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Keeping Our Florida Kids Healthy

Mom and her child on a swing

Protect Your Child’s Health

Florida families have multiple health care coverage options for their kids when parents do not have an affordable offer of coverage from another source such as employment or military benefits. This blog will briefly discuss each option and explain how to navigate the choices to protect your child’s health. 

  1. Medicaid Children’s Health Insurance Program – This combined Federal-State program provides comprehensive health coverage for children under the age of 19 with a household income of up to 133% of the federal poverty level ($33,383 per year for a family of 4). Medicaid/CHIP offers full coverage for the child’s medical, behavioral health, prescription, dental, and therapy needs. There are no monthly premiums for Medicaid/CHIP and no deductibles.
  2. Florida KidCare is operated by the Florida Healthy Kids Coalition and offers three coverage options for children under the age of 19. The options are: (1) $15 per month per child for a family with income up to 158% of the federal poverty level ($39,659 for a family of 4), (2) $20 per month per child for a family with income up to 200% of the federal poverty level ($48,200 for a family of 4). KidCare’s reduced-cost plans have no deductibles and minimal co-pays. (3) KidCare also offers a Full Pay option with monthly premiums starting at $215/month for families whose income exceeds 200% of the federal poverty limit.
  3. The Health Insurance Marketplace offers plans to children in households that do not qualify for Medicaid or Florida KidCare’s reduced cost options. Families with incomes between 200.01% and 400% of the federal poverty level ($61,500 for a family of 4) typically receive financial assistance to help pay for their child’s plan. Marketplace plans are private health insurance coverage offered through commercial insurance companies. The plan choices vary by county but in all cases, plans are required to offer 10 Essential Health Benefits plus an option for dental coverage to plan participants.

Choosing the Right Plan for Your Child

The State of Florida’s No Wrong Door Policy has been established to assist parents in working through the various options to choose the best solution for their child’s health coverage needs. As Marketplace Navigators, we encourage parents to start with us! 

Our services are free and we offer unbiased education and assistance helping parents walk through the process to select the best coverage for their child. Submitting a Marketplace application will immediately alert the parent whether their child may qualify for Medicaid. However, because the final Medicaid determination is made by the State of Florida, the Health Insurance Marketplace will electronically send the application to Florida Medicaid and a representative will contact the family if the child qualifies for a free plan. If the child does not qualify for free Medicaid, the family is notified and their application is forwarded to Florida Kid Care for processing. Florida KidCare will advise the parent if the child qualifies for reduced cost KidCare coverage or full pay coverage. Navigators can help parents send in important documents that may be requested as part of the application. If the child only qualifies for full pay coverage, the parent can return to the Navigator to research Marketplace plans that may be less costly and provide the needed benefits for the child.

Choosing the right plan for your child can be confusing! As Navigators, we help parents eliminate confusion, understand the best option for their children including researching treatment facilities, medication needs, and other special services that are unique to your child.

Call us today, we are licensed by the State of Florida and focus on serving residents in Orange, Lake, Seminole, and Osceola counties. Call us at 1-877-564-5031 or email: [email protected] for an appointment. And remember, our services are FREE!

What is Florida Healthy Kids, and how can they help?

Florida Healthy Kids provides lowcost health insurance for uninsured children in the State of Florida. The program offers coverage for doctor visits, hospitalization, lab tests, xrays, prescriptions, vision care, and more. The program is designed to help families with children who have limited or no coverage from their parents employers, Medicaid, or other sources. Families may qualify for the program based on income and family size, and may also qualify for additional assistance such as reduced premiums and additional coverage.

Nicholas Williams

Marketing Director for Primary Care Access Network
[email protected]

Please Note: While Covering Central Florida has compiled the information on this page diligently and to the best of its knowledge, Covering Central Florida does not assume any liability for the accuracy of the information or any damages resulting from the use of the information.
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Covering Central Florida is a program of Primary Care Access Network, a 501c3 nonprofit. All Marketplace Navigators are certified and  licensed by the State of Florida.

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Open Enrollment has ended, but you may be eligible for the Special Enrollment Period.
Open Enrollment for 2023 has Started
and runs through Sunday, January, 2023.

Covering Central Florida Marketplace Navigators are available to help answer any questions, listen to feedback, or other inquiries using our support form. All services are offered completely free of charge to everyone.

The Special Enrollment Period is a time outside the yearly Open Enrollment Period when you can sign up for health insurance based on certain life events. 

👋 Before You Go
You may qualify for year-round Health Insurance Marketplace enrollment, if your household income is no more than:

$19,320 for individuals
$26,130 for a family of 2
$32,940 for a family of 3
$39,750 for a family of 4
$46,560 for a family of 5
$53,370 for a family of 6

Covering Central Florida is federally funded, and services are offered completely free of charge.