Florida KidCare Full Pay: Premiums, Eligibility, and Enrollment

Florida KidCare Full Pay is the unsubsidized tier of the state’s children’s health coverage, designed for families whose income is too high to qualify for discounted KidCare but who still want the program’s pediatric benefits. For 2026, that generally means household income above 300 percent of the federal poverty level, or roughly $99,000 for a family of four.1HHS ASPE. 2026 Poverty Guidelines: 48 Contiguous States Families pay the full premium with no government help, but the coverage, provider network, and $10 copay cap are the same as subsidized KidCare.2Florida KidCare. Cost – Florida KidCare

Who Qualifies

The child must be under age 19, a Florida resident, and either a U.S. citizen or a lawfully present immigrant. There is no assets test.3Florida House of Representatives. Florida Code 409.814 – Eligibility

Income is what sorts a family into Full Pay rather than subsidized coverage. Subsidies cut off at 300 percent of the federal poverty level. For 2026, that cutoff looks roughly like this:1HHS ASPE. 2026 Poverty Guidelines: 48 Contiguous States

  • Family of 3: above roughly $84,000 per year
  • Family of 4: above $99,000 per year
  • Family of 5: above roughly $114,000 per year

If your income lands above the cutoff for your family size, the single KidCare application places your child in Full Pay automatically. You do not need to ask for it or know in advance which tier you are in.

One rule often catches families off guard. If your child could be added to an employer-sponsored plan and the cost to add them is 5 percent or less of your family income, the child is generally ineligible for KidCare, including Full Pay. When the employer plan costs more than 5 percent of income, the child may still enroll.3Florida House of Representatives. Florida Code 409.814 – Eligibility

What You Pay Each Month

Full Pay premiums for 2026 are set per child and depend on the child’s age, which also determines which part of KidCare they enroll in:4Florida KidCare. 2026 General Annual Income Guidelines

  • MediKids, for children ages 1 through 4: $248.21 per month, per child
  • Florida Healthy Kids, for children ages 5 through 18: $276.00 per month, per child, including dental

Premiums stack. A family with three enrolled children pays three full premiums. There is no deductible, and copays for covered services are capped at $10.2Florida KidCare. Cost – Florida KidCare Total out-of-pocket spending on premiums and copays combined cannot exceed 5 percent of your family’s annual income.

If you have children in both age bands, one child may land in MediKids while another lands in Healthy Kids, each with its own premium, insurance card, and plan materials.

What Full Pay Covers

Full Pay benefits mirror subsidized KidCare and are built around pediatric needs:5Florida KidCare. Home – Florida KidCare

  • Doctor visits, well-child check-ups, and immunizations
  • Hospital stays, surgery, and emergency care
  • Prescription medications
  • Dental care
  • Vision and hearing screenings
  • Mental and behavioral health services
  • Lab work and X-rays

Routine well-child and dental check-ups are covered without a copay under federal CHIP standards.6HealthCare.gov. Children’s Health Insurance Program (CHIP) Eligibility Requirements Dental is included in the Healthy Kids premium rather than sold as an add-on, which matters when comparing against private child-only coverage.

How to Apply and When Coverage Begins

Apply through the Parent Portal at floridakidcare.org, or request a paper application by calling 1-888-540-5437. Online applications are received within 24 to 48 hours; mailed ones take 7 to 10 business days to arrive.7Florida KidCare. FAQs – Florida KidCare

Have these on hand:8Florida KidCare. Florida KidCare Application

  • Social Security numbers for the children (or immigration document numbers for lawfully present non-citizens)
  • Employer and income information for everyone in the household: pay stubs, W-2s, or tax returns
  • Policy numbers for any current health insurance
  • Details on any employer-sponsored plan available to the family, including the cost to add a child

If nothing extra is needed, an eligibility letter typically arrives within a couple of weeks. When the program has to request more documents, the process can stretch to about six weeks.7Florida KidCare. FAQs – Florida KidCare

Approval alone does not start coverage. Coverage begins on the first day of the month after both the eligibility determination and your first premium payment are complete.7Florida KidCare. FAQs – Florida KidCare A child found eligible on March 10 whose premium is paid that same week starts coverage April 1. Waiting on the first payment pushes the start date back by a month.

Keeping Coverage Active

Two things end Full Pay coverage faster than families expect: a missed payment and a skipped renewal.

For MediKids, missing a monthly premium cancels coverage for at least 30 days. After that gap, coverage resumes once you pay.9Agency for Health Care Administration. Welcome to MediKids During the 30 days, your child has no KidCare coverage.

KidCare also requires an annual renewal, with updated income and household information. If you do not submit renewal documents, enrollment ends. You can dispute a termination if you believe the documents were submitted on time.10Florida KidCare. A Guide for Potential Florida Healthy Kids Enrollees The renewal window is also when a Healthy Kids family can switch to a different insurance company within the network.

Full Pay or a Marketplace Plan

Families above 300 percent of the federal poverty level sometimes ask whether a plan through the federal Health Insurance Marketplace would come out cheaper. A few points shape the answer:

  • Full Pay runs $248.21 to $276 per month per child with no deductible, and dental is included in the Healthy Kids premium. Private child-only plans on the individual market are often considerably more expensive and typically treat dental as a separate add-on.
  • Full Pay children are not CHIP-eligible, since their family income is too high, so they are not blocked from Marketplace coverage in the way subsidized CHIP children are. Whether a Marketplace plan would qualify for premium tax credits depends on household income and whether affordable employer coverage is available.6HealthCare.gov. Children’s Health Insurance Program (CHIP) Eligibility Requirements

For most families in the Full Pay income range, KidCare will be cheaper than comparable Marketplace coverage once dental is included. When your income puts you in line for substantial premium tax credits, pricing both options before enrolling is worthwhile.

Tax Treatment of the Premiums

Full Pay premiums come entirely out of pocket, but some of the cost can come back at tax time.

If you are self-employed and not eligible for an employer-sponsored health plan, you can deduct health insurance premiums for your dependents, including children under 27, as an above-the-line deduction. It reduces adjusted gross income directly and does not require itemizing.11Office of the Law Revision Counsel. 26 USC 162 – Trade or Business Expenses The deduction is capped at your net self-employment income for the year, and you cannot claim it for any month you were eligible to join a subsidized employer plan.

If you are not self-employed, Full Pay premiums can still count toward the medical expense deduction on Schedule A. Total unreimbursed medical expenses have to exceed 7.5 percent of your adjusted gross income before any benefit kicks in, and you have to itemize instead of taking the standard deduction. For a family earning above $99,000, that floor is at least $7,425, so this route generally helps only when premiums are stacked on top of significant other medical bills.