Medicaid Eligibility in Florida 2026: Income Limits and How to Qualify

Florida Medicaid provides health coverage for eligible low-income residents, but not everyone qualifies.

In 2026, Florida continues to run one of the most restrictive Medicaid programs in the country because the state has not expanded Medicaid.

This guide helps you quickly understand:

• Medicaid in Florida in 2026 is limited to children, pregnant women, very low-income parents, seniors age 65+, and people with disabilities
• Most adults without dependent children do not qualify, even if their income is extremely low or zero
• Income and asset limits depend on your category (child, parent, senior, disabled) and whether long-term care is needed
• Parents face some of the lowest income limits in the U.S., often under $700 per month for a family of three
• Seniors and disabled adults can qualify through long-term care Medicaid, even with higher income, if asset rules are met
• Nursing home and home-based waiver Medicaid use special financial rules, including income caps, asset limits, and spousal protections
• If income is too high, options like Qualified Income Trusts (Miller Trusts) or Medically Needy programs may allow eligibility

Applying with incorrect information can lead to denials or long delays. This page breaks down the rules clearly so you can check eligibility first and apply with confidence.

2026 Long-Term Care Income and Asset Limits (Florida)

Florida applies entirely different rules for people seeking Medicaid coverage for nursing homes or home- and community-based services (HCBS).

To qualify for Long-Term Care Medicaid in 2026, applicants must meet both income and asset limits. These limits are subject to annual adjustments and vary depending on marital status.

Core Financial Limits for Long-Term Care (2026)

Monthly Income Limit (Applicant):
$2,982 per month

Countable Asset Limit (Single Applicant):
$2,000 total

Spousal Asset Protection (Community Spouse):
Up to $162,660 may be retained by the non-applicant spouse

These limits apply to:

• Nursing home Medicaid
• HCBS waiver programs
• Institutional long-term care coverage

What Counts as Income?

Income includes:

• Social Security
• Pensions
• VA benefits
• IRA distributions
• Rental income

⚠️ Florida is an income-cap state
If your gross income exceeds $2,982/month by even $1, you are technically ineligible unless corrective planning is used.

Qualified Income Trust (Miller Trust)

Applicants over the income cap can still qualify by using a Qualified Income Trust (QIT):

• Excess income is deposited into the trust each month
• Only income above the cap goes into the trust
• This does not protect assets—only income

This is a common and legal strategy in Florida long-term care cases.

Asset Rules Explained

Countable assets include:

• Cash
• Bank accounts
• Investments
• Non-exempt property

Exempt assets may include:

• Primary residence (within equity limits)
• One vehicle
• Personal belongings
• Household items

Improper asset transfers can trigger penalty periods, so planning must be done carefully.

Protections for Married Couples

When only one spouse needs care, Florida protects the spouse remaining at home:

• Community Spouse Resource Allowance (CSRA):
  Up to $162,660 in assets protected
• Monthly Maintenance Needs Allowance (MMMNA):
  Allows income shifting so the at-home spouse can meet living expenses

These rules prevent spousal impoverishment and are critical for married applicants.

Why Long-Term Care Medicaid Is Different

Long-term care Medicaid:

• Has higher income limits
• Uses asset tests
• Allows legal planning tools
• Is not affected by Florida’s non-expansion status

This makes it one of the most valuable — and complex — Medicaid programs in Florida.

What Is Medicaid and How Does It Work in Florida

Florida Medicaid is the state’s health program for low-income people. It works with federal rules but has state details. The Agency for Health Care Administration runs it.

It covers basic care like doctor visits and hospital stays. Prescriptions and check-ups are included. Kids get dental and vision. Adults get emergency care.

Florida follows federal guidelines. State rules add limits on who qualifies. In 2026, this means tight eligibility for adults. The program helps keep people healthy without high costs.

Who Qualifies for Medicaid in Florida in 2026?

Florida Medicaid in 2026 is categorical, meaning you must fit into a specific group and meet income rules.

Unlike expansion states, Florida does not offer Medicaid to all low-income adults.

Eligible Groups in Florida (2026)

You may qualify for Medicaid in Florida if you belong to one of these groups:

• Children from low-income households
• Pregnant women, including extended postpartum coverage
• Parents or caretakers of minor children (very low income only)
• Seniors age 65 or older
• People with disabilities, including SSI recipients
• Individuals needing long-term care, such as nursing homes or HCBS waivers

🚫 Not Eligible:
If you are an able-bodied adult without dependent children, Florida Medicaid generally offers no coverage, even if your income is $0.

Medicaid Expansion Status (Important for 2026)

Florida has not expanded Medicaid under the Affordable Care Act. As of 2026:

• Expansion remains off the table
• Ballot efforts have been delayed until at least 2028
• Eligibility rules remain among the strictest in the U.S.

Income Rules Depend on Category

Medicaid income limits vary by group, not by a single statewide number:

• Children and pregnant women qualify at much higher income levels
• Parents qualify only at extremely low income
• Seniors and disabled adults follow separate long-term care rules (covered below)

Key takeaway:
Qualifying for Medicaid in Florida in 2026 depends more on who you are than how little you earn.

Florida Medicaid Income Limits for 2026

Income limits vary by program. For children and pregnant women, they are higher. Household size affects the limit.

Florida is expected to release additional updated Medicaid income limits in January 2026, so applicants should check for the most current figures before applying.

Limits base on federal poverty guidelines. They update yearly. For parents, limits are low.

Seniors and disabled have their own rules. Income counts after deductions. Use the state portal to screen. It gives a quick idea. But apply to confirm.

Does Florida Count Assets for Medicaid Eligibility?

Assets count for some groups. For children and pregnant women, no asset limits apply.

For seniors and disability Medicaid, assets matter. Limits are low for savings and property.

What counts as assets. Bank accounts, stocks, and extra cars. Homes and one car often don’t.

No asset limits for most other groups. This makes it easier for families. Check rules for your case.

Medicaid Eligibility for Seniors and Long-Term Care in Florida (2026)

Long-term care Medicaid helps with nursing homes or home services. It’s for those needing daily aid.

Financial rules include low income and assets. Medical needs must show care required.

Florida is also updating long-term care Medicaid rules for 2026, so applicants should watch for changes to income and asset limits.

Spend-down rules let you use medical bills to lower income. This helps qualify.

Apply through county offices. Proof of needs is key. This covers help like bathing or meals.

Can You Get Medicaid in Florida If You Are Working?

Many working people qualify for their kids. Florida Medicaid is income-based. Jobs don’t disqualify dependents.

For adults, limits are low without expansion. Part-time workers may fit if income stays under.

Hourly or gig work counts after averages. Apply to see if your family fits.

How to Apply for Medicaid in Florida (Step-by-Step)

Check eligibility first. Use ACCESS Florida online tool.

Gather documents. Include ID, income proof, and residency.

Apply online at myflorida.com/accessflorida  This is fast. Create an account and fill forms.

Apply in person at county offices. Find yours on myflfamilies.com. Bring papers.

Mail or fax forms too. Download from the site. Include copies.

Track status online. Respond to requests quick.

What Happens After You Apply?

The department reviews your form. They check eligibility. You may get a notice asking for more info.

Respond fast to requests. This keeps the process moving.

A decision comes by mail. If approved, coverage starts based on rules. Track online if needed.

How Long Does Medicaid Approval Take in Florida?

Most cases take up to 45 days. Disability or long-term care can take 90 days.

Delays happen with missing papers. Busy offices slow things.

You get contacted if more info is needed. Check status online or call.

Common Reasons Medicaid Applications Are Denied in Florida

Income too high causes denials. Check limits first.

Household size errors happen. Count everyone right.

Missing documents lead to rejections. Always send ID and income proof.

Asset issues for long-term care deny claims. Check rules.

Medicaid vs CHIP in Florida (2026)

Medicaid fits very low-income groups. It has no premiums. CHIP covers kids over Medicaid limits.

CHIP helps families with higher income. It has low costs.

If kids don’t fit Medicaid, check CHIP at floridakidcare.org. Both offer similar care for children.

Key Takeaways

Florida Medicaid in 2026 remains one of the most restrictive programs in the country. Eligibility is largely limited to children, pregnant women, seniors, and people with disabilities, while most low-income adults are excluded unless expansion occurs in the future.