If you're trying to figure out what health coverage you qualify for in Florida — Medicaid, CHIP, or an ACA marketplace plan — the answer depends heavily on your income, your family situation, and your age. Florida handles these programs differently than many other states, and the rules have real consequences for families trying to get covered. Here's a plain-language breakdown.
Florida Medicaid: Who Actually Qualifies
Medicaid in Florida covers health care costs for people who meet both an income and a categorical requirement. Unlike states that expanded Medicaid under the ACA, Florida has not expanded Medicaid. That means qualifying for Medicaid in Florida as an adult requires more than just having a low income.
Adults in Florida generally need to fall into one of these categories to qualify:
- Pregnant women — covered up to 196% of the Federal Poverty Level (FPL)
- Parents and caretaker relatives of dependent children — income limit is approximately 26–33% FPL, which is very low
- People with a qualifying disability — typically receiving or eligible for SSI/SSDI
- Adults age 65+ — covered through Medicare-Medicaid dual eligibility for very low-income seniors
If you are a low-income adult without children, without a disability, and not pregnant, you almost certainly do not qualify for Florida Medicaid regardless of how little you earn. This is the source of the state's coverage gap, explained below.
In the 38 expansion states, adults earning up to 138% FPL automatically qualify for Medicaid. Florida is not among them. Adults here need a categorical qualifier — disability, pregnancy, or dependent children — in addition to meeting income limits.
FL KidCare: Florida's CHIP Program for Children
FL KidCare is Florida's version of CHIP — the Children's Health Insurance Program. It covers uninsured children under age 19 whose family income is above the Medicaid threshold but at or below 200% FPL. How schooled a child is, where they live, or whether their parents are documented makes no difference — if your child is under 19, a Florida resident, a U.S. citizen or qualified immigrant, and your household income is within the limit, your child likely qualifies.
What FL KidCare Costs
For families below 100% FPL, FL KidCare is free. Between 100% and 200% FPL, premiums are low — typically $15–$20 per child per month, capped at $35 per family. Dental and vision are included. There are no deductibles for most FL KidCare plans.
Children-Only vs. Family Plans
FL KidCare is a children's program. It does not cover parents or adults in the household. If your children qualify for FL KidCare, you still need separate coverage for yourself — either through Medicaid (if you qualify) or through the ACA marketplace.
This combination — children on FL KidCare, parents on a subsidized marketplace plan — is actually one of the most cost-effective arrangements for working families in Florida.
The ACA Marketplace: Bridge for Families Above Medicaid Income
If your household income is between 100% and 400%+ FPL and you don't have access to affordable employer-sponsored coverage, the ACA marketplace is your primary option. Enhanced subsidies through the Inflation Reduction Act have been extended, meaning many Florida families pay $0–$50/month for Silver plans after the premium tax credit is applied.
To apply, visit HealthCare.gov during open enrollment (typically November 1 – January 15 in Florida) or during a Special Enrollment Period triggered by a life event like losing other coverage, having a baby, or moving.
| Program | Who It Covers | Income Range | How to Apply |
|---|---|---|---|
| Florida Medicaid | Pregnant women, disabled adults, low-income parents | Varies; very low for parents (~26–33% FPL) | DCF / Access Florida |
| FL KidCare (CHIP) | Children under 19 | Up to 200% FPL | DCF / floridakidcare.org |
| ACA Marketplace | Adults and families not covered above | 100%–400%+ FPL (subsidies) | HealthCare.gov |
The Florida Coverage Gap
The coverage gap is the most important thing to understand if you're a low-income adult in Florida without children. Here's the problem: ACA marketplace subsidies start at 100% FPL. Florida Medicaid for non-disabled adults without children essentially doesn't exist. So if you earn between $0 and roughly $15,060/year (100% FPL for a single person in 2026), you may not qualify for Medicaid AND you may not qualify for marketplace subsidies.
This gap affects an estimated 800,000+ Floridians. If you're in this situation, options include federally qualified health centers (FQHCs) that provide sliding-scale care, free clinics, and community health programs. It's not a good situation — but it's the current reality in Florida.
A licensed Florida advisor can walk through your household income and size to identify every program you might be eligible for. Get a free consultation or use Florida Plan Finder to explore your options.
How to Apply for Each Program
Medicaid and FL KidCare
Apply through the Florida Department of Children and Families (DCF). You can apply online at myflorida.com/accessflorida, by phone at 1-866-762-2237, or in person at your local DCF office. For FL KidCare specifically, you can also apply at floridakidcare.org. Applications are reviewed quickly — often within a few days — and coverage can begin the month you apply.
ACA Marketplace Plans
Apply at HealthCare.gov during open enrollment (November 1 – January 15) or during a Special Enrollment Period. When you apply, the system automatically checks your Medicaid/CHIP eligibility. If you're found eligible for Medicaid or FL KidCare, you'll be redirected to DCF to complete that enrollment instead.
When you apply at HealthCare.gov, the system checks Medicaid eligibility for your whole household at the same time. Your children may be enrolled in FL KidCare while you're enrolled in a marketplace plan — all from one application.
What About Keeping Children on a Parent Plan?
Under the ACA, children can stay on a parent's health plan until age 26 — this applies even if the child is not in school, is married, or lives in a different state. If you have employer-sponsored coverage or a marketplace plan, you may choose to keep your children on your plan rather than enrolling them in FL KidCare. The right choice depends on your premium costs and the child's healthcare needs. Run the numbers: if FL KidCare is free or very low cost for your children, it may be worth separating them out to lower your own marketplace or employer plan premium.