In this post, we will help you reach Florida Medicaid Customer Service and get help with your Medicaid application, enrollment, plan information, what services are covered, and more. However, before you call the Florida Medicaid Phone Number, scroll down below to see if the question you are calling about is already answered here.
As you can imagine, more people are calling Florida Medicaid, especially during the pandemic since most state offices are closed to the public or have limited hours.
As a result, the Florida Medicaid phone lines have been flooded with calls.
Due to that reason, hold times have been reported to be very long.
Rather than wait on hold in frustration, you can first seek answers below by reviewing our Florida Medicaid FAQs below.
With the FAQs below, we answer the top 10 questions why people call the Florida Medicaid Phone Number, with answers to all of them.
This post will cover:
- What is Medicaid in Florida?
- Florida Medicaid Phone Number
- Before you call the Florida Medicaid Phone Number
- Florida Medicaid FAQs
What is Medicaid in Florida?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
The Medicaid program is different in every state. The federal government sets the general guidelines and each state decides how to run the program.
Florida implemented the Medicaid program on January 1, 1970, to provide medical services to low-income people.
The Florida State Legislature determines who qualifies for Medicaid, what services will be covered, and how much to pay for the services.
The state agency that administers Florida Medicaid is the Agency for Health Care Administration (Agency).
Florida Medicaid Phone Number
Here’s how to contact the Florida Medicaid Agency:
Call the Florida Department of Children and Families
at 1-866-762-2237 for:
- Medicaid eligibility requirements and
applying for Medicaid benefits
- Medicaid eligibility requirements and
applying for Medicaid benefits
- Denial or termination of
- Share of Cost/Medically Needy Program
- Reporting lost Medicaid Gold Cards
- Medicare Buy-in Programs
To reach Florida KidCare, call 1-800-821-5437.
For Medicaid Applicant & Member Services, call 1-877-711-3662, TDD 1-866-467-4970.
Customer Service is available Monday through Thursday from 8 a.m. to 8 p.m.; Friday from 8 a.m. to 7 p.m.
If you are not enrolled in a health plan, call the Medicaid Helpline at 1-877-254-1055.
Also, if you need help finding contact information for your Medicaid plan, call our
Medicaid Helpline at 1-877-254-1055. You can get help with:
- Locating a doctor
- The services your plan covers
- Transportation to access covered services
- Other general questions you may have
Florida Medicaid Phone Number by Department
Here are the phone numbers by Department:
Florida Agency for Health Care Administration
Florida Department of Children and Families
Florida Department of Elder Affairs
(800) 955-8771 (TDD)
(877) 316-8748 (TTY)
(877) 486-2048 (TTY)
Social Security Administration
(800) 325-0778 (TTY)
Before you call the Florida Medicaid Phone Number
As we mentioned above, the Florida Medicaid phone lines are flooded with phone calls as a result of the fact that their offices have been closed during the pandemic.
Therefore, hold times are long when you call the phone number.
We have answered the top questions people call the Florida Medicaid Phone Number for.
Scroll down below to see if your question has been answered below.
Florida Medicaid FAQs
Here are the top reasons people call the Florida Medicaid Phone Number. We have answered each question in detail.
If you do not find your question answered here, you can ask us in the comments section below and we will be happy to help you.
Who is eligible for Medicaid in Florida?
See our post for Florida Medicaid Eligibility requirements and how to apply.
The following people may qualify for Florida Medicaid if they meet certain financial
- Low-income families with children
- Pregnant women
- Infants and children under the age of 21
- Recipients of Supplemental Security Income (SSI)
- Seniors who are aged 65 or older
- People who are blind or expected to be disabled for at least a year
- People who need nursing home care or home and community-based care
- Medicare Beneficiaries whose income is low
- Aliens and refugees under a special assistance program (Emergency Medicaid)
- Individuals who are medically needy
Who Determines Eligibility for Medicaid in Florida?
Eligibility for Medicaid in Florida is determined by the following agencies:
The Social Security Administration determines eligibility for Supplemental Security Income (SSI). Recipients of SSI are automatically eligible for Medicaid.
The Florida Department of Children and Families determines eligibility for low-income children and families, aged persons, persons with disabilities, and persons seeking institutional care.
Florida Healthy Kids Corporation determines eligibility for MediKids.
Can a single person get Medicaid in Florida?
Unfortunately, no. That is because Florida is one of 12 states that, as of August 2020, has not expanded Medicaid eligibility as allowed under the Affordable Care Act (ACA).
This means that adults without dependents who have low income cannot qualify for Medicaid, like residents in the 38 states that have expanded Medicaid.
In Florida, if Medicaid had been expanded under the ACA, some 391,000 people who do not currently have coverage would gain coverage.
Republicans control Florida’s House and Senate as well as the governor’s office.
Democrats in the Florida legislature have been pushing for Medicaid expansion for years, but have consistently been blocked by Republicans.
What is the Florida Medicaid Income Limit?
The FL Medicaid eligibility income limit charts are divided by groups.
For example, the first chart is focused on income limits for children who qualify for Medicaid.
Similarly, the second chart below focuses on the Medicaid income limits for adults in Florida who qualify for Medicaid.
Florida Medicaid Income Limit for Children
Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.
|Florida Medicaid Income Limit – Children|
|Children Medicaid Ages 0-1||For Children Medicaid Ages 1-5||Children Medicaid Ages 6-18||Children Separate CHIP|
Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.
Florida has not expanded Medicaid to include adults without dependents.
Therefore, adults without dependents do not qualify for Medicaid in Florida.
For an update on the Medicaid expansion debate and timeline in Florida, see our Florida Medicaid Expansion update below.
Florida Medicaid Income Limit for Adults
|Florida Medicaid Income Limit – Adults|
|Pregnant Women Medicaid||Adults (Medicaid) Parent/ Caretaker||Seniors & People w/ Disabilities (Medicaid)||Adults (Medicaid) Expansion to Adults|
How to Read the Florida Medicaid Income Limits Charts Above
You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.
Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.
For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 191% of the Federal Poverty Level – which for a family of two is $33,272 as shown in the chart above.
How do I sign up for Medicaid in Florida?
There are three steps to applying for Medicaid in Florida:
Click here to see our step by steps process in applying for Medicaid in Florida.
What documents will I need when I apply for Medicaid?
When you apply for Medicaid in Florida, you will be asked to provide various documents. This includes:
- Information about household members (name, date of birth and Social Security number)
- Rent or mortgage information
- Expenses (utilities, daycare, etc.)
- Vehicle information
- Bank statements
- Income (pay stubs)
- Proof of disability or medical records showing a lasting medical condition
- Recent medical bills
- Proof of citizenship
- Additional information as requested
How long does it take to get Medicaid in Florida?
If you meet the income requirements, you may be able to find out immediately if you qualify for benefits.
However, it usually takes 30-60 days for the application process to be completed.
Once you are approved, it takes approximately 2-3 weeks to get a Medicaid card.
If you need proof of your Medicaid eligibility right away, you can print a temporary card from your MyACCESS Account.
What services are covered by Florida Medicaid?
Medicaid in Florida covers a variety of services. Here are some of the services that are covered.
For a full list of services covered, click here.
- Allergy Services
- Ambulatory Surgical Center
- Anesthesia Services
- Assistive Care Services
- Behavioral Analysis
- Behavioral Health Overlay Services
- Birth Center and Midwife Services
- Cardiovascular Services
- Certified School Match Program
- Certified Substance Abuse County Match
- Chiropractic Services
- Community Behavioral Health Services
- County Health Department (CHD) Services
- Dental Services
- Dialysis Services
- Durable Medical Equipment (DME) and Medical Supplies
- Early Intervention Services
- Evaluation and Management Services
- Family Planning Waiver Services
- Federally Qualified Health Center Clinic Services
- Gastrointestinal Services
- Genitourinary Services
How do I contact my local Florida Medicaid office?
You can contact your local Florida Department of Children and Families office for help with your Medicaid application or benefits.
Click here to locate an ACCESS Service Center Locations. You can search by county.
In addition, local community partner agencies help the Department of Children and Families provide access to public assistance services.
To find a partner agency in your area, click here to search by county or zip code.
How do I find my Florida Medicaid number?
Your Florida Medicaid identification number is not listed on your gold card. Your Florida Medicaid number is kept in your Florida Medicaid file.
Any Medicaid provider can use your gold card or health plan’s membership card to check the Florida Medicaid file to find out if you are eligible for Florida Medicaid services.
What are co-payments and co-insurance?
Co-payments and co-insurance are amounts of money you pay directly to the provider for the service you receive.
Medicaid beneficiaries are required to pay a co-payment and co-insurance for certain services, unless they are exempted.
Contact your local Medicaid office for further information.
Where can I report possible Medicaid fraud or abuse in Florida?
If you suspect Medicaid fraud or abuse in the state of Florida, please call the toll-free number (800) 419-3456.
What’s the Eligibility Requirement for long-term Medicaid in Florida?
An applicant is not eligible for Florida Long Term Care Medicaid unless he or she meets certain asset and income limitations.
To be approved for Long Term Care Medicaid in Florida, you must be:
- At least 65 years of age or disabled;
- A United States citizen or a “qualified” alien;
- A Florida resident;
In addition, your:
- Gross monthly income must not exceed $2,382/month (2021); and
- Countable assets for a single person must not exceed $2,000.
Assets for a married couple allow the Community Spouse (the spouse not in long-term care) to have $130,380 (2021) in countable assets.
What is the eligibility for pregnancy Medicaid in Florida?
A pregnant woman may qualify for Medicaid if her family’s countable income does not exceed income limits.
For pregnant women who do not meet the citizenship requirements for Medicaid, there is Emergency Medical Assistance for Non-Citizens.
Furthermore, you can get Presumptively Eligible Pregnant Women (PEPW), which is temporary coverage for prenatal care only.
During the temporary coverage period, while you are on PEPW, you will have to submit an application to determine if you can continue to receive Medicaid benefits during your pregnancy.
Additionally, women with family income over the limit for Medicaid may qualify for the Medically Needy Program.
Florida Medicaid Phone Number Summary
We hope this post on Florida Medicaid Phone Number was helpful to you.
If you have any questions about Medicaid in the state of Florida, you can ask us in the comments section below.
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Be sure to check out our other articles about Medicaid.
Income limits for Florida Medicaid
How to Apply for Medicaid – by State
Alabama Medicaid Income Guidelines
Arizona Medicaid Income Chart and Limits
Arkansas Medicaid Income Limits