Florida’s Medicaid program provides essential health coverage for low-income families, children, pregnant women, seniors, and individuals with disabilities.
However, the state’s eligibility rules remain stricter than many others because Florida has not expanded Medicaid under the Affordable Care Act (ACA).
As a result, most adults without dependent children still do not qualify.
Want to see if you’re eligible this year?
Use our free Florida Medicaid Eligibility & Income Calculator to check your 2025 income and asset limits instantly.
Key Highlights for 2025:
- 🩺 Non-expansion state: Most childless adults remain ineligible regardless of income.
- 👶 KidCare expansion: Children in families earning up to 300% FPL now qualify.
- 🤰 Pregnant women: Generally covered up to 200% FPL.
- 👨👩👧 Parents: Must meet lower income thresholds tied to household size.
- 🧓 Seniors & long-term care: Strict income ($2,901/month) and asset ($2,000) caps apply, with options like Miller Trusts to qualify.
- 📉 Enrollment trends: Medicaid enrollment is declining after pandemic-era protections ended.
Florida Medicaid remains a vital but tightly regulated safety net, with expanded access for children in 2025 but continued limits for most adults.
Florida Medicaid Overview & 2025 Trends
Florida Medicaid is managed by the Agency for Health Care Administration (AHCA) and the Department of Children and Families (DCF). Unlike expansion states, Florida’s program excludes most childless adults, even those with very low incomes.
Enrollment changes are significant. According to a KFF report, Medicaid enrollment nationally fell 7.5% in 2024 and is expected to drop another 4.4% in 2025 as continuous coverage protections unwind. Florida mirrors this decline, with procedural disenrollments affecting many families.
A major 2025 update is the expansion of Florida KidCare (CHIP) to cover children in families earning up to 300% FPL, approved by the federal government in late 2024. This expansion significantly broadens access for children, even as adult coverage remains limited.
Florida Medicaid Income & Asset Limits 2025
Family-Related Medicaid (MAGI Rules)
Eligibility for children, parents, and pregnant women is based on Modified Adjusted Gross Income (MAGI) and FPL percentages.
| Household Size | 100% FPL | 133% FPL (Children) | 200% FPL | 300% FPL (KidCare Expansion) |
| 1 person | $15,650 | $20,845 | $31,300 | $46,950 |
| 2 person | $21,150 | $28,207 | $42,300 | $63,450 |
| 3 person | $26,650 | $35,570 | $53,300 | $79,950 |
| 4 person | $32,150 | $42,933 | $64,300 | $96,450 |
Source: Florida KidCare Income Guidelines 2025
Interpretation:
- Children are covered up to 300% FPL through KidCare.
- Pregnant women generally qualify up to 200% FPL.
- Parents qualify at much lower thresholds tied to household size.
- Adults without children remain ineligible regardless of income.
Long-Term Care Medicaid (Nursing Home / HCBS Waivers)
Florida applies stricter income and asset limits for seniors and individuals needing institutional or home-based care.
- Income limit (single applicant): $2,901/month
- Asset limit (single applicant): $2,000
- Community spouse resource allowance: Up to $157,920
- Home equity exemption: $730,000
- Personal Needs Allowance: $160/month
- Lookback period: 60 months for asset transfers
Who Qualifies for Florida Medicaid?
- Adults without children: Not eligible under current policy.
- Parents: Only if household income is significantly below FPL.
- Children: Covered up to 300% FPL through KidCare expansion.
- Pregnant women: Typically up to 200% FPL.
- Seniors/Disabled (LTC): Must meet income and asset rules, plus medical necessity. A Qualified Income Trust (Miller Trust) may help if income exceeds the cap.
How to Apply for Medicaid in Florida (2025)
- Visit MyFloridaBenefits to start your application.
- Use the eligibility screening tool.
- Gather documents:
- Proof of income (pay stubs, tax returns)
- ID & Social Security numbers
- Proof of Florida residency (lease, bill, license)
- Medical documentation (for disability or LTC programs)
- Proof of income (pay stubs, tax returns)
- Submit online, by mail, or at a local DCF office.
- Respond to any renewal or verification requests.
Alternatives If You Don’t Qualify
- KidCare (CHIP): Children up to 300% FPL now qualify.
- ACA Marketplace: Subsidies on HealthCare.gov may reduce premiums to as little as $20/month.
- Community health centers: Provide sliding-scale services.
- HCBS Waivers: Offer home-based care services even if institutional care is not required.
FAQs
Q1: Does Florida cover childless adults under Medicaid?
No. Florida is not an expansion state.
Q2: What is the 2025 income limit for LTC Medicaid?
$2,901/month with a $2,000 asset cap.
Q3: Can my spouse keep assets if I apply for LTC Medicaid?
Yes, up to $157,920 in resources.
Q4: What’s new for 2025 in Florida Medicaid?
The KidCare program expanded to 300% FPL.
Q5: Does home ownership disqualify me?
No, but home equity above $730,000 may.
Q6: How long is the Medicaid lookback period in Florida?
60 months for LTC eligibility.
Conclusion
Florida Medicaid remains one of the strictest programs in the nation, excluding most adults without children. However, children and pregnant women have broader access thanks to the KidCare expansion up to 300% FPL. Seniors and disabled individuals can qualify for long-term care if they meet income, asset, and medical need tests, with tools like Miller Trusts to bridge gaps.
If you think you qualify, apply through MyFloridaBenefits and check current income limits. Even if you don’t, programs like KidCare, ACA subsidies, and HCBS waivers provide additional coverage pathways.
