Getting Medicaid for a child in Florida

Florida Medicaid covers doctor visits, hospital care, dental, therapy, behavioral health, prescriptions, and regular check-ups for children at no cost to the family. Two agencies are involved: DCF decides eligibility, and AHCA runs the program and the health plans.

Once a child is approved, you choose a managed-care plan. For children with serious ongoing conditions, one of those choices is the Children's Medical Services (CMS) Health Plan, which adds a care coordinator. Since October 1, 2026 the CMS Plan is run by Molina Healthcare of Florida. (If you see older materials naming Sunshine Health or WellCare, they are out of date.)

Ways a child can qualify

There is more than one door. Use whichever fits:

Income. Children qualify when household income is at or below the limit for the child's age. DCF's chart for April 2026–March 2027 (monthly, before taxes, family of 4): under age 1, $5,803; ages 1–5, $3,989; ages 6–18, $3,796; ages 19–20 use the much lower parent/caretaker limit, $723. For a family of 1 the figures are $2,807 / $1,930 / $1,836 / $356. Full table: DCF Medicaid income limits (PDF) (opens in a new tab). You do not need to work this out to apply — the application screens for it, and applying is free. There is no asset test for families.
SSI. A child who receives SSI is automatically eligible. No separate Medicaid application is needed.
Over the income limit. Apply through Florida KidCare instead. One KidCare application routes the child to Medicaid, MediKids (ages 1–4), Healthy Kids (ages 5–18), or the CMS Plan. Premiums are $15 or $20 a month for families between the Medicaid limit and roughly 200% of the poverty level (KidCare's 2026 guidelines say 200%; its FAQ says 215%); above that there is a full-pay option ($248.21 a month per child for MediKids, $276 for Healthy Kids).
Waivers. Children at risk of institutional care may qualify through a home- and community-based waiver, such as the iBudget waiver for developmental disabilities (age 3+; see the APD guide). Waivers have their own application and often a waiting list.

Children under 19 keep Medicaid for the full 12-month eligibility period even if household income changes during the year. The exceptions are limited: the child turns 19, moves out of Florida, or dies; the family asks to end coverage; or the approval was based on an error or false information. This does not apply to Medically Needy (share-of-cost) coverage. Eligibility is re-checked at each yearly renewal; the rule does not add a year after an unsuccessful renewal.

Children under 21 can also get retroactive Medicaid for up to 3 months before the month you apply — tell DCF about recent medical bills.

Before you start: what to have ready

Proof of identity for the applicant.
Names, dates of birth, and Social Security numbers (or proof of application) for household members.
Income information. DCF verifies most income electronically and accepts your own statement for many items, so you may not need to upload pay stubs. Have them available in case DCF asks.
If applying under the "Medically Needy" route: paid and unpaid medical bills.

If you already have an open DCF case (for example, SNAP), some information, such as proof of identity, is already on file.

Step by step

Pre-screen (optional): myaccess.myflfamilies.com/AmIEligible/AESUM/ (opens in a new tab)
Apply at myaccess.myflfamilies.com (opens in a new tab). You can also apply by phone or on paper through the DCF Customer Contact Center, 850-300-4323.
Wait for a decision. The usual processing standard is 45 calendar days from the application date, or 90 calendar days when eligibility requires a disability determination. DCF begins counting the day after the application date. Send requested information promptly and contact DCF if your application is delayed. See DCF application-processing policy (opens in a new tab).
Choose a health plan. After approval, contact Choice Counseling at 1-877-711-3662 (TDD 1-866-467-4970) or flmedicaidmanagedcare.com (opens in a new tab). You can change plans in the first 120 days, during the yearly 60-day open enrollment, or for a state-approved reason.
Renew yearly. Coverage is approved 12 months at a time. DCF sends a renewal notice about 45 days before it is due.

If your child has a serious chronic condition: the CMS Plan

The CMS Plan is a Medicaid (or KidCare) specialty plan for children under 21 with chronic and serious physical, developmental, behavioral, or emotional conditions. Every member gets a case manager who coordinates care across providers.

To get in, the child needs a clinical eligibility screening. Two routes, and parents can start either one:

Parent survey by phone. Call DOH's CMS Plan clinical eligibility line, 1-855-901-5390 (TTY 711), Mon–Fri 8 a.m.–5 p.m., and ask to complete the parent-based survey.
Physician attestation. Ask your child's doctor or specialist to submit one; clinics know the process.

Then: Medicaid families choose the CMS Plan through Choice Counseling (1-877-711-3662); KidCare children who screen eligible are enrolled automatically and can opt out at any time. You can ask to be re-screened at any time.

Molina member services: 1-800-262-0750 (TTY 711), Mon–Fri 8 a.m.–7 p.m. Families moved from Sunshine Health on October 1 can keep seeing their current providers for a continuity period of up to 240 days — AHCA's member letters say through May 30, 2027 (Molina's materials say May 31), or until Molina finalizes a new care plan and authorizations. Ask your providers whether they will accept Molina after that. Medicaid members who were moved also have a 120-day window (until January 31, 2027) to switch to a standard Medicaid plan if a provider will not accept Molina.

Who to contact

DCF Customer Contact Center: 850-300-4323
Medicaid Helpline (AHCA): 1-877-254-1055 (TDD 1-866-467-4970), Mon–Fri 8 a.m.–5 p.m. ET
Choice Counseling (plan selection): 1-877-711-3662, Mon–Thu 8 a.m.–8 p.m., Fri 8 a.m.–7 p.m.; text 357662
CMS Plan Ombudsman (DOH): 1-833-956-0322

What we have not confirmed yet

Whether the CMS Plan under Molina includes a defined respite-care benefit.
Whether KidCare's income expansion above 200% FPL has taken effect (the official 2026 guidelines still cap at 200%).

Official sources

Program details can change. Follow the agency’s current instructions and the dates on your notices. Official links above take you to the organization responsible for the program.