Medicaid Income and Asset Limits in Florida in 2024 | Mira Health
Medicaid Income and Asset Limits in Florida in 2024
In Florida, the income limits for Medicaid vary based on the type of Medicaid program. Generally, eligibility criteria mainly depend on age, disability status, income level, and certain health needs.
Khang T. Vuong, MHA
Khang T. Vuong received his Master of Healthcare Administration from the Milken Institute School of Public Health at the George Washington University. He was named Forbes Healthcare 2021 30 under 30. Vuong spoke at Stanford Medicine X, HIMSS conference, and served as a Fellow at the Bon Secours Health System.
The Different Types of Medicaid Programs in Florida
Medicaid for Adults in Florida also offers two notable programs:
- Low-Income Adults can apply for Medicaid coverage if their family income does not exceed 100% of the FPL.
- Alternatively, Medically Needy Medicaid is available for those with variable incomes. It's crucial to underline that the income limit for these programs is also dependent on family size.
Children's Medicaid Programs in Florida offer three different avenues for coverage:
- The first is Medicaid for Low-Income Families with Children, which provides coverage for families with an income up to 100% of the Federal Poverty Level (FPL).
- Secondly, Florida KidCare is available for families with an income up to 200% of the FPL.
- Lastly, Medically Needy Medicaid is another option, although the income limit for this program can vary.
Medicaid coverage in Florida extends to the Elderly, Blind, and Disabled (EBD), with its own specific set of criteria. For this group, the income limit is set at 88% of the FPL. Additionally, there are also asset limits to consider. One notable benefit for this group is that the program includes coverage for long-term care, a crucial aspect for many in this category.
Eligibility
Non-financial criteria: Individuals need to be residents of Florida, U.S. nationals, citizens, permanent residents, or legal aliens to be eligible for Medicaid.
The financial criteria: primarily determined based on an individual's or a household's income.
Special circumstances: pregnancy, disability, and age. For instance, pregnant women, individuals with disabilities, and older adults may qualify for Medicaid with higher income levels compared to other groups.
Florida's Medicaid Income Limits For Adults
The Federal Poverty Level (FPL) serves as the benchmark for various assistance programs, including Medicaid. Defined by the HHS, the FPL is a set income amount, adjusted yearly, that takes into account the number of household members and the cost of living in a particular area.
Annual Household Income Limits (Before Taxes)
| Household Family Size | Gross Income Limit |
|---|---|
| 1 | $19,392 |
| 2 | $26,228 |
| 3 | $33,064 |
| 4 | $39,900 |
| 5 | $46,737 |
| 6 | $53,573 |
| 7 | $60,409 |
| 8 | $67,245 |
The Medicaid income limits, therefore, are calculated as a percentage of the FPL and vary depending on the specific Medicaid program. For instance, in Florida, children under the age of 18 are eligible for Medicaid if their family's income is at or below 206% of the FPL. Pregnant women can qualify if their income is at or below 196% of the FPL, while parents and caretaker relatives are eligible at or below 34% of the FPL. These percentages are all determined by the state within Federal guidelines, reflecting the targeted reach of different Medicaid programs.
Florida's Medicaid Income Limit for MediKids
| Family Size | Medicaid for Children | MediKids - No monthly premium (Up to 133% of FPL) | MediKids - $15 monthly premium (133.01 – 158% of FPL) | MediKids - $20 monthly premium (158.01% - 200% of FPL) | MediKids - Full pay plan (200.01% of FPL & over) |
|---|---|---|---|---|---|
| 1 | Up to $19,392.00 | Up to $19,392.00 | $19,392.01 - $23,040.00 | $23,040.01 – $29,160.00 | $29,160.01 & over |
| 2 | Up to $26,232.00 | Up to $26,232.00 | $26,232.01 – $31,164.00 | $31,164.01 - $39,444.00 | $39,444.01 & over |
| 3 | Up to $33,072.00 | Up to $33,072.00 | $33,072.01 - $39,288.00 | $39,288.01 – $49,728.00 | $49,728.01 & over |
| 4 | Up to $39,900.00 | Up to $39,900.00 | $39,900.01 - $47,400.00 | $47,400.01 - $60,000.00 | $60,000.01 & over |
| 5 | Up to $46,740.00 | Up to $46,740.00 | $46,740.01 - $55,524.00 | $55,524.01 - $70,284.00 | $70,284.01 & over |
| 6 | Up to $53,580.00 | Up to $53,580.00 | $53,580.01 - $63,648.00 | $63,648.01 - $80,568.00 | $80,568.01 & over |
| 7 | Up to $60,420.00 | Up to $60,420.00 | $60,420.01 - $71,772.00 | $71,772.01 - $90,840.00 | $90,840.01 & over |
| 8 | Up to $67,248.00 | Up to $67,248.00 | $67,248.01 - $79,896.00 | $79,896.01 - $101,124.00 | $101,124.01 & over |
| 9 | Up to $74,088.00 | Up to $74,088.00 | $74,088.01 - $88,008.00 | $88,008.01 - $111,408.00 | $111,408.01 & over |
| 10 | Up to $80,928.00 | Up to $80,928.00 | $80,928.01 - $96,132.00 | $96,132.01 - $121,680.00 | $121,680.01 & over |
Income Limit by % of Federal Poverty Line
Because the Federal Poverty Line tends to move every year due to changes in income, the best way to determine the income threshold is by referencing the percentage of FPL. Simply look up the FPL amount in your area and multiply that to the %.
1. Managed Medical Assistance (MMA) - Classic Medicaid
| Family Size | Income Limit (% of FPL) |
|---|---|
| 1 | 138 |
| 2 | 185 |
| 3 | 232 |
| 4 | 279 |
| 5 | 326 |
| 6 | 373 |
| 7 | 420 |
| 8 | 466 |
| 9 | 513 |
2. Long-Term Care (LTC)
| Family Size | Income Limit (% of FPL) |
|---|---|
| 1 | 326 |
| 2 | 435 |
| 3 | 544 |
| 4 | 653 |
| 5 | 762 |
| 6 | 871 |
| 7 | 980 |
| 8 | 1089 |
| 9 | 1198 |
3. Medicaid for Pregnant Women
| Family Size | Income Limit (% of FPL) |
|---|---|
| 1 | 185 |
| 2 | 232 |
| 3 | 279 |
| 4 | 326 |
| 5 | 373 |
| 6 | 420 |
| 7 | 466 |
| 8 | 513 |
| 9 | 560 |
4. Medicaid for Children
5. Healthy Start
6. Children's Medical Services Network (CMSN)
7. Medicaid for Individuals with Disabilities
| Family Size | Income Limit (% of FPL) |
|---|---|
| 1 | 326 |
| 2 | 435 |
| 3 | 544 |
Frequently Asked Questions
Who Qualifies for Medicaid in Florida?
In Florida, eligibility for Medicaid is determined by several factors, including income, family size, disability, elderly, and pregnancy status. According to the Florida Department of Children and Families, individuals who fall into these categories may qualify: children under 19 years old, pregnant women, adults responsible for children under 19 years old, individuals with disabilities, and seniors over 65 years old who meet the income and asset limits (source).
What Are the Income Limits for Florida Medicaid Programs?
The income limits for Florida Medicaid programs depend on the category of eligibility. For instance, for families with children under 19 years old, the income limit is set at 138% of the Federal Poverty Level (FPL). This means a family of three can earn up to $29,974 per year to qualify. For pregnant women, the income limit is 196% of FPL, and for the elderly and disabled, it is 88% of FPL (source).
How Does Family Size Affect Medicaid Eligibility?
Family size plays a significant role in determining Medicaid eligibility. The larger the family size, the higher the income limit to qualify for Medicaid. This is because the Federal Poverty Level (FPL) is adjusted based on family size. For instance, for a family of four, the FPL is higher than for a family of two. Therefore, a family of four could have a higher income and still qualify for Medicaid compared to a smaller family (source).
What Is the Federal Poverty Level (FPL)?
The Federal Poverty Level (FPL) is a measure of income issued every year by the Department of Health and Human Services (HHS). It is used to determine eligibility for certain programs and benefits, including Medicaid. The FPL varies based on family size, and it is adjusted annually to account for inflation (source).
How Are Medicaid Income Limits Calculated?
Medicaid income limits are calculated as a percentage of the Federal Poverty Level (FPL). For instance, if the Medicaid program has an income limit of 138% of FPL, it means that an individual's or family's income must not exceed 138% of the FPL to qualify. The FPL varies based on family size, so the actual income limit in dollars will depend on the size of the family (source).
Do Asset Limits Apply to Florida's Medicaid Programs?
Yes, asset limits apply to certain Medicaid programs in Florida, particularly those aimed at the elderly and individuals with disabilities. As of 2023, the asset limit for an individual is set at $2,000, and for a couple, it is $3,000. Not all assets are counted towards this limit, including a home, one car, household goods, and personal effects (source).
What Special Circumstances Can Affect Medicaid Eligibility?
Special circumstances such as pregnancy, disability, and old age can affect Medicaid eligibility. Pregnant women, for instance, are eligible for Medicaid if their income does not exceed 196% of the FPL. Similarly, individuals with disabilities and the elderly are eligible if their income does not exceed 88% of the FPL, and they meet the asset limits. Also, individuals who are part of the Medically Needy Program can be eligible for Medicaid even if their income is above the normal limits, provided they have high medical expenses (source).