Medicaid Costs and Coverage in Florida

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Medicaid coverage in Florida is important for low-income applicants seeking affordable health care. Florida offers different types of Medicaid insurance for approved applicants that cover a variety of medical services and treatments. Most new applicants wonder what services are covered by Medicaid and what does Medicaid not cover. Before beginning the Medicaid application process, petitioners should understand certain basic concepts surrounding the government program along with what Medicaid insurance options are available. The types of Medicaid insurance and services that Medicaid covers will depend on specific factors such as the age of the claimant, the type of Medicaid coverage the petitioner is eligible for and the type of Medicaid services that are necessary. The most basic Medicaid coverage in Florida may include areas such as doctor visits and hospice care. As important as it is to determine the services Medicaid covers, it is equally as important to understand what services Medicaid does not cover. While each state has services covered by Medicaid, Florida has an extremely thorough list for Medicaid coverage. To learn the different types of insurance through Medicaid, along with understanding how much is Medicaid and what costs are attached to Medicaid, continue reviewing the information below.

What services are covered by Medicaid in Florida?

Before looking in to how much does Medicaid cost, new applicants should understand the type of coverage offered. The purpose of Florida Medicaid coverage is to provide basic health care and medical services to low-income applicants eligible for Medicaid enrollment. It is important to understand the Medicaid services that are covered to properly prepare an applicant for his or her medical future. For example, Medicaid coverage in Florida usually spans through different medical fields, one of which is emergency transportation services. This means that coverage for Medicaid will include medically necessary transportation through emergency ground or air ambulance. Understanding this type of Medicaid coverage can help an applicant properly assess an emergency as needed. More coverage benefits for Medicaid in Florida can include but are not limited to services in:

  • Allergy and dialysis
  • Cardiovascular and gastrointestinal
  • Dental and vision care
  • Family planning and reproduction
  • Laboratory and radiology

After an applicant is approved for Medicaid, he or she will be notified of the type of Medicaid insurance available along with a list of services covered by Medicaid that will be applicable to his or her situation.

For a comprehensive list of services covered by most Medicaid plans, download our complimentary guide.

What services are not covered by Medicaid in Florida?

While there are a variety of services covered by Medicaid in Florida, there are also Medicaid services not covered, which will have associated fees. Services that are covered by Medicaid usually aim to fulfill the most basic medically necessary treatments in order to not hinder quality of life for an enrollee. For instance, applicants seeking cosmetic surgery will usually find the services denied by Medicaid coverage. All applicants should understand the services not covered by Medicaid to avoid any unnecessary surprises down the road. A few of the Medicaid services not covered in Florida include but are not limited to:

  • Private hospital rooms, unless medically necessary
  • Acupuncture and services not medically necessary
  • Dentures, hearing aids and personal comfort items
  • Services outside of the United States
  • Specific foot care services
  • Custodial care in a petitioner’s home

It is worth understanding that the kind of Medicaid coverages that are not available in Florida may have specific exceptions. For example, while cosmetic surgery is not covered through Medicaid, exemptions may include surgery performed in connection with severe burns or surgery to repair the face after a serious automobile accident.

How much does Medicaid cost in Florida?

Medicaid coverages and costs in Florida can greatly vary, depending on the age of the applicant, the type of services needed and the level of eligibility provided. Determining Medicaid cost estimates can be quite difficult, especially since there are many different moving parts to the program. Since Medicaid coverages are geared toward low-income, elderly or disabled applicants, the need for specific coverages and services for Medicaid can change greatly Eligibility for Medicaid coverage. is usually based on an applicant’s income and assets, which ultimately will establish the types of Medicaid insurance coverage he or she will receive. For instance, Medicaid applicants who find themselves on the higher end of the income requirements may be required to pay premiums, deductibles and copayments for their Medicaid services and treatments. Some Medicaid services that are partially covered will require the claimant to pay the different out of pocket. It is worth noting that a provider or medical professional can deny services or treatments to an applicant if they cannot pay the out-of-pocket expenses or the necessary copayments.

While considering out-of-pocket fees for Medicaid coverage sounds a bit daunting, the good news is costs for Medicaid are usually quite low. Federal law will prohibit costs for many of the basic medical services and treatments, while other services will have minimal out-of-pocket expenses. Since Medicaid is funded on a federal and state level, the costs remain low for the approved applicants. In cases when a deductible is needed for Medicaid coverage, the expenses are normally very low before Medicaid will begin to pay for its portion of the costs. It is important for all applicants to understand what services are covered by Medicaid and what services are not covered by Medicaid, so that financial planning can be assessed ahead of time.

Download our detailed guide for more about Medicaid costs and covered services available to enrollees.