Florida Medicaid Eligibility: Income, Assets, and Long-Term Care

Florida Medicaid eligibility turns on income and asset limits that vary by category: children can qualify with household income up to 211% of the Federal Poverty Level, pregnant women up to 196%, and parents up to roughly 26%, while seniors and disabled adults face both income caps (around $1,182 per month for community coverage, $2,982 for long-term care in 2026) and asset limits ranging from $2,000 to $6,000. Because Florida has not expanded Medicaid under the Affordable Care Act, most non-disabled adults without dependent children have no pathway to coverage regardless of how little they earn.

Two Ways Florida Measures Income

Which rules apply to you depends on your eligibility category, and the two systems produce very different results for the same household.

MAGI (Modified Adjusted Gross Income) covers children, pregnant women, and parents or caretaker relatives. It looks at taxable income — wages, self-employment, Social Security, and similar sources — and uses tax-filing relationships to define your household. There is no asset test. A built-in 5% of FPL income disregard is applied before your income is compared to the limit, which effectively raises every MAGI ceiling.¹

Non-MAGI rules apply to anyone who is 65 or older, blind, or disabled, and to anyone seeking long-term care. This method counts nearly all income sources, imposes asset limits, and uses different household and deduction rules.²

Income Limits for Children, Pregnant Women, and Parents

All four groups below are evaluated under MAGI rules, and the percentages already include the 5% disregard, so you can compare them directly to your household income.

Pregnant women: up to 196% of the FPL, which works out to roughly $3,535 per month for a household of two using 2026 poverty guidelines. Coverage continues for 12 months after the end of pregnancy.¹
Children under age 1: up to 211% of the FPL.
Children ages 1 through 18: up to 138% of the FPL. Children with family income above this but below 200% of the FPL may qualify for Florida KidCare, the state’s CHIP program, which charges small monthly premiums.³
Parents and caretaker relatives: the threshold is far lower than for children. For a family of three, the current monthly income limit is roughly $598, about 26% of the FPL.⁴

For reference, the 2026 Federal Poverty Level in the 48 contiguous states is $1,330 per month for a single person, $1,803 for a household of two, and $2,277 for a household of three.⁵

Why Most Adults Without Children Don’t Qualify

Because Florida has not expanded Medicaid, there is no coverage category for non-disabled adults between 19 and 64 who do not have dependent children. In expansion states, these adults qualify with income up to 138% of the FPL. In Florida, a working-age adult without a disability generally must be caring for a dependent child and earn below roughly 26% of the FPL to get Medicaid. Adults who earn too much for Medicaid but too little for Marketplace premium subsidies fall into a coverage gap with no public insurance path through the state program.

MEDS-AD: Community Coverage for Seniors and Disabled Adults

MEDS-AD (Medicaid for Aged and Disabled) provides full Medicaid benefits to low-income Floridians who are 65 or older or who have a qualifying disability but don’t need institutional care. The income limit is $1,182 per month for an individual or $1,596 for a couple, with asset limits of $5,000 and $6,000.⁴ If your income is at or below the SSI level of $994 per month in 2026, you likely qualify for SSI-related Medicaid automatically.⁶

Income Limits for Long-Term Care

Nursing home care, home and community-based services (HCBS) waivers, and the Program of All-Inclusive Care for the Elderly (PACE) use a separate income cap. Florida is an “income cap” state: your gross monthly income cannot exceed 300% of the SSI federal benefit rate, which is $2,982 per month in 2026 for a single applicant.⁶

If Your Income Exceeds the Cap

Being one dollar over $2,982 disqualifies you under normal rules. The workaround is a Qualified Income Trust (QIT), sometimes called a Miller Trust. You or someone with legal authority creates the trust, your income is deposited into it each month, and the trust funds go toward paying for your care. Any balance remaining at your death must be repaid to AHCA.⁷ A QIT does not shelter money from the cost of care; it is a legal mechanism to meet the income eligibility test, not a savings tool.

The Medically Needy Program

If your income is too high for standard Medicaid but you face overwhelming medical expenses, the Medically Needy program lets you “spend down” each month. Florida sets the Medically Needy Income Level at $180 per month for an individual and $241 for a couple.⁸ The difference between your countable income and that level is your “share of cost.” Once you incur that much in qualifying medical expenses in a given month, Medicaid picks up the rest for the balance of the month.⁹ The process resets every month. Asset limits are $5,000 for an individual and $6,000 for a couple.

Asset Limits for Non-MAGI Programs

MAGI programs have no asset test. Non-MAGI programs do, and the specific ceiling depends on which program applies.

Long-term care Medicaid (nursing home, HCBS waivers, PACE): $2,000 for an individual or $3,000 for a married couple applying together. If income falls within the MEDS-AD range, the asset limit rises to $5,000 or $6,000.¹⁰
MEDS-AD community Medicaid: $5,000 individual, $6,000 couple.
Medically Needy: $5,000 individual, $6,000 couple.

What Doesn’t Count as an Asset

Your primary home, as long as you live there or have stated an intent to return. For long-term care applicants, a signed letter of intent to return is sufficient. Home equity cannot exceed $752,000 in Florida for 2026, but the equity cap is waived entirely if a spouse, a child under 21, or a blind or disabled child of any age lives in the home.¹¹
One vehicle, regardless of value.¹⁰
Household goods and personal belongings, regardless of value.
Burial funds up to $2,500 per person, if clearly designated and kept separate from other resources.¹²
Irrevocable prepaid funeral contracts and burial trusts, entirely.

Retirement accounts like IRAs and 401(k)s are generally counted as available assets in Florida. If a retirement account would push you over the limit, one common strategy is to convert it into an irrevocable annuity that pays out in regular installments; the annuity has no cash value, so it’s treated as an income stream rather than a countable asset. That conversion carries tax consequences, so professional advice is worth the cost before liquidating.

Spousal Protections When Only One Spouse Needs Care

Federal law prevents the state from requiring the community spouse to drain everything so the institutionalized spouse can qualify, and Florida applies the maximums.

The community spouse can keep up to $162,660 in countable assets in 2026, and only assets above that amount count toward the institutionalized spouse’s eligibility.¹³ The community spouse is also entitled to a minimum monthly income floor of $2,643.75 in 2026. If their own income falls below that, part of the institutionalized spouse’s income can be redirected to make up the difference before the rest goes toward care.

The Five-Year Look-Back

When you apply for long-term care Medicaid, Florida reviews every asset transfer you made in the 60 months before your application date. Gifts, sales below market value, and transfers to family members without fair compensation are treated as attempts to qualify artificially.¹⁴

The penalty is a period of Medicaid ineligibility calculated by dividing the total value of improper transfers by the average monthly cost of private nursing home care in Florida. The penalty clock does not start on the date of the transfer. It starts when you apply and would otherwise be eligible. Giving away $100,000 four years before applying may feel like advance planning, but if it falls inside the window, the ineligibility period doesn’t begin until the day you file.

Limited exceptions exist. Transfers to a spouse, to a blind or disabled child, or to a trust for the sole benefit of a disabled person under 65 are generally not penalized. A home transferred to a child who lived there and provided care that delayed the parent’s need for institutional care — the caretaker child exemption — may also be excluded.

Estate Recovery After Death

Florida law requires AHCA to recover the cost of Medicaid benefits paid on behalf of anyone who received assistance after age 55. Benefits paid before 55 do not create a debt. After your death, the state can file a claim against your estate for what Medicaid spent on nursing home care, home health, and related services.¹⁵

Recovery cannot be enforced if you are survived by a spouse, a child under 21, or a child who is blind or permanently disabled. It also cannot reach property that is exempt from creditor claims under Florida law, and Florida’s homestead protections are among the strongest in the country. Any heir can request a hardship waiver, though the loss of an anticipated inheritance alone does not qualify as hardship.

How to Apply

Applications go through the Florida Department of Children and Families, not AHCA directly. The fastest route is the online MyACCESS portal at myaccess.myflfamilies.com. You can also call the DCF customer call center at 850-300-4323 or visit a local DCF service center. The application asks for proof of income, residency, citizenship or immigration status, and, for Non-MAGI programs, asset documentation.

If you plan to use a Qualified Income Trust, have the trust document prepared before you submit. Long-term care applications take longer to process than MAGI-based coverage because of asset verification and the look-back review. Apply as early as you reasonably can once institutional care looks likely; gaps in coverage leave families responsible for the full private-pay rate in the interim.

1
Medicaid.gov. Medicaid, Childrens Health Insurance Program, and Basic Health Program Eligibility Levels
2
Medicaid.gov. Eligibility Policy
3
Florida KidCare. 2025 General Annual Income Guidelines
4
Florida Department of Children and Families. Determining Your Income Limit
5
U.S. Department of Health and Human Services, ASPE. 2026 Poverty Guidelines – 48 Contiguous States
6
Social Security Administration. SSI Federal Payment Amounts for 2026
7
Florida Department of Children and Families. Qualified Income Trust Fact Sheet
8
Florida Department of Children and Families. Appendix A-7 – Family-Related Medicaid Income Limit Chart
9
Florida Senate. Medicaid Medically Needy Program Review – Interim Project Report 2001-024
10
Florida Department of Children and Families. Chapter 1600 Assets Program MFAM – 1640.0000 SSI-Related
11
U.S. Department of Health and Human Services, ASPE. Medicaid Treatment of the Home – Determining Eligibility and Repayment for Long-Term Care
12
Florida Department of Children and Families. CF-ES-2302, Designation of Resources as Burial Funds
13
Centers for Medicare and Medicaid Services. 2026 SSI and Spousal Impoverishment Standards
14
Centers for Medicare and Medicaid Services. Transfer of Assets in the Medicaid Program
15
The Florida Legislature. Florida Statutes 409 – 0409.9101