Florida Medicaid Application

Florida’s population is estimated to be 20,271,272 and of these residents, 3.3 million have been covered under the Medicaid program. Individuals and households residents must make a significantly low income so as to be eligible for Medicaid coverage.

As of April 2016, there were 3,591,512 people enrolled in the Florida Medicaid program. Eligibility for coverage under the program is tied into the national poverty level. Since the state hasn’t expanded its Medicaid program, 567,000 people are left in the coverage gap. Florida is next to Texas with respect to the proportion of residents that are in the coverage gap.

Governor Rick Scott declared in 2012 that the nation wouldn’t pursue a state-based medical insurance marketplace. Florida has since defaulted into a federally-facilitated exchange situated at healthcare.gov.

Between 2014 and 2024, Florida is expected to lose out on $66.1 billion in federal funding because of its rejection of Medicaid growth. Despite the fact that the nation has yet to expand Medicaid, its enrollment has increased because of the outreach efforts of Affordable Care Act navigators.

What’s Covered Under Florida Medicaid

• Birthing services for pregnant women
• Inpatient and outpatient hospital services
• Mental health clinics, substance abuse assistance, and rehabilitation services
• Doctor services
• Chiropractor services
• Podiatry
• Psychology care providers
• Nurse practitioner and nurse midwife services
• Prescription medicines
• Dentures, glasses, and hearing aids
• Durable medical equipment
• Prosthetics and orthotics
• Ambulance and non-emergency transportation
• Nursing facility providers

Who’s Covered Under Florida Medicaid

The Florida Medicaid program offers coverage to the following groups of individuals:

• Aged, blind, or disabled individuals
• Children up to 1 year old in families earning up to 206 percent of the federal poverty level
• Children aged 1 to 5 in families earning no greater than 140 percent of the federal poverty level
• Kids between 6 and 18 whose household income is no greater than 133 percent of the poverty level
• Pregnant women whose family income does not exceed 191 percent of the poverty level
• 19 to 20 year old adults whose family income does not exceed 30 percent of the poverty level
• Adults with dependents whose family income does not exceed 30 percent of the poverty level

Those who receive Supplemental Security Income are automatically qualified to receive Medicaid benefits in the state of Florida. Florida Governor Rick Scott has ardently opposed healthcare reform, and it has sued to declare sections of the Affordable Care Act unconstitutional.

Families and individuals seeking Medicaid coverage in Florida may complete an online application using the ACCESS Florida site. Governor Scott declared in 2012 that the nation wouldn’t take part in the creation of a health benefits market. Floridians can access the facilitated website at healthcare.gov so as to complete an application. Medicaid applicants filed at the national level will also be considered for participation in other applications.

In addition to Medicaid, families and individuals may use the connected application to apply for cash and food aid.

Following the Application Procedure

Upon submittal of this application, the Department of Children and Families will review the program for errors or incomplete information. In case the applicant doesn’t provide all the essential information, a rep for the DCF will be connected.

Approved Medicaid applicants will be given a golden Medicaid card in the mail.

Approved applicants can use the ACCESS Florida site to print out a temporary Medicaid card to get covered services. Medicaid cards typically require two to three weeks to arrive after approval. Replacement cards can be requested by phoning 1-866-762-2237.

Florida residents may use the ACCESS Florida site so as to check on the status of submitted applications.

Hearings on Program Decisions

People who have been denied for Medicaid coverage may appeal the decision. Application denials, reductions, and terminations in policy can be appealed by phoning 1-850-488-1429. Appeal requests may also be faxed to 1-850-487-0662 or by sending a letter through the mail to another address:

Emailed appeal requests are approved at appeal_hearings@dcf.state.fl.us.

Electronic applications offer the quickest way for applicants to be given a determination on eligibility for Florida Medicaid.

Florida Medicaid recipients are expected to enroll in a managed care plan once approved for coverage. An option adviser is available to help in the choice of a managed care plan by calling 1-877-711-3662.

Individuals seeking to stop Medicaid enrollment may do this by calling 1-866-762-2237.