Florida Medicaid is administered through Statewide Medicaid Managed Care (SMMC), and you apply at myaccess.myflfamilies.com, the MyACCESS Florida portal run by the Department of Children and Families (DCF). After DCF approves eligibility, you choose a managed care plan through Florida Choice Counseling at flmedicaidmanagedcare.com or by calling 855-355-5777. The Florida Agency for Health Care Administration (AHCA) sets Medicaid policy; DCF handles applications; SMMC handles plan enrollment.
This guide walks the 2026 flow: MyACCESS steps, income limits by category, what Florida does differently, the eight SMMC plans, and what changes under the One Big Beautiful Bill Act.
General information, not legal or financial advice. Confirm with DCF before applying.
How to Apply for Florida Medicaid in 2026
Eligibility runs through DCF; managed care enrollment runs through Maximus (branded Florida Choice Counseling). The two hand off automatically after approval. One process, seven steps.
1. Create your MyACCESS Florida account at myaccess.myflfamilies.com
Go to myaccess.myflfamilies.com and click "Create My Access Account." You need an email, phone, username, and password. The account stores your application, lets you upload documents, and is where you check status and renew. If you had a prior account, use "Forgot Password" rather than creating a new one.
2. Verify your identity
The portal asks identity-verification questions from public records. If you cannot answer them, you can still complete the application, but you will need to bring photo ID to a DCF service center or upload it through the portal before approval.
3. Enter your household and income
List every person in the household with date of birth, SSN (if any), and relationship. Enter every income source: wages, self-employment, Social Security, SSI, pensions, child support, unemployment, VA, rental. Use gross amounts. Mis-stating household size or income is the top reason Florida Medicaid applications get denied.
4. Upload required documents
The portal accepts PDFs and phone photos. Upload proof of identity, the last 30 days of pay stubs (or employer letter), proof of Florida residency, citizenship or immigration documents, and the program-specific items in the checklist below.
5. Submit and wait for DCF eligibility determination
Save the confirmation number. DCF has up to 45 days to process most Medicaid applications and up to 90 days for disability-related Medicaid that needs a medical review. The portal shows status, missing documents, and the decision notice.
6. Choose your SMMC plan through Florida Choice Counseling
This is the step that distinguishes Florida from simpler states. After DCF approves you, AHCA sends the case to the SMMC enrollment broker. You get a plan-selection packet by mail and have 30 days to choose at flmedicaidmanagedcare.com or by calling 855-355-5777. The site shows plans in your county, lets you check whether your doctor is in-network, and compares extras (dental, vision, transportation, OTC).
7. Confirm enrollment and get your plan ID card
Once you choose a plan (or get auto-assigned), the plan mails a member ID card, handbook, and provider directory within about 10 to 14 days. Coverage starts the first of the following month in most cases. From then on, use the plan's network, not the state Medicaid card.
2026 Florida Medicaid Income Limits by Category
Florida Medicaid is categorical: there is no single income limit. You qualify based on which category fits (parent, pregnant, child, aged or disabled). The 2026 numbers below use the HHS poverty guidelines published in January 2026 and Florida's category-specific FPL percentages.
| Category | 2026 FPL Limit | Monthly Income (Household of 1) | Monthly Income (Household of 4) | Notes |
|---|
| Adult parent or caretaker | ~33% FPL | $431 | $891 | Non-expansion; childless adults excluded |
| Pregnant (Pregnancy Medicaid) | 196% FPL | $2,560 | $5,290 | Includes 12 months postpartum |
| Infant (under age 1) | 206% FPL | $2,691 | $5,560 | Higher than older children |
| Child age 1-5 | 140% FPL | $1,829 | $3,778 | Medicaid |
| Child age 6-18 | 138% FPL | $1,803 | $3,724 | Medicaid |
| Florida KidCare CHIP | up to 215% FPL | $2,809 | $5,802 | Small premium above 158% FPL |
| Aged 65+ (SSI-related) | up to SSI FBR | $967 | n/a | $2,000 / $3,000 asset limit |
| Blind/disabled (SSI-related) | up to SSI FBR | $967 | n/a | Same asset limits |
| Medically Needy | No income cap | n/a | n/a | Share-of-cost deductible model |
If your income is above the limit for your category, run a screening before assuming you do not qualify. Florida has narrow Medicaid eligibility but layered programs (KidCare, Pregnancy Medicaid, Medically Needy) that catch people one income test misses. Check your eligibility for Florida benefits in 2 minutes before filling out the full DCF application.
What's Different About Florida Medicaid
Florida runs a Medicaid program with policy choices that change how the portal and the SMMC system behave. These are the differences that matter most in 2026.
- Non-expansion state and the coverage gap. Florida is one of 10 non-expansion states in 2026. Adults ages 19 to 64 without dependent children cannot qualify for Medicaid at any income unless pregnant, disabled, or in another categorical group. Parents qualify only at about 33% FPL. KFF estimates roughly 400,000 Floridians are in the coverage gap. DCF routes them to the federal marketplace at healthcare.gov.
- Medically Needy program. If your income is above the regular Medicaid limit but you have high medical bills, you can qualify by meeting a monthly "share of cost" deductible. Once your bills that month reach the share of cost, Medicaid covers eligible expenses for the rest of that month. Resets monthly.
- Eight SMMC managed care plans. AHCA contracted with eight plans for the 2025 to 2030 SMMC cycle. Plans vary by region; not all eight serve every county. See the table below.
- Florida KidCare brand for CHIP. "Florida KidCare" is the umbrella for full children's coverage: Medicaid for children, MediKids (ages 1 to 4), Healthy Kids (ages 5 to 18), and the Children's Medical Services (CMS) plan for special healthcare needs. MyACCESS routes each child to the right one.
- Long-term care is a separate SMMC enrollment. Nursing facility and HCBS waiver services enroll under SMMC Long-Term Care (LTC). Same broker, separate plan selection, separate clinical and financial eligibility. Most LTC applicants need a CARES evaluation first.
- OBBB cut retroactive coverage to 60 days. The One Big Beautiful Bill Act, signed July 4, 2025, cut Medicaid retroactive coverage from 90 days to 60 days before the application date, effective 2026. Apply quickly if you have outstanding bills.
- OBBB redeterminations and federal work requirements. The law moved expansion-state adults to 6-month redeterminations. Because Florida did not expand, the change mainly affects existing Florida adult recipients case by case. Federal work requirements for able-bodied adults phase in starting January 2027.
Documents You Need Before You Start
Have these ready in PDF or phone-photo form. Missing documents are the top reason MyACCESS Florida applications get delayed or denied in 2026.
- Photo ID for every adult applicant. Florida driver's license, Florida ID, passport, or military ID.
- SSNs for everyone applying. Children applying for Medicaid or KidCare need SSNs too. Non-applicants do not.
- Proof of Florida residency. Utility bill, lease, mortgage statement, or government letter dated within the last 60 days.
- Income verification for the last 30 days. Pay stubs, or an employer letter on letterhead with gross pay and hours. Self-employed: profit-and-loss, last year's tax return, or 90 days of business bank statements.
- Other income proof. Social Security/SSI award letters, pensions, unemployment determinations, child support orders, VA letters.
- Proof of citizenship or qualified immigration status. US birth certificate, passport, naturalization certificate, or USCIS document. Mixed-status households are normal in Florida.
- Proof of pregnancy (for Pregnancy Medicaid). Provider note confirming pregnancy and due date.
- Asset documentation (for aged or disabled applicants). Bank statements, vehicle titles, life insurance, retirement accounts. SSI-related Medicaid has a $2,000 individual / $3,000 couple asset limit.
- Medical bills (for Medically Needy). Receipts, invoices, EOBs used to meet your monthly share of cost.
- Insurance information. If anyone in the household has private insurance, employer coverage, or Medicare, list it. Medicaid is payer of last resort.
You do not need every document to start. You do need to upload them within DCF's window (usually 10 days from request) or the case is denied.
Choosing a Florida SMMC Plan
After DCF approves you, the SMMC enrollment broker sends a plan-selection packet. You have 30 days to choose at flmedicaidmanagedcare.com or 855-355-5777. Plan footprints vary across Florida's 11 SMMC regions; the packet shows which plans serve your county. The eight contracted plans for the 2025 to 2030 cycle:
| Plan Name | Parent Company | Coverage Footprint | Notable Extras |
|---|
| Sunshine Health | Centene | Statewide | Largest network in Florida |
| Humana Healthy Horizons | Humana | Statewide | Telehealth, OTC, smartphone benefit |
| Aetna Better Health | CVS Health | Multiple regions | CVS pharmacy / MinuteClinic access |
| Simply Healthcare | Elevance Health | Statewide | Long-standing Florida plan |
| Molina Healthcare | Molina | Select regions | Care coordination, extra dental |
| UnitedHealthcare Community Plan | UnitedHealth | Select regions | National network, UHC app/telehealth |
| Lighthouse Health Plan | Centene | Select regions | Newer Florida-specific regional plan |
| Florida Community Care | Independent Living Systems | LTC regions | Specialty in LTC and HCBS waiver |
All SMMC plans cover the same core Medicaid benefits, so the real differences are network (does your doctor take this plan?), extras (dental, vision, transportation, OTC), and customer service. Florida Choice Counseling helps by phone at no cost.
What Happens After You Submit
Standard processing is up to 45 days for most Medicaid applications and up to 90 days for disability-related Medicaid needing a medical review. Pregnant women often get faster decisions.
Once DCF approves you, AHCA hands the case to the SMMC enrollment broker. The plan-selection packet arrives by mail within about 10 days and you have 30 days to choose. If you do not pick, the system auto-assigns based on county, household members already enrolled, and prior plan history. Auto-assignment can land you in a plan your doctor does not accept, so picking is worth the 15 minutes.
After the initial pick or auto-assignment, you have a 90-day open enrollment window to switch for any reason. After that, you are locked in until annual SMMC open enrollment unless you have a good-cause reason (moving regions, your plan dropping your provider, quality issues).
If denied, the DCF notice tells you why and how to request a Medicaid fair hearing. You have 90 days from the notice date. If you appeal within 10 days, benefits continue during the appeal if you were already enrolled.
To check status, log into myaccess.myflfamilies.com or call DCF at 850-300-4323.
Frequently Asked Questions
How long does Florida Medicaid approval take in 2026?
Up to 45 days for most Medicaid applications and up to 90 days for disability-related Medicaid needing medical review. Pregnant women often get faster decisions. After approval, you have 30 more days to choose a SMMC plan before auto-assignment.
Which SMMC plan is best for Florida Medicaid?
No single plan is best because all SMMC plans cover the same core Medicaid benefits. The right plan depends on whether your doctors are in the network, which extras you value (dental, vision, transportation, OTC), and which plans operate in your county. Use flmedicaidmanagedcare.com or call 855-355-5777 for free help.
What is Florida's Medically Needy program?
A pathway for people whose income is above the regular Medicaid limit but who have high medical bills. Each month you meet a "share of cost" deductible based on how far your income exceeds the limit. Once your bills that month reach the share of cost, Medicaid covers eligible expenses for the rest of that month. Resets monthly.
Can I get Medicaid in Florida if I'm childless and not disabled?
In almost all cases, no. Florida did not expand Medicaid, so adult eligibility requires you to be a parent or caretaker (about 33% FPL), pregnant, aged 65+, blind, or disabled. A childless, non-disabled, working-age adult does not fit any Florida Medicaid category regardless of income. This is the "coverage gap." Roughly 400,000 Floridians are in it. Alternatives: the federal marketplace at healthcare.gov, community health centers with sliding-scale fees, and county hospital district programs.
What happens if I don't choose a Florida Medicaid plan?
If you do not pick within 30 days, the enrollment broker auto-assigns you based on county, household members already enrolled, prior plan history, and capacity. You can switch out during the 90-day open enrollment window after coverage starts. After that, you are locked in until annual SMMC open enrollment unless you have a good-cause reason.
How do I switch SMMC plans in Florida?
In the first 90 days of coverage, switch for any reason at flmedicaidmanagedcare.com or 855-355-5777. After that, you can switch only during annual SMMC open enrollment or for a state-approved good-cause reason (moving regions, your plan dropping your provider, quality problems, service delays).
Check Your Eligibility Before You Apply
Florida Medicaid has narrow adult eligibility, a separate plan-selection step, and a Medically Needy pathway most online guides ignore. A free screening saves 45 minutes if you do not qualify, and can flag programs you did not know about (Florida KidCare, Pregnancy Medicaid, Medically Needy, county indigent care).
Check your eligibility for Florida benefits in 2 minutes with Benefits USA's free screener. It checks Medicaid, Florida KidCare, SNAP, TANF, ACA subsidies, and other programs at once.
For situation-specific questions, call DCF at 850-300-4323 or Florida Choice Counseling at 855-355-5777.
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