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  • Access Florida’s Medicaid Program
September 20, 2013

While Medicaid in Florida might be a federal program, the money is actually funneled to the individual states to use as they best see fit. Each state will therefore have different requirements when it comes to qualifying for Medicaid and the benefits that come with that. In Florida most of the Medicaid cases are actually handled through the Asset Florida program, which is directly supervised by the Department of Children and Families (DCF). As with any Medicaid program, there are plenty of rules governing how it is run and how funds are sourced out, so without any further wait read on to see some of the most important questions regarding Access Florida’s Medicaid program.

What’s different about Florida Medicaid?

There are several different government bodies involved with Medicaid in Florida. The first government agency to know about is the Agency for Health Care Administration which handles the actual administration of Medicaid services. However they are not the ones who determine eligibility or help individuals to find what they qualify for.

Qualification requirements and the final determination on who is eligible for Medicaid help and who is not are made by one of two organizations: the Department of Children and Families (DCF) who grant access to Medicaid benefits through the Access Florida program, or the Social Security Administration, in the cases where the individual is covered by Social Security Insurance (SSI). Applicants can expect the DCF to handle any cases that do not clearly fall under Social Security coverage.

What does Florida Medicaid cover?

Medicaid is designed to be a broad program that supports a wide range of different needs that individuals may have. This includes, but is not limited to, doctor visits, physicals, hospital expenses, emergency expenses, and more. Medicaid also has programs that allows for nursing home costs or certain long term at home care to also be covered under this program.

Who is eligible for Florida Medicaid?

Anyone who qualifies under Social Security Insurance (SSI) qualifies for Medicaid automatically. However any individual who does not fall under the SSA jurisdiction needs to apply through Access Florid programs to enjoy the benefits. While each case needs to be judged by the DCF on a case by case basis, some individuals who may qualify for Medicaid include:

–          Children

–          Low income families who have children

–          Women who are pregnant

–          Elderly who are not covered under Social Security

–          Disabled individuals not covered under Social Security

–          Non-citizens who are experiencing a medical emergency

Not every single member of these groups is going to qualify for these benefits, but this at least gives an idea of the options that are actually available for a large group of people.

Florida Medicaid for children

Florida Medicaid for children is a program designed where a parent or guardian can apply for Medicaid on behalf of their child as long as that child is 18 years old or younger and living in the home. There is one exception: a child 19 years old who is living in home and finishing up high school also often qualifies to be included in this particular Florida Medicaid program. There are also other state programs that can chip in to help cover expenses for children under different circumstances.

Florida Medicaid for low income families with children

This one is fairly straight forward, although obviously there are some specific numbers that need to be met in order to make it work. There are two big numbers to look at to qualify for Medicaid under this particular program. The first is the federal poverty line. The family income needs to be at 180% of the federal poverty line for a family their size or less. If that standard is met, the second is to have a list of the total family assets and for the total of those to combine for $2,000 or less. There is an exception for vehicles, but the vehicle must be necessary for work and it must be worth less than $8,000 blue book value.

As long as both of these income scenarios are met, there’s a good chance that individuals would be able to qualify for Medicaid treatment.

Florida Medicaid for pregnant women

There are actually three different applications that pregnant women can fill out in order to try and qualify for Medicaid services. These three applications are:

–          The Access application – This is a regular application for full Medicaid benefits and often is one of the most popular applications for care.

–          Presumptively eligible pregnant women – This application does almost immediately qualify an individual woman for temporary coverage until a fuller examination and determination can be made.

–          Simplified eligibility for pregnant women – This is a simplified version of full Medicaid coverage for pregnant women only.

Finding the right application and getting into the program will help push applicants to the right program that can cover all of their needs.

Florida Medicaid for the elderly (SSI issues)

Most elderly individuals are covered by the Social Security Administration, but there are some individuals who might not be covered by Social Security. In these rare circumstances the best way to get Medicaid benefits is to go through the Access Florida programs.

Getting a Medicaid card

Getting a Medicaid card is extremely important. While people who qualify for full time Medicaid can get a “gold card” that can be used at any time to identify them as covered under the program, those who are temporarily covered under the Access Florida Medicaid benefits can still get a temporary card that identifies them as being covered for the time being. This is always a good idea, and those with an Access account can print their card directly from their account once it is available.

Be aware of “share of cost” options

While not everyone will qualify for full Medicaid coverage under Access Florida programs, they should still check out any “share of cost” options that might be available. There are programs where Medicaid through Access Florida will help to pick up partial costs for procedures, long term treatments, and other similar medical needs. Applications for this can be put in through Access Florida.

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