How to Get Medicaid in Florida (Even if You Got Turned Down)

If you got turned down for Medicaid in Florida, or you had Medicaid and got cut off, or you thought you would be turned down so didn’t bother applying, don’t give up hope!

There are several different Medicaid programs in Florida. The financial criteria and medical criteria are different for each program. Please do not give up hope until you have looked into each program to see if one might be a match for you.

BE PERSISTENT

Most of our readers report that the people who work at Medicaid did not tell them about all of the different types of Medicaid. They just did a simple financial screening and then denied them.

If you want to apply for a different kind of Medicaid, you may wish to research the programs yourself using the links below. Many of our readers have done this successfully.

Sometimes readers discover that no one at their local Medicaid office has ever heard of the Medicaid program they are trying to apply for, so they have to print out the policy and bring it to the Medicaid office to show them. That is what happened to Pansy and she got her $40,000 hospital bill paid for.

Here are seven different Medicaid programs in Florida:

MEDICAID FOR PEOPLE ON MEDICARE

If you got cut off Medicaid when your Medicare started, don’t give up. You can still apply for other Medicaid programs. If you were approved for disability recently, and you have a waiting period before Medicare starts, you can apply for any of the programs on this page while you wait. Learn more about how to apply for Medicaid and other forms of assistance:  How to Escape Medicare Fees

MEDICAID LONG TERM CARE

If you need help with bathing, eating, dressing, or personal care (or if someone is now helping you with any of these things) you may be eligible for Medicaid Long Term Care in Florida.

This is a fantastic program that provides full medical health insurance (all hospitals, doctors, prescriptions, etc) plus it also provides home aides who can help with shopping, cooking, cleaning, laundry, and personal care. Many other services are also available through this program.

The income limit is $2,250 per month for you (Important: Ignore any figures for married people: If you are married, your spouse’s income will not count…. unless your spouse also needs longterm care)

• How to Apply for Medicaid Long Term Care – Important information on how to apply and how to qualify.
• Florida Long Term Care Program provides an overview of financial criteria.
• Florida State Managed Medicaid Long Term Care – Provides and overview of what services are available. Hint: Although this page is for seniors, the information also applies to people with disabilities at any age.
• How to Apply for Medicaid Long Term Care When You Have Too Much Money

MEDICAID THROUGH SSI DISABILITY

SSI automatically comes with Medicaid. SSDI does not come with Medicaid, however, if you are under the income limit for Florida Medicaid for Age or Disabled, you can get Medicaid with SSDI.

If you are applying for disability and you are looking for ways to improve your application, and increase your chances of getting approved, check out: The Sleepy Girl Guide to Social Security Disability.

FLORIDA MEDICAID WAIVERS FOR KIDS

If your child has disabilities, check out Medicaid Waivers for children in Florida. There are medicaid waivers for certain conditions. The income of the parents will not matter.  Many excellent extra services are available through waiver programs.

Hint: Many parents run into problems because the person processing their application does not know about waivers and does not exclude the parental income, so their application is denied. Make sure to speak directly to someone in charge of processing waiver applications.

FLORIDA MEDICAID WAIVERS FOR ADULTS

Florida has special Medicaid Waiver programs for people with HIV/AIDS, Autism, Traumatic Brain Injuries, Cystic Fibrosis, Developmental Disabilities, and other conditions. You can also look up the names of different waiver programs.

These waiver programs will provide full health insurance – hospitals, doctors, medications, etc. They will also provide a wide range of other helpful services. If there is a waiver program you are interested in, contact your state or local Medicaid office.

Hint: The person who answers the phone at Medicaid has probably never heard of any of these programs. Keep asking questions until you find the person there who knows about waivers.

MEDICAID FOR AGED OR DISABLED

This program will have limits for both income and assets. You have to be poor. If you are not a senior and yet on disability, they will have to determine if you are disabled. This generally takes a few months. If possible, it may be helpful to submit an RFC form from your doctor and any other documentation you can get. Please Remember: This is a different application than Social Security. You will need to ask who is handling your Medicaid decision and send this information directly to that person. Here’s where you can apply for Florida Medicaid for Age or Disabled.

QUALIFIED INCOME TRUSTS

You may be able to place some of your income in a trust, allowing you to qualify for Medicaid. This practice is commonly used by seniors and people with disabilities who need to qualify for Medicaid for home care services. More information is here: https://www.myflfamilies.com/service-programs/access/docs/qualified_income_trust_factsheet.pdf

Note: Medicaid home care programs are also called “waivers” or “long term care.” In addition to home care, they also provide insurance for doctors, hospitals, medications, etc.

SPECIAL RULES FOR MARRIED PEOPLE

If you are married and you are applying for medicaid for long term care (home care), you may be able to shift some of your income to your spouse. If you are applying for Medicaid and your spouse is not applying, this income will no longer count. In addition, some of your assets may be shifted. More information is here: https://www.payingforseniorcare.com/medicaid-waivers/fl-aged-and-disabled-adult-waiver.html

Note: Medicaid home care programs are also called “waivers” or “long term care.” In addition to home care, they also provide insurance for doctors, hospitals, medications, etc.

FLORIDA MEDICAID FOR KIDS & PARENTS

The CHIP program can provide medicated two children, parents, and women who are pregnant. Learn more about Florida Medicaid for Kids and Parents

MOVING

“I moved to a state that expanded Medicaid. I was in Idaho. I moved forty five minutes away to Oregon. I moved just over the boarder – my house is five miles from the border, and I got Medicaid. It was completely worth it.” – Heather

This is not an actual Medicaid program, it is just a way some people get Medicaid. Some people with serious health conditions move to a different state so they can get the help they need. In some states it’s super easy to get on Medicaid, in other states it’s really difficult.

Start by finding a state that has expanded medicaid and of course make sure you will meet the requirements before making any big moves. The income limits are different in different states.

Most states that expanded Medicaid have no asset limits. They don’t care how much money you have in the bank, but they do care about your income.

In many states, you can be considered a resident and apply for Medicaid the first day you arrive and set up residence somewhere, but there may still be a wait time while your application is processed.

Warning: If you are on Medicare, this may not work out for you. Some states will not let people on Medicare into the MAGI Medicaid programs. Research the regs to make sure you can qualify for Medicaid in the state you are considering.

Medicare vs Medicaid

Medicare and Medicaid are two separate programs. Some people have one, some people have the other and some people have both. Learn more here: What’s the Difference Between Medicare and Medicaid?

OTHER OPTIONS

If all else fails, you can give up on Medicaid and instead try some other ways to find medical care: How to Get to the Doctor When You Can’t Get to the Doctor

“SOMETHING WENT WRONG”

If you applied for one of the programs above and got turned down, don’t give up hope. There may be a solution. What went wrong?

“My spouse makes too much money”

“Someone else I live with makes too much money.”

“My parents have too much money”

“I have a too much income.”

“I was approved but the Spend Down is really expensive”

“I have too much savings or I might get an inheritance”

“Child support is making my child not eligible”

“I think I should qualify, but I got turned down”

“Medicaid said I’m not disabled or not medically eligible”

“Someone at Medicaid told me I don’t qualify”

Updated June 2019. Please comment below with stories, ideas, questions or suggestions. Please let us know if any links on this page stop working.