Medicaid provides medical coverage to low-income individuals and families. The state and federal government share the cost of the Medicaid program. Medicaid services in Florida are administered by the Agency for Health Care Administration.
Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI recipients). DCF determines Medicaid eligibility for: (1) aged or disabled individuals not currently receiving Supplemental Security Income (SSI); (2) non-citizens with medical emergencies; (3) former foster care individuals; (4) pregnant woman; (5) children; and (6) parent(s) and caretaker relatives(s) of children.
Medicaid for low-income individuals who are either aged (65 or older) or disabled is called SSI-Related Medicaid. DCF determines eligibility for Medicaid programs that have full benefits, including Medicaid for aged and disabled individuals (MEDS-AD), Institutional Care Program (ICP), Hospice, and Home and Community Based Services (HCBS) Waiver Programs. DCF also determines eligibility for Medicaid programs that have limited benefits, including: Medically Needy (MN) and Medicare cost-sharing programs, such as Qualified Medicare Beneficiary (QMB), Special Low-Income Medicare Beneficiary (SLMB) and Qualifying Individuals 1 (Q1-1).
Florida residents who are eligible for Supplemental Security Income (SSI) are automatically eligible for Medicaid coverage from the Social Security Administration. There is no need to file a separate ACCESS Florida Application unless nursing home services are needed.
Individuals may apply for regular Medicaid coverage and other services using the online ACCESS Florida Application at http://www.myflorida.com/accessflorida/ and submitting it electronically. If long-term care services in a nursing home or community setting are needed, the individual must check the box for HCBS/Waivers or Nursing Home on the Benefit Information screen. HCBS/Waiver programs provide in-home or assisted living services that help prevent institutionalization.