What is Public Health Insurance in Florida?

Florida’s public health insurance plans offer low-cost or completely free health insurance coverage. It refers to government-sponsored health insurance plans in Florida, like Florida Medicaid, Medicare, and Florida Children's Health Insurance Program.

Florida Medicaid

As of 2023, Florida continues to reject the federal expansion of Medicaid. When the COVID-era temporary expansion ended in March of 2023, up to 2 million Florida residents were expected to lose coverage.

Medicaid is a federal and state government-sponsored health insurance program that provides free and low cost health coverage. It provides health coverage for a selected group of people (like pregnant women, children, seniors, and disabled adults) in the state that earn low wages. This policy aims to improve the health of individuals who cannot afford medical care for themselves and their kids. The Agency for Health Care Administration administers Medicaid services in Florida. To qualify for Medicaid in Florida, you must be living in Florida and a U.S. national, citizen, permanent resident, or legal alien, requiring health care/insurance assistance, with low income. In addition, you must meet any of the following requirements:

• Pregnant
• Blind
• Have an 18-year-old old or younger child
• Have a disability or a family member with a disability
• Be 65 years old or above

In Florida, individuals on Medicaid plans are enrolled in the Statewide Medicaid Managed Care program, which has three parts:

• Managed Medical Assistance (MMA) plan: It covers medical services provided like hospital care, prescribed drugs, doctor visits, mental health care, and the cost of going for these services
• Long-Term Care (LTC): It covers care in a nursing facility, assisted living, or at home. You must be at least 18 years old and meet the nursing home or hospital level of care to qualify for this plan
• Dental plan: It covers dental services for children and adults and is compulsory for people on Medicaid plans.

Medicare

Medicare is a federal program that subsidizes ACA-compliant healthcare services for individuals aged 65 years or older or specific young people with disabilities. While not free, Medicare plans offer affordable health insurance coverage. In 2023, over 4.9 million people in Florida are using Medicare coverage. To be eligible for Health Insurance through any Medicare program, you must be a United States citizen or a legal resident who has lived in the country for a minimum of five years and fulfill at least one of the following:

• Be 65 years of age
• Have a disability based on the Social Security's definition of disability
• Have amyotrophic lateral sclerosis (ALS)
• Have end-stage renal disease (ESRD) (permanent kidney failure requiring dialysis or transplant)
• Have worked and paid Medicare taxes for a minimum of 10 years

There are multiple Medicare plans in Florida that residents can choose from. These plans are designed to help Floridians find the best health insurance coverage option that suits their lifestyles and medical needs. Medicare is divided into Original Medicare (Parts A and B), Part C (Medicare Advantage), and Part D (Prescription Drug). Unlike Original Medicare, Medicare Advantage doesn't have health qualifying questions, so it can be used as a fallback plan if the rates for Medigap or supplemental plans are too high.

In 2023, 47% of Florida’s Medicare users chose Original Medicare and 53% Medicare Advantage.

Read more on Medicare insurance in Florida

Florida Children's Health Insurance Program (CHIP):

Florida CHIP, known as Florida KidCare provides health coverage to children and families whose income is too high to qualify for Medicaid, but too low to afford private coverage. Florida KidCare has four state-sponsored programs, including Florida Healthy Kids, Medicaid, MediKids, and Children's Medical Services (CMS). These programs provide continuous coverage for Florida children from birth until after their 18th year. This program covers:

• Dental and vision care
• Doctor visits
• Emergency services
• Immunizations
• Inpatient and outpatient hospital care
• Laboratory and X-ray services
• Prescriptions
• Routine check-ups