What Does Florida Medicaid Pay for?

Medicaid is run by individual states, with funding from both the federal and state governments. Specific programs and eligibility requirements can vary significantly from state to state. Rather than having a single Medicaid policy for all recipients, Florida offers a variety of health plans from which Medicaid recipients may choose.

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Medicaid Eligibility

To qualify for Medicaid, you must have low or very low income. Most people who qualify for Florida's Medicaid program also fall into one of these categories:

  • Pregnant women
  • Parent or relative caretaker of children under 19
  • Children
  • Seniors
  • Disabled adults
  • SSI recipients

As of the time of this writing, Florida does not extend Medicaid benefits to low income adults who do not fit into one of these categories.

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Those determined to be "medically needy," -- meaning they have significant monthly medical bills -- also may be eligible to receive help paying their medical bills through Florida Medicaid, even if their income is greater than the normal income limits. Eligibility for this program is reevaluated monthly and the amount Medicaid will cover is based on the recipient's income.

Covered Services

The services covered by Medicaid in Florida vary somewhat depending on which health plan is chosen. The age of the recipient and the medical necessity also are major factors in determining whether Florida Medicaid will cover a given medical service.

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Tip

Florida provides counseling services to those applying for Medicaid to help them select the health care plan that best meets their needs. You can speak with a counselor by phone at 1-877-711-3662.

Generally speaking, services that the health care plans approved by Florida Medicaid cover include:

  • Doctor visits with physicians approved and listed in your health care plan
  • Hospital visits
  • Family planning, including birth control, pregnancy and birth care
  • Home health care
  • Home based services
  • Community based services
  • Nursing home services
  • Hospice
  • Transportation to and from medical care services
  • Dental services
  • Vision services
  • Community behavioral health
  • Child health check ups
  • Prescription drugs
  • Medicare deductibles, if enrolled in both programs
  • A portion of Medicare copay, if enrolled in both programs

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Applying for Medicaid in Florida

You can apply for Florida Medicaid online or by calling the Florida Department of Children and Families at (866) 742-2237. When you apply, be prepared to provide names, birth dates, Social Security numbers and place of birth for each person for whom you are applying. You also will need to provide a residency card or proof of U.S. citizenship. Additional information you will need includes:

  • All income, including child support and Social Security
  • Information about your rent or mortgage, utility costs and other household expenses
  • Information about all vehicles owned
  • Information about all bank accounts, cash on hand and savings bonds

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