When Does Medicaid End for a Child in Florida?

Florida Medicaid coverage for a child usually ends on the child’s 19th birthday, but it can end earlier if the family’s income rises above the limit for the child’s age group or if other eligibility rules are no longer met. It can also continue past 19 in a few specific situations, including young adults ages 19 and 20 who meet a separate income test and former foster youth who keep coverage until age 26.

The Standard Cutoff: Age 19

Children’s Medicaid in Florida runs through the day before the child’s 19th birthday. To stay eligible up to that point, the child must be unmarried and not legally emancipated.¹ Turning 19 moves the child out of the standard children’s coverage group, but it does not always mean Medicaid itself ends.

When Coverage Can Continue Past 19

Young Adults Ages 19 and 20

Florida has a separate Medicaid coverage group for people who are 19 or 20 years old. The young adult must be unmarried or have had the marriage annulled. The group has its own income limits, and the young adult does not need to live with a parent; those living on their own or with non-relatives can still qualify.¹ This group is easy to overlook, so it is worth checking before assuming coverage is over.

Former Foster Youth Until Age 26

A young adult who aged out of foster care at 18 while on Medicaid can keep coverage until turning 26, with no income limit. The foster care can have been under any state’s responsibility, not just Florida’s, as long as the person was on Medicaid when they aged out.² The state verifies the foster care history electronically when the person applies.³

Children With Special Healthcare Needs

Children with serious or chronic medical conditions may be enrolled in the Children’s Medical Services (CMS) Health Plan, a specialized Medicaid managed care plan, after a medical or behavioral screening.⁴ A child in CMS can continue coverage through the 19-and-20 age group if that group’s requirements are met.

When Coverage Ends Before 19

The most common reason a child loses Medicaid before 19 is a change in household income. Florida uses three income thresholds based on the federal poverty level (FPL), and the child’s age controls which one applies:

Infants under age 1: household income at or below 185% FPL.
Children ages 1 through 5: household income at or below 200% FPL.
Children ages 6 through 18: household income at or below 133% FPL.

These figures come from Florida’s Family-Related Medicaid income chart.⁵ A 5% income disregard under federal MAGI rules can help a family just over the line still qualify, which effectively lifts the cap for children 6 through 18 to about 138% FPL.⁶ Because income is counted as modified adjusted gross income, pre-tax deductions like retirement contributions reduce the number the state actually uses.

Income is not the only trigger. A child can also lose coverage before 19 for these reasons:

Moving out of Florida. Medicaid is state-run and requires Florida residency; a family that relocates has to apply in the new state.
Household size changes. If someone leaves the household, the applicable income limit drops with the smaller family size, and a family that previously qualified may no longer fit.
Failure to complete the annual renewal. If a family does not respond to requests for updated information, coverage will be terminated even when the child is still financially eligible.⁷

Gaining access to other coverage, such as a parent’s employer plan, does not by itself end a child’s Medicaid. If the child still meets the age and income rules, they can stay enrolled even when other insurance is available.

The 12-Month Protection Against Mid-Year Loss

Federal law requires every state to give children under 19 a full 12 months of continuous Medicaid eligibility. The rule took effect January 1, 2024, under the Consolidated Appropriations Act of 2023.⁸ A child who qualifies keeps coverage for 12 months from the last eligibility determination, even if household income rises above the limit during that period. Florida’s fact sheet confirms this: children under 19 who become ineligible mid-year may remain on Medicaid for up to 12 months after their last eligibility review.¹ A raise or a new job partway through the year will not immediately cut off the child’s coverage. The reassessment happens at the annual renewal.

How the Annual Renewal Works

Every Medicaid case in Florida is reviewed once a year. The state first tries to confirm eligibility automatically using electronic data like tax and wage records. When the data confirms the family still qualifies, renewal happens without any action from the family, and a notice is sent that coverage has been extended.

When the state cannot confirm eligibility on its own, it mails a renewal notice about 45 days before the renewal date with instructions.⁷ Families can respond through the MyACCESS portal, by mail, or at a DCF office. Keeping the mailing address, phone number, and email current in MyACCESS is the single most important step for avoiding accidental coverage loss, because returned mail is a leading cause of missed renewals.

The Termination Notice and the 90-Day Window

When Medicaid is being terminated, the Department of Children and Families sends a Notice of Case Action explaining the reason, the effective date, and appeal rights.⁹ Notices come by mail, or by email alert for families signed up for paperless notifications.

If coverage is ending because requested renewal information was not returned, the family has 90 days from the date Medicaid ends to submit the missing documents. The state may be able to restore eligibility without a new application.⁹ This is far easier than reapplying from scratch, so acting quickly is worthwhile even after the first deadline has passed.

Appealing a Termination

A family that believes coverage was wrongly ended can request a fair hearing within 90 days of the date on the Notice of Case Action, by phone, in writing, or through the ACCESS call center.⁹ Timing is critical. If the hearing request is filed before the effective date of the termination, federal rules require Medicaid to continue during the appeal.¹⁰ File after that date and the child will be uncovered while the appeal is pending. The notice shows the exact termination date, so families who disagree with the decision should file right away.

What to Do If Coverage Ends

Losing Medicaid does not have to mean going without insurance. Several options exist, and most carry their own enrollment windows tied to the loss of coverage.

Florida KidCare

Florida KidCare is the state’s umbrella program for children’s health coverage and includes CHIP-funded plans for families who earn too much for Medicaid. Children under 19 with household income up to 300% of the federal poverty level are eligible.⁴ Many families pay $15 or $20 per month to cover all eligible children in the household.¹¹ A KidCare application is automatically screened for Medicaid eligibility first, so separate filings are not required.

ACA Marketplace Coverage

Losing Medicaid opens a Special Enrollment Period on the federal Marketplace at HealthCare.gov. The window runs 60 days before or after the loss of coverage.¹² Families with income between 100% and 400% of the federal poverty level may qualify for premium tax credits that reduce the monthly cost.¹³

A Parent’s Employer Plan

If a parent has health insurance through work, the child’s loss of Medicaid or CHIP triggers a 60-day special enrollment window to add the child to the employer plan. This right applies under federal law regardless of the employer’s regular open enrollment schedule. The parent must request enrollment within those 60 days.

Reapplying for Medicaid

If circumstances change again, through a drop in income, job loss, or a larger household, the family can reapply at any time through MyACCESS or a DCF office. There is no waiting period, and approval can be retroactive up to three months before the application date if the family was eligible during that period.

1
Department of Children and Families. Family-Related Medicaid Program Fact Sheet
2
Florida Department of Children and Families. Medicaid for Young Adults
3
Florida Department of Children and Families. Medicaid to Age 26
4
The Florida House of Representatives. Florida Statutes 409.814 – Eligibility
5
Florida Department of Children and Families. Appendix A-7 Family Related Medicaid Income Limits
6
Medicaid.gov. Medicaid, Children’s Health Insurance Program, and Basic Health Program Eligibility Levels
7
Florida Department of Children and Families. Florida’s Medicaid Redetermination Plan
8
Medicaid.gov. Continuous Eligibility for Medicaid and CHIP Coverage
9
Florida Department of Children and Families. Notice of Case Action
10
GovInfo. 42 CFR 431.230 – Maintaining Services
11
Florida KidCare. Florida KidCare Home
12
Centers for Medicare and Medicaid Services. Understanding Special Enrollment Periods
13
HealthCare.gov. Federal Poverty Level (FPL)