If you're wondering whether you or your family members qualify for Florida Medicaid, the first and most important thing to know is that Florida is one of approximately 10 states that has not expanded Medicaid under the Affordable Care Act. This creates a fundamentally different eligibility landscape than in expansion states — and it means many low-income Florida adults have fewer coverage options than their counterparts in states like California, New York, or Texas.
The ACA gave states the option to expand Medicaid eligibility to all adults with income up to 138% of the Federal Poverty Level (approximately $22,025 for a single person in 2026). In expansion states, a single adult earning $20,000/year qualifies for Medicaid. In Florida, that same person likely does not.
Florida's legislature has repeatedly declined Medicaid expansion, making it one of the holdout states even as of 2026. This policy decision affects an estimated 600,000–1,000,000 Florida adults who fall into the coverage gap — earning too little to receive ACA marketplace subsidies (which start at 100% FPL) but not qualifying for Florida's limited Medicaid program.
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Florida Medicaid does cover several categories of residents, primarily the most vulnerable populations. Eligibility requires both income requirements AND categorical requirements — simply having low income is not enough for most categories.
Children under age 19 have the broadest Medicaid and CHIP coverage in Florida. Florida KidCare is an umbrella program that includes:
Children should be checked for KidCare eligibility even if adults in the household do not qualify for Medicaid. A family where the adults fall into the coverage gap may still have children who qualify for KidCare.
Pregnant women in Florida may qualify for Medicaid during their pregnancy at higher income levels than the general adult population. Florida provides Medicaid coverage for pregnant women with income up to approximately 196%–200% FPL. Coverage is specifically for pregnancy-related services and extends through 60 days postpartum.
Parents and caretaker relatives of dependent children may qualify for Florida Medicaid, but the income limits are very low — much lower than even the non-expanded Medicaid threshold. As of 2026, the income limit for parents/caretakers in Florida is typically around 33% of FPL for a family of three (approximately $9,000/year), though exact figures are set by the Florida Legislature and subject to change.
This means even most parents with dependent children who have income above roughly $9,000/year do not qualify for Florida Medicaid.
Older Floridians may qualify for Medicaid if they meet income and asset requirements. Florida Medicaid for the elderly covers nursing home care, home and community-based services (HCBS), and related services. These programs are means-tested — both income and assets are evaluated. Many older Floridians with modest income but significant assets (such as a home) may not qualify without careful planning.
Older adults who are on Medicare may also qualify for Medicare Savings Programs (MSPs), which help pay Medicare premiums and cost-sharing — these are separate from the traditional Medicaid program.
Florida Medicaid covers individuals who receive Supplemental Security Income (SSI) and certain others with qualifying disabilities. Coverage for this population is generally linked to SSI receipt or meeting SSI-equivalent disability criteria. Various waiver programs also exist for individuals with developmental disabilities, brain and spinal cord injuries, and other specific conditions.
| Population | Income Range | Coverage Status |
|---|---|---|
| Adults without children (most) | 0–100% FPL ($0–$15,960 single) | Coverage gap — not Medicaid eligible (no expansion), not subsidy-eligible (below 100% FPL) |
| Adults without children | 100%–400% FPL | ACA marketplace with premium tax credits available |
| Parents with children (very low income) | Below ~33% FPL | Florida Medicaid eligible |
| Parents with children (moderate income) | 33%–100% FPL | Often in the coverage gap; children may qualify for KidCare |
| Children under 19 | Up to ~200% FPL | Florida Medicaid or KidCare CHIP eligible |
| Pregnant women | Up to ~200% FPL | Florida Medicaid for pregnancy-related services |
If you are an adult in Florida's coverage gap — income below 100% FPL, no qualifying children, not elderly or disabled — your options are limited but not zero:
For the full overview of ACA eligibility and options, see our Florida ACA Eligibility guide and our Florida Medicaid Income Limits 2026 detailed reference.
If you believe you or a family member may qualify for Florida Medicaid or KidCare, apply through:
Medicaid enrollment is year-round. Unlike marketplace plans, there is no open enrollment period — if you qualify, you can apply and receive coverage at any time.
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Compare Florida Plans — FreeSources: HealthCare.gov · KFF.org · Florida Office of Insurance Regulation (FLOIR)