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Lost Florida Medicaid? How to Get Marketplace Coverage
Help moving from Florida Medicaid to a Marketplace plan without a gap. Call or text 813-302-7151.
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3 months ago
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3 months ago
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A Medicaid termination letter starts a clock. You don't have to wait for the next Open Enrollment: you have 90 days after Medicaid ends to enroll in a Marketplace plan, and you can apply before it ends. Start with the date coverage ends and the reason Florida gave. A missing renewal document and a change in eligibility call for different next steps.
Why people are losing Florida Medicaid
Florida checks eligibility at renewal and when your circumstances change. A higher income, a change in who lives in the home or a renewal document that never arrived can end coverage. Pregnancy Medicaid also has a set end: Florida DCF says a pregnant woman stays eligible through the pregnancy and a 12-month postpartum period, regardless of income changes (Florida DCF: coverage for expecting mothers). When that period ends, the rules for adults apply again.
Read the entire notice, including the appeal instructions. If the decision seems wrong, contact the Florida Department of Children and Families: Medicaid promptly; an insurance application does not challenge the Medicaid decision for you.
Your Special Enrollment window: 90 days
Losing Medicaid or CHIP opens a Marketplace Special Enrollment Period. You have 90 days after your Medicaid ends to enroll, and you can also apply up to 60 days before it ends (HealthCare.gov: Special Enrollment Period). Applying before the end date is the best way to avoid days without coverage.
The Marketplace eligibility notice confirms your window and start date. A late application can leave a gap even when you can still enroll, so don't wait until day 89.
The gap between Florida Medicaid and Marketplace help
Florida has not expanded Medicaid; in 2024, HHS listed it among the 10 states without the ACA expansion (HHS report on Medicaid expansion). Florida Medicaid covers adults mainly if they are parents or caretakers of a minor child at home, pregnant, former foster youth, aged or disabled. Even for parents the limit is low: $478 a month for a household of two on the Florida DCF Medicaid income limits (April 2026).
So what happens next depends mostly on your income compared with the federal poverty level:
| Your yearly income | What usually happens |
|---|---|
| Below 100% of the poverty level, and you don't fit a Medicaid group | No Medicaid and no Marketplace savings. This is the coverage gap. |
| 100% to 250% | You may get a premium tax credit, plus lower deductibles and copays on a Silver plan (cost-sharing reductions). |
| Above 250% up to 400% | You may get a premium tax credit. |
| Above 400% | You can buy a plan, usually without a tax credit. |
The 100% amounts the Marketplace uses are below. Coverage for the rest of 2026 uses the 2025 guidelines; 2027 coverage uses the 2026 guidelines (HealthCare.gov: federal poverty level).
| Household size | 100% for 2026 coverage | 100% for 2027 coverage |
|---|---|---|
| 1 | $15,650 | $15,960 |
| 2 | $21,150 | $21,640 |
| 3 | $26,650 | $27,320 |
| 4 | $32,150 | $33,000 |
If your income is below the poverty level and you don't fit a Medicaid group, HealthCare.gov: Medicaid expansion and you explains that you won't qualify for either savings program. You can still buy a plan at full price, and community health centers can help with primary care. Our ACA income limits guide has the full chart. We update this page when the new figures are published.
Kids may still qualify for Florida KidCare
A parent's loss of Medicaid does not determine a child's eligibility. Children may qualify under different income rules through Medicaid or another Florida KidCare program. Keep each child's notice and check the official program separately. Covered by Guzman can point you to the right resource; Florida decides eligibility and administers those applications.
Checking your doctors when you switch
Your doctor's Medicaid network and Marketplace network are not interchangeable. Check the exact plan, office location and specialists, plus active prescriptions and the pharmacy. If you are in treatment, ask the new plan about prior authorizations and transition-of-care procedures before assuming the old approval transfers.
What to bring when you call us
Send us the termination notice through an appropriate secure channel, your ZIP code, expected annual household income and the people needing coverage. Include doctors, medications and any employer coverage offer. We review Marketplace options and timing while you address any Medicaid correction or appeal with the state. Keep paying for existing coverage until the end date is confirmed.
Official resources: HealthCare.gov: moving from Medicaid to the Marketplace; Florida KidCare.
Frequently Asked Questions
What do I do if I lost Medicaid in Florida?
Read the reason and the end date on the notice, contact Florida DCF about any error, and start a Marketplace application right away. You have 90 days after Medicaid ends to enroll, and applying before the end date helps you avoid a gap.
How long do I have to get new coverage?
You have 90 days after your Medicaid or CHIP coverage ends to enroll in a Marketplace plan, and you can apply up to 60 days before it ends. Your Marketplace eligibility notice confirms the exact window.
Is Medicaid the same as Obamacare?
No. Medicaid is a public program run by the state, while Marketplace (Obamacare) coverage is private insurance you buy through HealthCare.gov, often with a tax credit based on income.
Can my children stay on Medicaid or KidCare?
Possibly. Children are checked under their own rules, and a child may qualify for Medicaid or another Florida KidCare program even when a parent does not. Check each child's notice and apply through Florida KidCare if needed.
Will my doctors take Marketplace plans?
Some do and some don't. Check each doctor against the exact new plan and office location, because accepting Medicaid does not mean a doctor is in a Marketplace network.
Can I reapply for Medicaid?
Yes. You can apply again whenever your situation changes, for example a lower income, a pregnancy or a disability. Florida decides the result, so keep your Marketplace deadline in view while you wait.
This guide is general information, not legal, tax or medical advice. Your plan documents, including the Summary of Benefits and Coverage, control what is covered and what you pay.
About the Author
Raymundo Guzman
I am Raymundo Guzman, a licensed independent insurance agent and the owner of Covered by Guzman. On the health side, I help Florida individuals, families and small businesses compare ACA Marketplace plans, Medicare Advantage and Part D, and dental and vision coverage, checking doctors and medications before anything is submitted. I work in English and Spanish, and a member of our team speaks Arabic. We usually meet by phone or video, and I stay available after enrollment.
Independent Insurance Agent · License #W512374 | NPN #18906048 · 813-302-7151
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Send your county, household, doctors and medications and we will check the plans available to you. Call or text 813-302-7151.
