Florida Medicaid Income Limits (2026)

Florida Medicaid is the third-largest state Medicaid program by enrollment but operates under some of the most restrictive adult eligibility rules in the country. Because Florida did not adopt the Affordable Care Act's Medicaid expansion, there is no income-based pathway for working-age adults who are not pregnant, not disabled, and not raising dependent children. The Department of Children and Families (DCF) administers eligibility determinations, while the Agency for Health Care Administration (AHCA) oversees the Statewide Medicaid Managed Care (SMMC) program that delivers benefits. The 2026 Federal Poverty Level, $15,960 for a single person and $33,000 for a family of four in the 48 contiguous states, anchors every income threshold described on this page.

Florida Medicaid eligibility divides into four main population groups. Parents and caretaker relatives of dependent children qualify only up to 27% of the Federal Poverty Level, a threshold that has remained frozen for years and translates to roughly $599 per month for a family of three in 2026. Pregnant women receive the most generous coverage at 196% FPL ($4,462 per month for a family of three), and coverage continues for 12 months after delivery under federal postpartum extension rules. Children qualify up to 138% FPL for Medicaid (or higher thresholds for younger children), and Florida KidCare provides CHIP coverage above those limits up to 200% FPL. The fourth group, aged and disabled adults, qualifies through separate SSI-linked and long-term-care Medicaid pathways with an asset test of $2,000 for individuals.

Florida Medicaid delivered services through Statewide Medicaid Managed Care plans to approximately 5 million enrollees as of early 2026, following the Medicaid unwinding period that began in April 2023. The coverage gap created by Florida's non-expansion status affects an estimated 388,000 adults who earn too little to qualify for ACA marketplace subsidies (which start at 100% FPL using the prior year's poverty guidelines) but too much to qualify for traditional Florida Medicaid. A 2026 ballot initiative to expand Medicaid was withdrawn and rescheduled for 2028 after legislative changes altered petition rules. Until expansion occurs, Florida Medicaid remains a targeted safety-net program rather than a universal low-income health coverage program.

Florida Medicaid income limits by household size (2026)

Florida Medicaid income limits 2026 by household size. The Adult column shows the 138% FPL threshold used by expansion states; Florida adults (non-pregnant, non-disabled, without dependent children) generally do not qualify through this pathway. Parents and caretakers are capped at 27% FPL (see footnote). The Children column shows the 138% FPL standard for children ages 6-18. The Pregnancy column shows Florida's 196% FPL limit for pregnant women. All figures are based on the 2026 Federal Poverty Level for the 48 contiguous states.

Florida Medicaid eligibility requirements (non-income)

Florida Medicaid eligibility requires meeting both income criteria and several non-income criteria. The four main coverage groups are: parents and caretaker relatives of dependent children, pregnant women, children under age 19, and aged or disabled adults. Each group has its own income threshold and, for the aged and disabled group, an asset limit. All MAGI-based categories (parents, pregnant women, children) have no asset test.

• Florida residency: the applicant must live in Florida. Florida DCF verifies residency through a utility bill, lease agreement, mortgage statement, or similar document in the applicant's name. Temporary absence from the state does not generally disqualify a resident.
• U.S. citizenship or qualifying immigration status: U.S. citizens qualify immediately. Lawful permanent residents (green card holders) who have had their status for fewer than 5 years qualify only for emergency Medicaid under the federal 5-year bar. Certain qualified immigrants are exempt from the bar (refugees, asylees, special immigrant visa holders, Cuban and Haitian entrants). Undocumented individuals generally do not qualify for full Florida Medicaid; emergency Medicaid covers labor and delivery costs for qualifying undocumented pregnant women.
• Social Security Number (SSN): every household member applying for Medicaid must provide or apply for an SSN. Members who are not applying (such as an undocumented parent applying only for a U.S.-born child) do not need to provide an SSN, but the child's SSN is still required.
• Household composition rules under MAGI: Florida Medicaid uses the Affordable Care Act's MAGI household-counting rules for parents, pregnant women, and children. In general, the tax-filing household plus any dependents form the Medicaid household. A pregnant woman's household size counts the unborn child(ren), which can affect the income threshold used.
• Asset test for aged and disabled categories: Florida Medicaid for aged or disabled adults (Medicaid for Aged and Disabled, or MAD) applies an asset limit of $2,000 for individuals and $3,000 for married couples. Exempt assets include a primary home (if the applicant intends to return), one vehicle, personal belongings, and prepaid burial arrangements up to $2,500. Long-term care Medicaid (nursing home) uses the same $2,000 individual asset limit and applies a 60-month look-back period for uncompensated asset transfers.
• Coverage exclusion for most working-age adults: because Florida did not expand Medicaid, adults ages 19-64 who do not have dependent children, are not pregnant, are not disabled, and are not 65 or older do not qualify for Florida Medicaid regardless of how low their income is. This is the Florida Medicaid coverage gap. Adults in the gap who earn between 100% FPL and 400% FPL may qualify for ACA marketplace subsidies; those below 100% FPL have no subsidized coverage option through Florida's current Medicaid program.
• No other comprehensive insurance: Florida Medicaid is generally not available to individuals who already have access to comprehensive employer-sponsored insurance at affordable premium rates. Third-party liability rules mean Florida Medicaid pays last if another payer is responsible.

What income counts for Florida Medicaid

Florida Medicaid uses Modified Adjusted Gross Income (MAGI) methodology for most eligibility categories: parents, caretakers, pregnant women, children, and young adults. MAGI counts most forms of taxable income but excludes several categories that low-income households commonly receive. Aged, blind, and disabled adults in SSI-related categories use a different income counting methodology that may disregard certain income types not excluded under MAGI. Florida does not apply an additional 5% FPL disregard on top of the MAGI calculation for the parent/caretaker category, which keeps the effective threshold at the published 27% FPL level.

Income sources included

• Wages, salaries, and tips: all W-2 earnings from employment, including overtime pay, bonuses, and commissions, count in full toward MAGI.
• Self-employment net income: net profit from a self-employed business or freelance work (Schedule C income) counts. Allowable business expenses reduce the amount counted, but home-office deductions that are not allowed for regular tax purposes are not deducted.
• Social Security retirement and survivor benefits: the taxable portion of Social Security retirement and survivor benefits counts for MAGI purposes. If a household member receives SSDI (Social Security Disability Insurance), the taxable portion also counts.
• Interest, dividends, and capital gains: taxable interest from savings accounts, dividends from stock holdings, and net capital gains from the sale of investments or property all count toward MAGI income.
• Unemployment compensation: Florida state unemployment benefits and federal pandemic unemployment supplements (where still applicable) count as income under MAGI.
• Pensions and retirement distributions: taxable distributions from 401(k), 403(b), and IRA accounts, as well as traditional defined-benefit pension payments, count toward MAGI income. Roth IRA distributions that are nontaxable do not count.
• Rental income (net): net rental income after allowable expenses (mortgage interest, property taxes, depreciation, repairs) counts toward MAGI. If rental activity produces a net loss, the loss does not offset other income for Medicaid purposes.
• Alimony received under pre-2019 divorce decrees: alimony payments received under divorce decrees finalized before January 1, 2019, count as MAGI income. Alimony from decrees after January 1, 2019, is not counted (due to the Tax Cuts and Jobs Act change in tax treatment).

Income sources excluded

• Supplemental Security Income (SSI): SSI payments from the Social Security Administration do not count as MAGI income. SSI recipients in Florida automatically qualify for full Medicaid (through an SSI-Medicaid link) without a separate MAGI income test.
• Child support received: child support payments received on behalf of a child do not count as MAGI income for the household receiving them.
• Veterans' benefits: VA disability compensation, GI Bill educational benefits, and VA pension payments are excluded from MAGI income. Military retirement pay, however, is taxable and does count.
• Workers' compensation: payments received for a work-related injury or illness under Florida's workers' compensation system do not count as MAGI income.
• TANF and most cash public-assistance payments: Temporary Assistance for Needy Families (TANF) benefits and most other means-tested cash assistance payments are excluded from MAGI income.
• Gifts, inheritances, and non-recurring lump sums: one-time gifts, inherited assets, and non-recurring lump sums (such as a personal injury settlement) do not count as MAGI income in the month received and are not averaged over multiple months for MAGI purposes.

How to apply for Florida Medicaid in Florida

Florida Medicaid applications go through MyACCESS, the statewide self-service portal operated by the Department of Children and Families (DCF). The same application captures Florida Medicaid, Florida KidCare (CHIP), SNAP food assistance, and Temporary Cash Assistance, so most applicants only need to fill out one form. Florida residents can apply online at myaccess.myflfamilies.com, by phone at 1-866-762-2237, by mail, or in person at any DCF public benefits office. Pregnant women's applications are processed on an expedited timeline under federal rules.

1. 1. Gather your documents: photo ID for the head of household, Social Security Numbers for all household members applying for coverage, proof of Florida residency (utility bill, lease, or similar), proof of citizenship or qualifying immigration status, and the most recent month of pay stubs or proof of income.
2. 2. Create or log into your MyACCESS account at myaccess.myflfamilies.com. You can start the application without completing it in one session; the system saves your progress. If you prefer not to apply online, call 1-866-762-2237 to apply by phone or visit your nearest DCF service center.
3. 3. Complete the application: list every household member, report all income from every source, answer questions about assets (required for aged and disabled categories), and disclose any other health insurance coverage. The online application takes approximately 30-60 minutes for a typical household.
4. 4. Upload or submit supporting documents through MyACCESS. Required documents vary by case type but typically include proof of identity, residency, income, and immigration status. Uploading documents directly to the portal speeds processing and prevents lost paperwork, which is a leading cause of delays.
5. 5. Submit the application and note your case number from the confirmation screen. DCF will send a letter requesting any additional documents within 10 days of receiving your application. Respond promptly: failure to respond to a document request within the deadline is the most common reason Florida Medicaid applications are denied.
6. 6. Wait for the eligibility determination notice. Standard Florida Medicaid applications are decided within 45 days. Pregnancy applications are processed within 15 days under federal expedited rules. Disability determinations take longer, typically 60-90 days, because they require medical review.

Official portal: myaccess.myflfamilies.com

Documents needed

• Photo ID for the head of household (Florida driver's license, state ID card, U.S. passport, or equivalent government-issued photo ID).
• Social Security Numbers for every household member applying for coverage (or documentation that an SSN application has been submitted).
• Proof of Florida residency: a utility bill, lease or rental agreement, mortgage statement, or other official mail addressed to the applicant at a Florida address dated within the past 90 days.
• Proof of U.S. citizenship or qualifying immigration status: a U.S. birth certificate, U.S. passport, Certificate of Naturalization, permanent-resident card (green card), or other USCIS documentation confirming lawful status.
• Proof of income for all household members: the most recent 30 days of pay stubs for wage earners; the most recent federal tax return or 12 months of income records for self-employed applicants; award letters for Social Security, pension, or unemployment benefits; or a written explanation with documentation if income is zero.
• For pregnant women: documentation from a health care provider confirming the pregnancy and the estimated due date (a prenatal care visit record, ultrasound report, or letter from an OB-GYN). This is required for the expedited pregnancy processing track.
• For aged or disabled applicants: documentation of age (birth certificate or state ID), disability award letter from Social Security Administration (if applicable), and a list of all countable assets with current balances (bank statements, investment account statements).

Processing timeline: Standard Florida Medicaid applications are decided within 45 days from the date DCF receives a complete application. Pregnancy applications are processed within 15 days under federal expedited rules. Applications for aged and disabled adults involving a disability determination can take 60-90 days. Long-term care Medicaid applications often take 90 days or longer because they require asset verification and sometimes estate planning review. DCF sends a written notice of approval or denial; applicants denied have 90 days to request a fair hearing.

Common reasons applications get denied

• Income above the population-specific threshold: the most common denial reason. Parents and caretakers with income above 27% FPL, children with income above the applicable children's threshold, or pregnant women above 196% FPL do not qualify for Florida Medicaid.
• Failure to respond to DCF's 10-day document request: DCF routinely requests additional documents after receiving an application. Applicants who do not respond within the stated deadline are denied for failure to complete the application, even if they otherwise meet all eligibility criteria.
• Adult applicant without a qualifying category: an adult ages 19-64 who is not pregnant, not disabled, not age 65 or older, and not a caretaker of a dependent child has no Florida Medicaid pathway regardless of income because Florida did not expand Medicaid.
• Federal 5-year bar for recently arrived lawful permanent residents: lawful permanent residents who have had their status for fewer than 5 years do not qualify for full Florida Medicaid under the federal bar. Emergency Medicaid may cover labor and delivery for qualifying pregnant immigrants during the 5-year waiting period.
• Assets above the limit for aged and disabled applicants: individuals 65 or older or disabled adults seeking Medicaid for Aged and Disabled (MAD) or long-term care Medicaid must have countable assets at or below $2,000. Exceeding the asset limit while failing to spend down or meet program-specific transfer rules results in denial or a period of ineligibility.

If your child's family income exceeds the Florida Medicaid limit

Florida KidCare is Florida's Children's Health Insurance Program (CHIP). KidCare covers children under age 19 whose household income is above the Florida Medicaid threshold but at or below 200% of the Federal Poverty Level, roughly $66,000 per year for a family of four in 2026. Florida KidCare has four component programs: Medicaid (the base program), MediKids, Children's Medical Services Network, and Healthy Kids. Premiums for Healthy Kids range from $15 to $20 per month per child for families between 138% and 200% FPL; children in families below 138% FPL are covered at no cost through Medicaid. KidCare applications go through the same MyACCESS portal at myaccess.myflfamilies.com or directly at floridakidcare.org.

Compare CHIP and Medicaid income limits across all 50 states

If you are 65 or older or disabled and have Medicare: Medicare Savings Programs

Florida operates three Medicare Savings Programs (MSPs) for low-income Floridians who have Medicare: the Qualified Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the Qualifying Individual (QI) program. These programs pay for Medicare Part B premiums and, in the case of QMB, also cover Medicare Part A and Part B cost-sharing (deductibles, copays, and coinsurance). In 2026, QMB covers individuals with monthly income up to $1,350 and couples up to $1,824. SLMB covers individuals up to $1,616 per month and couples up to $2,184. QI covers individuals up to $1,816 per month and couples up to $2,455. Asset limits are $9,950 for individuals and $14,910 for couples. Florida DCF administers MSP applications through the same MyACCESS portal. Dual-eligible Floridians (those who qualify for both Medicare and Medicaid) may also be eligible for a Special Needs Plan that coordinates benefits across both programs.

Read the Medicare eligibility guide

Frequently Asked Questions