Skip to main content

Florida Medicaid income limits 2025

Last verified: June 2026

~27% FPL
Parents (very restrictive)
133–200%
Children (by age)
196% FPL
Pregnant individuals
GAP
~200K adults uninsured

Florida Medicaid income limits by coverage group (2025)

Income limits are expressed as percentages of the Federal Poverty Level (FPL), which HHS updates each January. The dollar amounts below are approximate, based on 2025 HHS federal poverty guidelines. Verify current figures with DCF, as income limits update when HHS publishes new guidelines.

Coverage group Income limit Notes
Children under age 1 200% FPL ~$31,300/yr (single parent)
Children ages 1–5 133% FPL ~$20,815/yr (family of 1)
Children ages 6–18 100% FPL Above 100% → Florida Healthy Kids
Pregnant women 196% FPL Full-scope coverage; Medically Needy above limit
Parents / caretaker relatives ~27% FPL Approx. $6,000/yr for family of 3; extremely restrictive
Adults without children (non-expansion) Not eligible No pathway unless disabled, elderly, or pregnant
SSI recipients (elderly / disabled) SSI limit Automatic Medicaid eligibility
Former foster care youth (under 26) No income limit Must have been in foster care under FL responsibility

Sources: DCF ESS Program Manual; myflfamilies.com/medicaid; Florida KidCare income guidelines (floridakidcare.org, 2025). Dollar approximations use 2025 HHS federal poverty guidelines. Verify current limits with DCF before applying.

Florida Medicaid income limits for children (2025 FPL table)

Children ages 1–18 qualify for Medicaid up to 100% FPL; children under 1 qualify up to 200% FPL. The Florida KidCare program extends coverage up to 210% FPL for children 5–18 through a separate CHIP component. The table below shows approximate annual household income limits by family size. Source: Florida KidCare income guidelines, 2025.

Family size Medicaid (up to 133% FPL) Florida Healthy Kids ($15/mo premium) Florida Healthy Kids ($20/mo premium)
1 Up to $20,815 $20,816–$24,727 $24,728–$31,300
2 Up to $28,130 $28,131–$33,417 $33,418–$42,300
3 Up to $35,445 $35,446–$42,107 $42,108–$53,300
4 Up to $42,760 $42,761–$50,797 $50,798–$64,300
5 Up to $50,075 $50,076–$59,487 $59,488–$75,300
6 Up to $57,390 $57,391–$68,177 $68,178–$86,300

Source: Florida KidCare 2025 General Annual Income Guidelines (floridakidcare.org). Above the "full pay" threshold ($200.01% FPL+), families may purchase Florida KidCare at full premium. These figures apply to children ages 1–18; different thresholds apply to children under age 1.

Asset limits: MAGI programs have none, but elderly and disabled programs do

Standard Medicaid for families, children, and pregnant women uses MAGI (Modified Adjusted Gross Income) rules. No asset test applies. A car, savings account, or home does not affect eligibility for those groups.

SSI-related Medicaid programs — covering seniors 65 and older, and non-elderly adults with disabilities — have asset limits. Per DCF's SSI-Related Programs Financial Eligibility Standards, the countable resource limit is $2,000 for an individual and $3,000 for a couple (aligned with SSI resource limits). Certain assets are excluded: a primary home, one vehicle, burial funds up to $2,500, and household goods.

For nursing facility Medicaid, the income rules are also different. Florida uses a Qualified Income Trust (also called a "Miller Trust") for applicants whose income exceeds the income cap. Ask DCF or a Medicaid planning attorney about this structure if the applicant's monthly income is above approximately $2,829 (the 2025 income cap for nursing facility Medicaid).

The Medically Needy program covers people just over the income limit

Floridians who do not qualify for standard Medicaid due to income may qualify under the Medically Needy program. This program allows Medicaid coverage after meeting a monthly "share of cost" — essentially a deductible based on your income above the Medicaid limit. Once you pay medical bills equaling your share of cost for the month, Medicaid pays the remainder. Download the Medically Needy Program brochure (PDF) from DCF for details.

The Florida coverage gap at a glance

Income range (% FPL) FL Medicaid eligibility ACA marketplace subsidies Result for adults w/o children
0%–27% FPL Yes (parents only) No (below 100% FPL) Parents may qualify; childless adults — no options
27%–100% FPL (gap) No No Coverage gap — ~200K+ uninsured Floridians
100%–400% FPL No Yes (APTC subsidies) Marketplace plans with premium tax credits

Adults with children may qualify for Medicaid up to ~27% FPL regardless of position in this table. Pregnant women qualify up to 196% FPL. This gap would be closed if Florida adopted the ACA Medicaid expansion.

What counts as income for Florida Medicaid (MAGI rules)

Counted income

  • • Wages, salaries, and tips
  • • Self-employment net income
  • • Unemployment compensation
  • • Social Security benefits (most types)
  • • Alimony received (for pre-2019 agreements)
  • • Rental income (net of expenses)
  • • Taxable interest and dividends

Not counted

  • • Child support received
  • • SNAP, TANF, and most public benefits
  • • Veterans' benefits (most types)
  • • Gifts and inheritances
  • • Workers' compensation
  • • Student loans and grants (for living expenses)
  • • SSI payments

MAGI rules apply to families, children, and pregnant women. Elderly and disabled individuals may be evaluated under older SSI-related rules that include asset tests ($2,000 individual / $3,000 couple) and different income disregards.

Florida's Medically Needy program provides a spend-down path for some

Florida's Medically Needy program allows people who are over the income limit to qualify by spending down their income on medical expenses until they reach the medically needy income level. This is primarily available to elderly, blind, and disabled individuals and certain families. Contact DCF at (850) 300-4323 to ask if you might qualify.

Related guides