SSI-Related Medicaid. Florida residents on SSI are automatically eligible through SSA. Non-SSI applicants apply through the ACCESS Florida application.
• Non-citizens with medical emergencies — Emergency Medicaid covers serious medical emergencies including labor and delivery. No postpartum coverage attaches to emergency Medicaid.

Coverage pathways beyond traditional Medicaid

• Medically Needy Program — Florida's spenddown program. Adults with income or assets too high for Medicaid can earn coverage after incurring monthly medical bills equal to their share of cost. Common for high-cost prescriptions, hospital stays, or chronic conditions.
• Florida KidCare — Title XXI children's coverage for kids whose family income is above Medicaid. Includes MediKids (ages 1–4), Florida Healthy Kids (5–18), and CMS Health Plan for children with serious chronic conditions.
• Medicare Savings Programs — QMB, SLMB, and QI-1 help Medicare beneficiaries pay Medicare premiums and (for QMB) cost-sharing. Apply via the Medicaid/Medicare Buy-In Application.

Florida Medicaid income limits

Florida publishes Medicaid income limits in annual PDF charts on the DCF site, revised each April (federal poverty level updates take effect in Florida the April after the January federal change). Dollar figures depend on your Medicaid coverage group and household size — verify the current chart before relying on a specific number.

How DCF determines your income limit

1. Determine your coverage group — Parents and Caretakers, Pregnant Women, Infants under age 1, Children ages 1–5, Children ages 6–18, Children ages 19–20.
2. Determine your household size — DCF uses modified adjusted gross income (MAGI) rules for family-related Medicaid. Household size depends on tax-filing status, whether you're claimed as a dependent, and who else lives with you.
3. Find your maximum monthly income on the published chart for your group and household size.

Approximate Family-Related Medicaid income bands (MAGI)

The Family-Related Medicaid program ranges from very low limits for parents and caretakers to higher limits for pregnant women and infants. Approximate FPL caps in Florida:

SSI-Related Medicaid (aged, blind, disabled)

Different rules apply. SSI-Related Medicaid uses the Supplemental Security Income standards — income roughly at the federal benefit rate ($994 for an individual in 2025) and an asset limit of $2,000 individual / $3,000 couple. The Medically Needy Program lets people with income above the limit qualify after meeting a monthly share-of-cost based on medical expenses.

Long-term care (Medicaid HCBS Waiver and nursing facility)

Florida applies the federal 300% SSI rule — gross monthly income up to $2,901 (2025 figure) for a single applicant. Applicants over the cap can still qualify by establishing a Qualified Income Trust ("Miller trust") that diverts excess income.

How to apply for Florida Medicaid

One application — through DCF's MyACCESS — covers Florida Medicaid, the Medically Needy Program referral, Florida KidCare referral, SNAP food assistance, TANF cash assistance, and Optional State Supplementation. Most Medicaid applicants apply online; SSI-Related Medicaid for nursing-facility care has additional steps.

Apply online through MyACCESS

myaccess.myflfamilies.com is Florida's official benefits portal, operated by DCF. Allow 30–60 minutes to complete the application. Create an account so you can save progress and upload documents later. After you submit:

• DCF reviews the application and contacts you if more information is needed.
• Medicaid applicants do NOT need an interview. SNAP and TCA applicants may need one.
• DCF makes most Medicaid decisions within 45 days. SSI-Related and disability-based determinations can take up to 90 days.
• Coverage can be retroactive up to three months before the application month for qualifying medical bills.

Apply by phone, in person, or with help

• DCF Customer Service Centers — find your local center at familyresourcecenter.myflfamilies.com. Walk-in and phone help available.
• DCF approved Community Partners — clinics, hospitals, community organizations, and tribal programs trained to submit MyACCESS applications on a household's behalf. Search the Community Partner Lookup tool on the DCF site.
• Florida KidCare — a separate online application at floridakidcare.org; DCF automatically refers KidCare applicants when Medicaid denies.
• Medicare Buy-In — print the Medicaid/Medicare Buy-In Application and mail or fax it to your local DCF Customer Service Center.

Documents you may need

Identity (driver's license, state ID, student ID), income (recent pay stubs, unemployment letters, Social Security or pension award letters), residence (lease, utility bill), and — for SSI-Related Medicaid — proof of resources (bank statements, vehicle title, property records). DCF will tell you which documents to upload after you submit.

If your application is denied

You have a right to appeal within 10 days of the denial letter. File the appeal with DCF's Office of Inspector General. You can keep your Medicaid coverage in place while the appeal is pending.

What Florida Medicaid covers

Most Florida Medicaid recipients get coverage through Statewide Medicaid Managed Care (SMMC), administered by AHCA. SMMC has three components — Managed Medical Assistance (MMA) for general acute and primary care, Long-Term Care (LTC) for adults needing nursing-facility-level care, and a Statewide Dental Program. AHCA implemented SMMC 3.0 on February 1, 2025, consolidating from 11 regions to 9 and renegotiating plan contracts.

Standard Medicaid benefits (MMA)

• Doctor visits, hospital and outpatient care, surgery, specialist care, lab and imaging
• Prescription drugs, immunizations, and well-child checkups
• Mental health services and substance use disorder treatment, integrated through MMA plans
• Pregnancy care (prenatal, delivery, postpartum 12 months)
• Family planning services
• Non-emergency medical transportation to covered appointments
• Statewide dental benefits delivered through plans dedicated to dental care
• Vision and hearing for children, limited adult vision

EPSDT — Child Health Check-Up Program

Children under 21 receive Florida's Child Health Check-Up Program, the state's implementation of federal EPSDT (Early and Periodic Screening, Diagnostic, and Treatment). The program covers scheduled checkups, immunizations, dental screenings and treatment, vision, hearing, behavioral health, and any medically necessary service that addresses a child's health condition — even when the service is not covered for adults.

Long-Term Care (LTC) component

The Department of Elder Affairs evaluates medical eligibility for LTC; DCF determines financial eligibility. Applicants need to meet nursing-facility-level-of-care criteria established by federal Medicaid rules.

SMMC specialty plans

• Children's Medical Services (CMS) Health Plan — for children with serious or chronic medical conditions, run by the Florida Department of Health through WellCare.
• Serious Mental Illness specialty plans — coordinated behavioral health management for adults.
• HIV/AIDS specialty plans — integrated medical and case management.
• Child Welfare specialty plans — for children in dependency or foster care.

Other state Medicaid pages