Florida Medicaid Income Limits – 2021

"What are the income limits for Medicaid in Florida"

The Medicaid Income Limit is the most important criteria for deciding whether you qualify for Medicaid in your state. In this post, we are going to explain in detail the Florida Medicaid Income Limits for 2021.

Based on this information, you will be able to determine whether your income qualifies you for Florida Medicaid or not.

However, before we get into details about the income limit, we will first explain the Medicaid program in Florida and how it works.

Next, we will discuss who is eligible for Medicaid, including how eligibility works for various categories, including Children, Pregnant Women, and Adults.

Finally, we will explain how to check if your income qualifies for Medicaid in Florida and how to apply.
To learn more, please keep reading this post below.
"Florida Medicaid Income Limits"

In this post on Florida Medicaid Income Limits, we will cover:

  • What is Medicaid?
  • Who Can Get Medicaid in Florida?
  • Florida Medicaid Income Limit for 2021
  • How to Apply for Medicaid in Florida

What is Medicaid?

Medicaid is a federal and state health insurance program for people with a low income.

It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.

The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.

How Many People are on Medicaid?

According to the Centers for Medicare & Medicaid Services, as of July 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:

  • 75,521,263 individuals were enrolled in Medicaid and CHIP
  • 68,826,573 individuals were enrolled in Medicaid
  • 6,694,690 individuals were enrolled in CHIP

Florida Medicaid

The Florida Medicaid program provides medical coverage to low-income individuals and families.

As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered 3.9 million people.

This includes 2.5 million children as shown by the image below.

"Medicaid enrollment in Florida"

Medicaid services in Florida are administered by the Agency for Health Care Administration (AHCA).

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

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 Income Limit

The Florida Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.

To qualify, you must meet the Florida Medicaid Income limits listed below.

Here is the Federal Poverty Level (FPL) for 2020.

2020 Federal Poverty Levels
for the 48 Contiguous States & D.C.
Household Size Poverty Guideline for 48 states & DC Alaska Hawaii
1 $12,760 $15,950 $14,680
2 $17,240 $21,550 $19,830
3 $21,720 $27,150 $24,980
4 $26,200 $32,750 $30,130
5 $30,680 $38,350 $35,280
6 $35,160 $43,950 $40,430
7 $39,640 $49,550 $45,580
8 $44,120 $55,150 $50,730
Over 8 people add $4,480 for each additional person $5,600 $5,150

Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:

  • Children up to age 1 with family income up to 206 percent of FPL
  • Any child age 1-5 with a family income up to 140 percent of FPL
  • Children ages 6- 18 with family income up to 133 percent of FPL
  • Pregnant women with family income up to 191 percent of FPL
  • Parents of minor children with family income up to 28 percent of FPL
  • Individuals who are elderly, blind, and disabled with family income up to 88% of the FPL
  • Women with Breast and Cervical Cancer with Family Income up to 200% of the FPL

Florida Medicaid Income Limit Charts

The FL Medicaid eligibility income limit charts are divided by groups.

For example, the first chart is focused on income limits for children who qualify for Medicaid.

Similarly, the second chart below focuses on the Medicaid income limits for adults in Florida who qualify for Medicaid.

Florida Medicaid Income Limit for Children 

Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.

Florida Medicaid Income Limit – Children
For Children Ages 0-1 Medicaid Children Ages 1-5 Medicaid For Children Ages 6-18 Medicaid Children Separate CHIP
% FPL 100% 206% 140% 133% 210%
Household Size
1 $12,760 $26,286 $17,864 $16,971 $26,796
2 $17,240 $35,514 $24,136 $22,929 $36,204
3 $21,720 $44,743 $30,408 $28,888 $45,612
4 $26,200 $53,972 $36,680 $34,846 $55,020
5 $30,680 $63,201 $42,952 $40,804 $64,428
6 $35,160 $72,430 $49,224 $46,763 $73,836
7 $39,640 $81,658 $55,496 $52,721 $83,244
8 $44,120 $90,887 $61,768 $58,680 $92,652

Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.

Florida has not expanded Medicaid to include adults without dependents.

Therefore, adults without dependents do not qualify for Medicaid in Florida.

For an update on the Medicaid expansion debate and timeline in Flordia, see our Florida Medicaid Expansion update below.

Florida Medicaid Income Limit for Adults

Florida Medicaid Income Limit – 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 $12,760 $24,372 $3,573 $11,229 N/A
2 $17,240 $32,928 $4,827 $15,171 N/A
3 $21,720 $41,485 $6,082 $19,114 N/A
4 $26,200 $50,042 $7,336 $23,056 N/A
5 $30,680 $58,599 $8,590 $26,998 N/A
6 $35,160 $67,156 $9,845 $30,941 N/A
7 $39,640 $75,712 $11,099 $34,883 N/A
8 $44,120 $84,269 $12,354 $38,826 N/A

How to Read the Florida Medicaid Income Limits Charts Above

You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.

Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.

For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 191% of the Federal Poverty Level – which for a family of two is  $32,928 as shown in the chart above.

What is Considered Income for Medicaid Eligibility?

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

For most people, MAGI is identical or very close to your adjusted gross income (AGI). Similarly, this can be found on your tax return.

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.

Resource Limits

If you cannot calculate your modified adjusted gross income, Florida Medicaid eligibility can also be determined by using resource limits.

When determining your eligibility you must meet a set of resource limit criteria. For example, here is a list of resources 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 three steps to applying for Medicaid in Florida:

Step 1 – Am I Eligible For Florida Medicaid?

Click here for a link to ACCESS Florida’s Pre-screening Tool to find out if you’re eligible for Medicaid.

Step 2 – Apply For Florida Medicaid

You can apply online through the DCF ACCESS Florida website. Click here to be taken there.

Gather the necessary documentation before beginning the application (social security card, income information, etc.).

Step 3 – Contact A Florida Medicaid Provider’s Office

Once you’ve received your Flordia Medicaid card, you can now schedule a visit with your Medicaid accepted health care provider.

To find a Medicaid accepted health care provider in Florida near you, click here.

Florida Medicaid Expansion Update

Florida is one of 12 states that, as of August 2020, has not expanded Medicaid eligibility as allowed under the Affordable Care Act (ACA).

This means that adults without dependents who have low income cannot qualify for Medicaid, like residents in the 38 states that have expanded Medicaid.

In Florida, if Medicaid had been expanded under the ACA, some 391,000 people who do not currently have coverage would gain coverage.

Republicans control Florida’s House and Senate as well as the governor’s office.

Democrats in the Florida legislature have been pushing for Medicaid expansion for years, but have consistently been blocked by Republicans.

Florida Medicaid Income Limits Summary

We hope this post on Florida Medicaid Income Limits was helpful to you.

If you have any questions about Medicaid in the state of Florida, you can ask us in the comments section below.

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Be sure to check out our other articles about Medicaid.