Written by a parent, not a doctor. Nothing here is medical advice.

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Florida program

Child coverage above the Medicaid limit (Florida KidCare)

Florida KidCare offers child health insurance when income is above the Medicaid limit.

What it is

Florida KidCare offers child health insurance when income is above the Medicaid limit.

KidCare brings together several children’s plans. Its subsidized coverage costs $15 or $20 a month for all your children. Existing insurance and the child’s age affect which route fits.

Eligibility rules
  • MediKids covers ages 1–4 and Florida Healthy Kids covers ages 5–18. The KidCare CMS plan serves children under 19 who meet its clinical test.
  • The subsidised premium runs to about twice the poverty line, roughly $5,360 a month for four. KidCare works out the exact figure when it screens the application.
  • The quoted insurance exclusion concerns enrollment in a family member’s group or private plan costing 5% of family income or less. An unaccepted offer alone is not that exclusion.
What you get
  • Subsidized coverage for $15 or $20 a month per family.
  • Full-pay options when the subsidized income route does not fit.
  • Screening for the Children’s Medical Services Health Plan when a child has special health needs.
What the help covers
  • The 2026 chart lists $15 for the 133.01–158% poverty band and $20 for the 158.01–200% band. Medicaid eligibility is checked first.
  • Full-pay MediKids costs $248.21 per child monthly. Full-pay Healthy Kids with dental costs $276 per child monthly.
If you decide to apply
  1. Ask Florida KidCare or the hospital counselor to review one application for Medicaid and KidCare.
  2. Have ready current income and the cost and coverage details of any work plan.
  3. Ask what premium and start date would apply before changing coverage.

Florida KidCare, 1-888-540-5437 · Official page ↗

What happens next
  • Coverage begins on the first of the month after approval and the required premium. These are not Medicaid’s earlier-bill rules.
  • There is no longer a waiting period after other insurance ends. Once enrolled, your child keeps coverage for 12 months.
Good to know

An offer of work insurance you have not taken does not block KidCare or Medicaid. If your child already has other insurance, KidCare must confirm any replacement or overlap before you change it.

Other details
  • Once enrolled, children under 19 generally have 12 months of continuous eligibility, with permitted exceptions. Initial premiums, renewal and protection during that period have different rules. A premium notice needs review before assuming coverage ends.

Federal background: Children’s Health Insurance Program (CHIP).

Official sources
Ask your social worker

“Would KidCare cover our child, and how would its premium, start date and doctors compare with our other options? Could you help us check the income limit and apply if it fits?”

Why I’m asking: I want affordable coverage without a gap in treatment or an unexpected change of doctors.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Apply once at floridakidcare.org, report this month's income and any insurance, and pay the first premium the day the notice comes.

Your social worker

The social worker checks your income against both published limits and starts the Children's Medical Services Health Plan screening.

The care team

The doctor fills in the clinical screening or attestation for the Children's Medical Services Health Plan.

Who decides
Florida KidCare: the Healthy Kids Corporation handles premiums, Florida's benefits office (DCF) does the income budget, and Children's Medical Services does the special-needs screening.
Ask your social worker
“Can you help us apply for KidCare this week and ask for the Children's Medical Services plan screening? What does our work plan cost for the child, as a share of our income?”

How to apply

First step: Apply at floridakidcare.org or call 1-888-540-5437. The one application checks Medicaid first. Pay the first premium the day the notice arrives, and ask for the Children's Medical Services plan screening.

  1. Apply once through floridakidcare.org; the application checks Medicaid first.
  2. Pay the first premium the day the notice arrives.
  3. Ask for the Children's Medical Services Health Plan screening in the same call.

Official application / program page ↗

Where it starts: One KidCare application covers Medicaid and KidCare: floridakidcare.org or 1-888-540-5437 (or MyACCESS, which routes to KidCare).

What to gather

  • Child's Social Security number and birth date
  • This month's income for the tax household
  • Insurance cards, or the date coverage ended
  • What the work plan would cost for the child each month

How long: KidCare publishes no decision time. Coverage is expected to start after the first premium, not for earlier months (not confirmed). Once in, coverage lasts 12 months.

What a yes looks like

A notice with the premium ($15 or $20 a month) and the start month, and a plan choice. Ask for the Children's Medical Services Health Plan and check the hospital is in it.

What a no looks like, and the next move

Ask whether the reason was income, other insurance, or that Medicaid took your child instead (that is better: no premium and three months back). Over the limit, you can still buy full-pay MediKids or Healthy Kids, and ask the Children's Medical Services Safety Net about gaps.

Watch out

  • KidCare prints two limits: its chart says 200% of the poverty line, its FAQ says under 215%. If you fall between them, apply and let the caseworker do the math.
  • If your child is on a work plan that costs 5% of family income or less, KidCare says no. An offer you never took does not count against you.
  • Florida was approved in 2024 to raise KidCare toward 300% of the poverty line, but the 2026 chart still stops at 200%. Do not plan on the higher limit until KidCare prints it.
  • KidCare coverage begins on the first of the month after approval and the required premium. This timing does not describe Medicaid’s earlier-bill rules.

Dates that change this

2024-12-02: Florida has federal approval to go to 300% of the poverty line; the 2026 chart still ends at 200%, and no start date or premium schedule for the higher income ranges is published.

2025-06-03: No waiting period for children's insurance anywhere since June 3, 2025; Florida's law still prints a 60-day wait that is not in force.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

Full child coverage for $15 or $20 a month per family (2026 chart). If you earn too much for that, full-pay MediKids is $248.21 a child and Healthy Kids $276 a child with dental. The chart's limit is 200% of the poverty line; the FAQ says under 215%.

  • $15/month — Family premium, 133.01-158% FPL band
  • $20/month — Family premium, 158.01-200% FPL band
  • $248.21/month — Full-pay MediKids, per child
  • $276/month — Full-pay Florida Healthy Kids including dental, per child
  • $200 — Top subsidized band on the 2026 chart
  • $215 — KidCare FAQ ceiling (MAGI, 210% plus 5%)

Covers: Doctor and hospital care · Prescriptions · Dental and vision · Children's Medical Services Health Plan for a qualifying condition (no full-pay version)

What it costs the family: $15 or $20 a month per family for most. Over the limit, full-pay MediKids is $248.21 and Healthy Kids $276 a child each month; the Children's Medical Services plan has no full-pay version.

The eligibility facts, as published

Age
1 through 18 (MediKids 1-4, Healthy Kids 5-18, CMS Plan under 19 with a qualifying condition)
Age max exclusive
19
Income
over the child Medicaid line; chart ceiling 200% FPL, FAQ 215% (MAGI 210% + 5%)
Insurance status condition
excluded if covered under a family member's group or private plan costing 5% of family income or less; an offer alone is not the quoted exclusion
Waiting period
none in force since 2025-06-03; statute still prints a 60-day text
Continuous eligibility months
12
Residency
Florida

Decisions this site cannot make: KidCare income budget · Children's Medical Services clinical screening (optional)

Expect friction on: Two published income lines · First premium before coverage

The trap: KidCare prints two official numbers: the chart says 200% of the poverty line and the FAQ says under 215%. If you are anywhere near either, apply; the caseworker does the real math.

Where I read this

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