CHIP in Florida

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Florida Children’s Health Insurance Program (CHIP) helps provide over 430,000 children in the state with health care coverage. While CHIP and Medicaid enrollment serve similar purposes, the two programs are not the same. Starting in 1997, CHIP has ensured that children could still have health coverage even if from low-income households not eligible for Medicaid. This means that even if adult members in a family do not have Medicaid eligibility children from that household can still be eligible for CHIP. Medicaid for children in Florida has different enrollment practices than the standard request for Medicaid. Learn how to apply for CHIP in Florida and more details about the program in the information below.

Florida’s Children’s Health Insurance Program Overview

Many may wonder, “What is CHIP Medicaid?” when inquiring about the government program. The Florida Children’s Health Insurance Program, like the Medicaid program, is part of the federal Social Security Act and offers coverage for qualified applicants. Each state manages its CHIP program differently and requirements for Medicaid eligibility for children may vary. Florida KidCare is the name of the four Children’s Health Insurance Programs in the state.

To receive benefits, petitioners must meet the state’s prerequisites when applying for Medicaid CHIP in Florida. Benefits from Medicaid CHIP enrollment include free or low-cost health care services for children and teens. Since Florida KidCare specifically caters to residents younger than 19 years of age, covered services offered are age appropriate. Knowing what is covered by CHIP Medicaid can help parents and caregivers arrange routine appointments, check-ups and care for little to no cost.

Learn more about benefits available to CHIP enrollees and how to apply to the program successfully in our free guide.

Is CHIP considered Medicaid in Florida?

Florida Medicaid for children is an extension of the Medicaid program. Medicaid and CHIP enrollment benefits often cover the same medical services for minors. Both programs are public insurance programs jointly funded by Florida and the federal government. However, the two programs vary by eligibility and cost. Children from households ineligible for standard Medicaid may still enroll in CHIP. In fact, children who do not qualify for free or low-cost insurance premiums can sign up for a full-pay CHIP plan.

Who is eligible for CHIP in Florida?

Florida Medicaid and CHIP enrollment is available for children who are U.S. citizens or legal aliens living in the state. To meet CHIP eligibility children must be of a certain age and from households earning less than a specific amount, which depend on the specific program. There are four health insurance programs for children in Florida that are variations of the children’s Medicaid program: MediKids, Florida Healthy Kids, Children’s Medical Services Managed Care Plan (CMS Plan) and Medicaid for children. Each have basic eligibility requirements:

  • MediKids is only available for children one to four years of age
  • Florida Health Kids are for those five to 19 years of age
  • CMS Plan covers children with special health care needs from birth to 19 years of age
  • Medicaid covers Florida minors from birth to 19 years of age

There are also income requirements for these Medicaid eligible children, which also vary by program. The government structures all financial limitations around the federal poverty level (FPL) and considers the number of household members comparative to income thresholds. During Medicaid and CHIP enrollment in Florida, officials will also use these guidelines to determine if a household is eligible for low-cost or no monthly premiums. After applying, applicants will learn for which specific program they are eligible.

What services are covered by CHIP in Florida?

Services for children covered by the CHIP program are very similar to the Medicaid services available for young enrollees. The most common services covered by the Children’s Health Insurance Program in Florida include check-ups and routine doctor’s visits as well as vaccines and necessary shots. The CHIP programs in the state also offer dental and vision coverage but services vary by the plan type. Standard covered medical services include:

  • Hospitalization
  • Most surgeries
  • Mental health care
  • Hearing exams
  • Emergency services and transport

Certain services covered by the children Medicaid program are limited, as one cannot get more than one physical exam or teeth cleaning within a 12-month period. If an enrollee wants to have more than one of these limited services in a year’s time, he or she will have to cover the cost. Other services may be covered by the CHIP program including medical equipment such as inhalers and wheelchairs. Medicaid covers these services and more especially if a recipient has a disability and needs specific services or equipment.

Much like with a private insurance provider, CHIP enrollees should stay in-network when seeking medical care. CHIP recipients can see whichever doctor they want as long as the physician is in the program’s network of medical professionals. Medicaid CHIP may not financially cover services recipients receive from an out-of-network provider.

How to Apply for CHIP in Florida

Applicants can apply to CHIP by submitting an online application on their Florida KidCare account. Those interested in CHIP enrollment offline can also print the application to mail, apply in person or apply by phone at 888-540-5437. The CHIP application can be mailed to:

Florida KidCare
P.O. Box 980
Tallahassee, FL 32302

While applying for CHIP benefits, applicants must furnish documents proving their identity, income and citizen or immigration status. If more than three children from the same family are applying for CHIP coverage, their parents may need to use two forms, as there is only space for three children per application. Most people receive a status update about their CHIP enrollment in a little over a month’s time. If denied, applicants can always file an appeal.

Find out which documents you need to provide to establish eligibility for Medicaid benefits for children by downloading our detailed guide.