What Is Florida Medicaid?
Medicaid is a joint federal-state health insurance program that provides free or low-cost coverage
to people who meet income and eligibility requirements. In Florida, the Medicaid program is called
Florida Medicaid. It is administered by the state but jointly funded by state and federal governments.
Florida Has NOT Expanded Medicaid
Florida has not expanded Medicaid under the ACA. Medicaid eligibility for non-disabled,
non-pregnant adults without children remains very limited — generally below approximately
$9,326 per year. Most low-income adults in Florida who do not fit a traditional
Medicaid eligibility category must use the ACA marketplace for coverage.
Adults earning below 100% FPL in non-expansion states like Florida fall into the "coverage gap"
— they earn too little to qualify for marketplace subsidies (which start at 100% FPL) but
too much for their state’s Medicaid program. The ARP and IRA extended enhanced subsidies,
but the coverage gap remains a significant issue in non-expansion states.
Florida Medicaid Eligibility Categories
Beyond the general adult expansion (in states that expanded), Medicaid covers several other groups:
- Children: All states cover children in families at much higher income thresholds
than adult Medicaid, often up to 200-300% FPL or more through CHIP
- Pregnant women: Covered at higher income thresholds (typically 185-250% FPL)
in all states
- People with disabilities: SSI recipients and people with qualifying disabilities
are eligible in all states
- Elderly adults: Adults 65+ with limited income and resources qualify through
the Medicare Savings Programs
Marketplace as Alternative in Florida
If you don’t qualify for Florida Medicaid, the ACA marketplace is your primary option.
Florida marketplace carriers include: Florida Blue, Ambetter from Sunshine Health, Aetna, Cigna, Molina Healthcare, Oscar Health. ACA premium tax credits are available for
households earning between 100% and 400% FPL (~$15,650–$62,600 for a single adult in 2026).