Florida Medicaid Income Limits 2026: Monthly Eligibility Chart

Florida Medicaid income limits 2025 monthly chart

Last Updated: January, 2026

Florida Medicaid income limits for 2026 depend on your age, health status, and family situation. The Florida Department of Children and Families (DCF) determines who qualifies, while the Agency for Health Care Administration (AHCA) delivers the services.

Income limits range from $355/month for parents to $2,982/month for seniors needing nursing home care.

Quick Summary:

  • Seniors and disabled adults have income limits between $1,149 and $2,982/month
  • Children and pregnant women qualify based on Federal Poverty Level percentages
  • Florida has NOT expanded Medicaid, so most childless adults don’t qualify
  • Asset limits also apply for seniors and disabled individuals
  • Special programs exist for those who exceed standard income limits
  • You can check your specific eligibility using the Florida Medicaid eligibility calculator 2026

Who Qualifies for Florida Medicaid?

Florida divides Medicaid into two main categories. Family-Related Medicaid covers children, pregnant women, and parents. SSI-Related Medicaid helps seniors and people with disabilities.

Understanding which group you fall into is the first step. Each group has different income and asset rules.

Seniors and Disabled Adults (Ages 65+ or Disabled)

If you’re 65 or older or have a qualifying disability, your income limits depend on the type of care you need.

Long-Term Care (Nursing Homes and Home Care Waivers)

Monthly Income Limit: $2,982 for one person (as of January 1, 2026)
Asset Limit: $2,000 for one person; $3,000 for a couple applying together

If you need nursing home care or home-based services, this is your income cap. Going even $1 over this limit may disqualify you unless you use a special trust.

Spousal Protection Rule:
If only one spouse needs care, the healthy spouse can keep up to $162,660 in assets. This protects families from losing everything to medical costs.

Regular Medicaid for Seniors (MEDS-AD)

Monthly Income Limit: $1,149 for a single person; $1,552 for a couple
Asset Limit: $5,000 for one person; $6,000 for a couple

This program is for seniors who don’t need nursing home care. The income limit is much lower than long-term care Medicaid.

These limits apply from April 1, 2025 through March 31, 2026.

Children and Pregnant Women

These groups use percentages of the Federal Poverty Level (FPL). Limits vary by age and family size.

Coverage GroupMonthly Income Limit (Family of 1)FPL Percentage
Infants (Under Age 1)$2,754211% FPL
Children (Ages 1–5)$1,893133% FPL
Children (Ages 6–18)$1,801133% FPL
Pregnant Women$2,588196% FPL
Parents/Caretakers$355~26% FPL

Important: These limits increase with family size. For example, a family of 3 with children ages 1-5 has a monthly limit of $3,222.

Florida offers 12-month continuous coverage for pregnant women after birth, even if income rises during that time.

Parents and Caretaker Relatives

Florida has one of the lowest parent income limits in the United States.

Monthly Income Limit: $355 for a family of one

This limit rarely changes. It has stayed flat for years despite inflation. Most working parents earn too much to qualify.

What If Your Income Is Too High?

Don’t give up if you’re slightly over the limit. Florida offers backup programs that may still help you.

Medically Needy (Spend-Down) Program

This works like an insurance deductible. If your medical bills are high enough, you can still get Medicaid coverage.

How It Works:

  1. The income standard is $180/month for individuals or $241/month for couples
  2. Subtract this standard from your actual income
  3. The difference is your “share of cost” (your deductible)
  4. Once you pay medical bills equal to this amount, Medicaid covers the rest for that month

Example:
You earn $1,500/month. The standard is $180. Your share of cost is $1,320. If you have $1,320 in medical bills, Medicaid pays everything after that.

Qualified Income Trust (Miller Trust)

Seniors whose income exceeds $2,982/month can still qualify for nursing home care. They must place excess income into a special trust account.

Example:
Your Social Security and pension total $3,200/month. You’re $218 over the limit. You put the extra $218 into a Qualified Income Trust each month. Now you qualify for long-term care Medicaid.

A lawyer or financial planner can help set up this trust.

Medicare Savings Programs

If you have Medicare, Florida may help pay your premiums and co-pays.

2026 Income Limits:

  • QMB (Qualified Medicare Beneficiary): $1,350/month (individual); $1,824/month (couple)
  • SLMB (Specified Low-Income Medicare Beneficiary): $1,616/month (individual); $2,184/month (couple)

These programs don’t count as full Medicaid but provide significant financial help.

Asset Limits Explained

Florida counts your savings, investments, and property when determining Florida Medicaid eligibility 2026. But some things don’t count.

What Doesn’t Count (Exempt Assets)

  • Your primary home (up to certain equity limits)
  • One vehicle of any value
  • Personal belongings and household items
  • Prepaid burial plans
  • Life insurance policies under $2,500

What Does Count

  • Bank accounts and cash
  • Stocks and bonds
  • Second homes or investment properties
  • Additional vehicles

If you’re close to the asset limit, financial planning can help. Some people legally transfer assets to qualify.

The Florida Coverage Gap

Florida has NOT expanded Medicaid under the Affordable Care Act. This creates a coverage gap for certain adults.

Who Falls in the Gap:

  • Adults ages 19-64 without disabilities
  • People without minor children
  • Anyone earning too much for Medicaid but too little for Marketplace subsidies

These individuals have no income limit because they’re categorically ineligible. They often earn too much for Medicaid ($355/month for parents) but too little to afford marketplace insurance.

Approximately 800,000 Floridians fall into this gap.

How to Apply for Florida Medicaid

Applying is free and can be done online, by phone, or in person.

Step 1: Gather Your Documents

You’ll need:

  • Proof of income (pay stubs, Social Security statements)
  • Bank statements
  • Social Security numbers for everyone applying
  • Proof of Florida residency
  • Medical records (if applying due to disability)

Step 2: Submit Your Application

Online: Visit the ACCESS Florida portal at accessflorida.com
Phone: Call 1-866-762-2237
In Person: Visit your local DCF office

The state has 45 days to process most applications. Pregnant women and children may get faster decisions.

Step 3: Complete Your Interview

DCF may schedule a phone interview. Be ready to explain your income, assets, and household situation.

Step 4: Enroll in Managed Care

If approved, most recipients must choose a managed care plan. Florida uses Statewide Medicaid Managed Care (SMMC) for most services.

You’ll select from several health plans in your area.

Keeping Your Coverage Active

Medicaid isn’t automatic forever. You must renew annually.

Annual Redetermination

Florida requires yearly renewals through the ACCESS Florida portal. You’ll receive a notice when it’s time to renew.

What Happens If You Don’t Renew:
Your coverage ends. You’ll have to reapply from scratch.

Report Income Changes

If your income increases or decreases by more than $100/month, report it within 10 days. This prevents overpayment issues or wrongful termination.

Keep Contact Information Updated

Many people lose coverage because renewal notices go to old addresses. Update your phone, email, and mailing address immediately when they change.

Frequently Asked Questions

What is the income limit for Florida Medicaid in 2026?

It depends on your coverage group. Seniors in nursing homes can earn up to $2,982/month. Children ages 1-5 qualify at $1,893/month for a family of one. Parents have a $355/month limit. Pregnant women can earn up to $2,588/month.

Can I qualify if my income is slightly over the limit?

Yes, through the Medically Needy spend-down program. You pay your excess income toward medical bills each month. Once you meet your share of cost, Medicaid covers remaining expenses. Seniors can also use Qualified Income Trusts to qualify.

Does Florida Medicaid count my house and car as assets?

No. Your primary home and one vehicle are exempt from asset limits. You can own both and still qualify. Investment properties, second cars, and bank accounts do count toward the $2,000 or $5,000 asset limit.

Are childless adults eligible for Florida Medicaid in 2026?

Generally no. Florida hasn’t expanded Medicaid, so most childless adults under 65 without disabilities don’t qualify regardless of income. About 800,000 Floridians fall into this coverage gap with no affordable insurance options.

How do I check if I qualify using the calculator?

Use the Florida Medicaid eligibility calculator 2026 to enter your income, household size, and age. The calculator compares your information against current limits and tells you if you likely qualify. You still need to submit a formal application.

What happens to pregnant women after they give birth?

Pregnant women remain eligible for 12 months postpartum, even if their income increases during that period. This ensures continuous healthcare for new mothers. After 12 months, they must requalify based on standard parent income limits.

Official Resources

For the most current information, visit these government websites:

These sites have application forms, contact information for local offices, and updates on policy changes.

Final Thoughts

Florida Medicaid income limits vary widely in 2026 depending on who you are. Seniors and disabled adults face strict income and asset tests. Children and pregnant women have more generous limits based on family size.

If you’re close to the limit, special programs may help. The Medically Needy program, Qualified Income Trusts, and Medicare Savings Programs provide alternatives for those who don’t fit standard categories.

The most important step is applying. Even if you’re unsure about qualifying, submit an application. DCF will review your specific situation and determine Florida Medicaid eligibility 2026 based on your unique circumstances.

Don’t wait. Healthcare coverage can start as soon as next month if you apply today.

Scroll to Top