Florida Medicaid Eligibility: Who Qualifies for Medicaid in the State of Florida?

Medicaid is a federal program that is state regulated and administered to qualified individuals.  In the state of Florida, there are certain criteria one must meet before they are able to receive this coverage.  There is a program called the Institutional Care Program, or ICP, that handles people who require nursing home care.  Under the ICP, someone with Medicaid can receive help paying for their nursing home expenses.  This can be a lifesaver for those on a fixed income as nursing home care can be extremely expensive. 

Florida Medicaid eligibility is determined by one of two agencies: The Department of Children and Families or the Social Security Administration.  The Social Security Administration handles cases for individuals over the age of 65 and anyone requiring nursing home care as described above.  The Department of Children and Families handles eligibility for pregnant women, low income families who have children, disabled or elderly individuals who do not receive SSI benefits, and foreign visitors who require emergency medical services.

Medicaid will cover most inpatient and outpatient doctor and hospital visits, some types of medical equipment, certain diagnostic and preventative tests, prescription medications, and surgical procedures.  Sometimes, the individual is required to make a small co-payment upon receiving services which may range from $5 to $20 as an estimated average.  If you are unsure about whether or not you qualify for Medicaid in the State of Florida, you should speak to your local Department of Social Services.  This is also where you would apply for coverage and be assigned a caseworker who can help you.

If your income is deemed too high to qualify you for Medicaid, you still may be able to qualify for the Medically Needy program.  This program requires individuals to incur a specific amount of medical expenses per month before they are considered for approval.  The amount of coverage and the qualification criteria will depend on your household income and size, as well as how much your medical costs are.  To learn more about this and other programs that you may qualify for, contact the Department of Social Services in your area.

19 Responses to Florida Medicaid Eligibility: Who Qualifies for Medicaid in the State of Florida?

  • john BROWN says:

    where can you get a list of doctors WHO TAKE MEDICAID in and around BRADENTON,florida. please let me know

  • Edward M. Axelrod says:

    My client’s mother who is a Florida resident, 90 years old, needs more medical attention. She lives in a house purchased by her family 25 years ago, lives on social security and what her 3 daughters give her. She needs much more help in order to remain in her house. If she applies for Medicaid, presuming that she is eligible, would the State give her help i.e. a person in her house daily? If so, who do I contact to start this application? Thank you ed Axelrod ( 203) 655- 8525

  • Maria E. Cueva says:

    I just received my Medicaid gold card and I have to enroll first according to the info they send me to the phone # 1 888 367-6554 and I star colling since July 7 from 8:00 am to 7:00 pm and the line is allways busy, I can’t enroll so please tell me if there is another nymber or how I could enroll. thank you Miami, Fl.

  • patricia Boatwright says:

    my ss# is 515-60-7853 I have never recieved the gold card. I am 100 % disabled. When I applied for medicaid, IMy spouse makes 8.50 hr. So I recieved share of cost of 1,994.00 . I cannot do anything with that. I had to go to the emergency room, and it met the share of cost. I take alot of medications, but cannot get them filled unless I meet the 1,994. Then the scripts are free. One script cost me 285.00 I can’t afford that. Even with the type of medicaid I have it does not help me. I do believe it was not correctly done. My Medicare doesn’t become effective until Dec.08. I have recieved letters stating, because of the income, I have qualified for extra prescription coverage. but none of it starts until Dec 08. What type of help can I get now? As I stated the share of cost seems too much.I was told I would recieve the gold card. Never did. Can you advise me?

  • KIM KAMMINGA says:

    FL SUCKS. i HAVE BOTH MEDICARE AND MEDICARE AND MEDICARE i WAS TOLD WILL PAY FOR MY MEDICARE OF 97.00 PER MONTH i’EVE BEEN WHATING 6 MONTHS FOR THEM TO DO SOO i KEEP CALLING THEM TO TALL THEM i HAVE NOT RESIVED IT, if this keeps up I will be on the street I’m trying to live on 579.+117.00 food stamps They keep talling me they now I should get the 97.00 dollers and they admet the need to pay me for six months but i never get it

  • mary ann sexton says:

    My grandaughter who is 19 lives in an apartment with a friend and has a job no insurance just makes enough to barlely live just went into the hospital for an emergency and they told my son that she was not eligable for medicaid and she has to try to pay for lab work and the hospital bill was 1200.00 plue lab work.. then they couldn’t tell her what was wrong so they sent her to a specialist who she can’t afford either… no wonder we need a health care system that helps the people.. she lives in Punta Gorda Fla… tell me what she should do ……

  • Christa says:

    I need medicaid benifits,i don’t have a job, and i can’t afford a health
    insurance plan which i feel i should get ,what are the qualfiications
    so i can have medicaid or free health insureance…

  • Alberto Gonzalez says:

    My dad lives in Hialeah and is 80 years old. He lives with my Aunt his sister in law who takes care of him. My question is there any way that he could get help in paying his utilities?

  • Judy Zuchero says:

    I am a disability advocate..pls. e=-mail me back the financial eligibility for Food Stamps and Medicaid. I have a consumer who is moving to Florida and we need this information. Thank you.

    He is one person,

  • LaNell says:

    I filled out forms apply for medical and dental help…I have not heard back and am in desperate need of dental things now. How long does processing things for that with the state normally take? I am nearly deaf and would appreciate if someone could email an answer.

  • Tom Vittore says:

    I hot very difficult times with social security to qualify for social security and disability . I had to wait 25 months and I was denied 7 times. It is not easy at all to get there so easy the way everybody thinks. Even so it is not enough for me to survive even my lady friend helps me and I do get my meals on wheels . One meal a day plus my lady does help me for the groceries and for the cooking. I did burn my self a few times due to my seizure episodes with no medically answers from 25 -30 Doctors I had then. The last 2 years ago I had 18 Doctors for 7 months with no explanation of my events. This is part of the story.

  • donna says:

    did that person just say her social security #

  • Ana Carrero says:

    I am 47 yrs. old. I have high bloodpressure and no medication. I am unemployed with no income. I have no insurance so I cannot see a doctor. My symptoms seem to be getting worst. I applied for Medicaid and was told I am not eligible but could have Medically Needed coverage where I pay out of pocket and then they covered the rest. If I had money to pay a doctor I would not ask for Medicaid. What do I do and where can I go to get medicated?

  • Lillian Cunningham says:

    I received a letter on June 1st, 2011 the day of my birthday, I turned 65 years old. The letter is from DCF which stated that I am approved for Medicaid. I have not received my Medicaid Card. I have talked to several of my friends who said they received their card a month before their 65th birthday. Please give me an idea of when I can get my card. Thank You.

  • Joe Foote says:

    Where do i apply for medicaid?

  • R says:

    Florida sucks and lets peopel worsen and die and some attorney should fight this and also contact me at portlife2 at yahoo. In NY and many other states-ones automatically get medicaid if low inncome and its actually required!! and not on the same arm as ssi. Also,medicaid is a federal program and obama said medical care for alll-so why does a state decide if one should die, suffer, or worsen? this is genocide-i would have more med care in africca with the missionaries that care.

  • Gabriella says:

    I have my daughter who has medicaid until sept 03, 2011. She will be 19yrs old and won’t qualify for children medical service (CMS)anymore.
    unfortunally my daugther suffers from zeisure disorder and depends on medicaton daily… does she still qualify for medicaid at 19 yrs old..? if there is any type of medical service for her?

  • jim slack says:

    a friend’s child has had medicaid under the disability portion. what all does the medicaid cover and what are the limits: the child has cancer.

  • serena norton says:

    where is the medicaid office for me to sign my 4 month old daughter up for medicaid I live in Punta Gorda Florida

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