Frequently Asked Questions

Florida KidCare is the brand while Florida Healthy Kids is one of the four program options. 

Florida KidCare has four program options. Eligibility is primarily based on a family’s household size and gross annual income, along with the child’s age and health care needs. Eligible children are automatically placed in the best fit program.

1. Florida Healthy Kids (FHK) for children ages 5 until the 19th birthday
2. Medicaid for children from birth until the 19th birthday
3. MediKids for children ages 1 until the 5th birthday
4. Children’s Medical Services (CMS) Health Plan (for children from birth until the 19th birthday who have special health care needs). Children enrolled in CMS Health Plan with mental health or substance use concerns may also be eligible for the Behavioral Health Network.

Here’s how to contact us:

Phone: 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays
Fax: 1-866-867-0054
Email: contactus@healthykids.org

You can also send us letters by mail. There is one address for letters and one for payments.

For letters:

Florida KidCare
P.O. Box 980
Tallahassee, FL 32302-0980

For payments:

Florida KidCare
P.O. Box 31105
Tampa, FL 33631-3105

Find us on social media:

• Facebook: @FLKidCare
• X (Twitter): @FLKidCare
• YouTube: @FloridaKidCare
• Instagram: @FLKidCare

The Children’s Health Insurance Program (CHIP) provides federal funds to help pay for health insurance for children in low-income families. The federal government has guidelines for CHIP, but each state designs and runs its own program.

In Florida, these programs make up the federally authorized CHIP program:

• Florida Healthy Kids
• MediKids
• Children’s Medical Services
• (CMS) Health Plan

Once we get a completed application and all required documents, you should get a letter in a couple of weeks. If we have to ask for more information or documents, the decision could take up to six weeks. Once your application is approved, you must pay your payment to start coverage. Coverage starts on the first day of the month after your child is found eligible and the first month’s payment is made. You will have a monthly payment after that.

To learn the status of your application, log in to your Parent Portal account anytime or chat online with a live agent during business hours.

You can also call us at 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays, and select Option 4. You will need the confirmation number sent to you when you submitted your application.

It usually takes 24-48 hours for us to receive an application submitted online. It takes 7-10 business days for a mailed application.

An application can be pending because it’s missing information. You must submit this information and we must receive it within 45 days. You can upload documents in your Parent Portal account or chat online with a live agent during business hours.

Examples of missing information include:

• Missing Social Security number (SSN) for a child applying for coverage
• Missing date of birth for a child applying for coverage
• Missing name for a child or parent
• Application not signed
• Relationship of the child applying to coverage to other members of the household
• Incomplete employment and income information

You can apply for coverage as soon as you have a Florida address. Make sure to use your new Florida address when you apply.

We will send a written notice acknowledging your dispute within 3 calendar days from receipt of the dispute. It will tell you what to do next.

Your health or dental plan has a process for you to submit disputes, appeals, and grievances about providers, treatments, and coverage. To make sure you receive the support you need, contact your plan. They can review your information, address your concerns, and give you more details.

Your child could lose coverage if:

• You do not make payments on time. To avoid this, you can set up AutoPay.
• You do not renew your account every year
• Your child reaches 19 years of age
• You move out of Florida
• Your child is incarcerated
• Your child has other health insurance, like private or employer-sponsored insurance.

There may be other reasons a child could lose coverage. If you have questions, chat online with a live agent during business hours or call Florida KidCare at 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays.

We can review the family account to determine what caused the eligibility loss.

Children who continue to meet eligibility requirements may reenroll in Florida KidCare without reapplying. Children whose coverage has been canceled because they did not meet eligibility requirements must reapply.

You can access your Parent Portal account to reapply. Your information should automatically appear in the application.

The Children’s Health Insurance Program (CHIP) is a low-cost Florida KidCare program for families who earn too much to qualify for Medicaid and less than 215% of the federal poverty level (FPL). The monthly cost ($15 or $20) depends on household size and income. This monthly payment covers all children in the same household who are eligible for CHIP coverage.

CHIP coverage includes health, dental and vision coverage with low or no copays.

MediKids full-pay covers health, dental and vision for $248.21 per child per month. No copay is required for services.

Florida Healthy Kids full-pay covers health, dental and vision for $276 per child per month. Families may choose to opt out of dental coverage for a monthly payment of $256 per child. A small copay is required for certain services.

Children’s Medical Services Health Plan does not have a full-pay option.

Yes. For CHIP (subsidized) coverage, out-of-pocket costs are limited to 5% of your family’s gross annual income. This is your yearly income before taxes and other deductions each plan year. The plan year is your child’s “continuous eligibility” period, which starts when your child enrolls and lasts for 12 months.

Out-of-pocket costs for CHIP coverage include any copays your family pays plus the monthly CHIP payment.

Gather your receipts for out-of-pocket costs and chat online with a live agent during business hours or call us at 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays.

Once your receipts are verified, we will send a letter saying you do not owe any monthly payments or copays for CHIP coverage the rest of the plan year. The plan year is your child’s “continuous eligibility” period, which starts when your child enrolls and lasts for 12 months.

You can show this letter to providers. Your child’s plan will also tell providers that your family does not owe any copays.

You must pay the monthly payment and copays when your child’s next plan year starts. You must make the payment the month before for the next month’s coverage.

CHIP coverage includes dental care. Florida Healthy Kids full-pay provides dental coverage for $15 extra per month. Families can choose to opt out of full-pay dental coverage.

Your Florida KidCare health plan and dental plan will send you an identification card. Show this card at the doctor’s office and pharmacies. If your child needs services before you get the card, ask your plan how to get a digital card on your mobile phone, or ask your provider to look your child up to check enrollment.

If you are not receiving paperless notifications, make sure the email address and cell phone number on file are correct.

If you have confirmed your email address and phone number are correct but are still not seeing letters in your Parent Portal account, chat online with a live agent during business hours or call 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays.can choose to opt out of full-pay dental coverage.

You signed up for paperless notifications. If you want to start getting letters mailed to you, log in to your account and select Mail under Communications Preference. You can also chat online with a live agent or call 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays, to turn paperless notifications off.

Yes. You can choose to receive letters by mail and also in your Parent Portal account. To change your communication preferences, you can log in to your account or chat with a live agent or call 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays.

Payments are due on the first day of each month for the next month’s coverage. For example, to have coverage March 1, we need to receive your payment by February 1.

You can make payments online through the automated system, by mail or by logging in to your Parent Portal account, and setting up automated payments. Payments are posted the next business day.

You can confirm your payment has been received by logging in to your Parent Portal account or chatting with a live agent calling 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays. You should allow 1 to 2 business days for online, cash and phone payments and 5 to 7 business days for checks (to account for the mailing time).

Generally, you have 90 days to change plans when your application is approved and when you renew coverage 12 months later. These 90-day periods are called your open choice period. You may have good-cause reasons to be able to change plans outside of the open choice period. If your child is in:

• Florida Healthy Kids and you are in your open choice period, you can log in to your Parent Portal account to change plans; otherwise, you can chat with a live agent or call 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays.
• MediKids, call 1-877-506-0578.
• Medicaid, call 1-877-254-1055.
• Children’s Medical Services (CMS) Health Plan, call 1-866-799-5321. Your only option will be to leave the CMS Health Plan and join a Florida Healthy Kids or MediKids plan, depending on your child’s age.

To process a plan change, we can access the family account and see how we can assist them.
The plans can be changed:

• The first 90 days during the open choice period
• During a child’s annual renewal period
• During the 90-day open choice period following the annual renewal

If your child is in:

• Florida Healthy Kids and you are in your open choice period, you can log in to your Parent Portal account to change plans; otherwise, you can chat with a live agent or call 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays.
• MediKids, call 1-877-506-0578.
• Medicaid, call 1-877-254-1055.
• Children’s Medical Services (CMS) Health Plan, call 1-866-799-5321. Your only option will be to leave the CMS Health Plan and join a Florida Healthy Kids or MediKids plan, depending on your child’s age.

Each Florida KidCare program has its own set of benefits.  All Florida Healthy Kids plans cover the same benefits, but they do offer different, extra benefits, like swimming lessons. MediKids plans all cover the same benefits as Medicaid, but there are some differences between plans. Children’s Medical Services (CMS) Health Plan has one health insurance company and one dental insurance company. CMS Health Plan generally provides the same benefits as Medicaid and MediKids.  

When choosing a plan, your family should consider: 

• The services your child needs 
• The plan your doctor accepts 
• The kind of doctors your child needs, such as a pediatrician, family doctor, and specialists 
• Any extra benefits your child needs 

Yes. Except in emergencies, your child must go to a network provider for services to be covered. You may also need to get a referral from your child’s primary care provider to see a specialist. To learn more about the providers in your plan’s network, contact your plan. Except for emergencies, if you see a provider outside of the network, you may be responsible for the entire cost. 

Yes. You can choose any doctor in your plan’s network. There may be different doctors in each plan. 

A network provider is a provider that has a contract with a plan to see enrollees.

These providers can include: 

• Doctors 
• Dentists 
• Hospitals 
• Pharmacies 
• Medical supply companies 

To learn more about the providers in your plan’s network, contact your plan. 

Questions may include:   

• How can I get a referral? 
• When is a referral required or needed? 
• Are there other requirements like referrals? 
• How do I find a specialist if there are no network specialists in my area? 
• What do I do if a specialist is needed for services? 

The requirements for referrals and prior authorizations differ between plans. To make sure you get the support you need, contact your plan. They can review your information, address your concerns, and give you more details. 

Questions may include:   

• What requirements does my plan’s network have to meet? 
• What can I do to reduce the wait time at an appointment? 
• Who should coordinate sending medical records and getting bills paid? 
• Where should I send my medical bills?  

Information about health care providers, services and medical billing can differ between plans. To make sure you get the support you need, contact your plan. They can review your information, address your concerns and give you more details. 

Florida Healthy Kids will send that information to the IRS. A parent may still request a copy of their child’s 1095B tax form if they would like one. They will need to call Florida KidCare at 1-888-540-KIDS (5437).

No. Children in Healthy Kids already receive help with the cost of their coverage Children who can get Healthy Kids for $20 per month or less can’t get a premium tax credit.

Premium tax credits are not available for Florida Healthy Kids full-pay participants. If you want a premium tax credit, you must apply for coverage through the healthcare.gov website during open enrollment.

Most parents with children on Florida Healthy Kids may qualify for a premium tax credit through the Federal Marketplace, although there are times when that isn’t the case. You can find more information at healthcare.gov.

Only children that are eligible for the full-pay program have the option to participate with their parents in the Marketplace. Children who can get Florida Healthy Kids for $20 per month or less must by law remain in this program.

Only one parent can claim the child as a dependent. That is the parent who will report the coverage and who might owe a penalty if the child goes without health insurance.

No. You can request a copy of any year your child was enrolled in Florida Healthy Kids and would have received a 1095B tax form. You may contact Florida KidCare at 1-888-540-KIDS (5437) to make this request.

Parents will no longer receive a mailed 1095B tax form starting with the 2020 calendar year. This information will automatically be provided to the IRS, so there is no action needed on the part of a parent. However, a parent may request a copy of their child’s 1095B tax form by contacting Florida KidCare at 1-888-540-KIDS (5437) to make this request.

Create a Parent Portal account and submit a new application. Once approved, use your Family Account Number to access your account information.  

To link to your account, click Manage your Parent Portal. Give one of these sets of information: 

• Family Account Number, date of birth, and Social Security number 
• Date of birth, email, first name, last name, and ZIP Code 
• Social Security number, email, first name, last name, and ZIP Code 

The most secure way to submit documents online is: 

1. Log in to your Parent Portal account on FloridaKidCare.org.  
2. Click Document uploads.  
3. Click Upload a new document.  
4. Select a reason you are uploading a document to your account.  
5. Click the type of document you want to upload.  

These are the requirements to upload documents: 

• Each file must be under 10MB. 
• Approved file types are .jpg, .jpeg, .gif, .pdf, .png, and .tif.  
• Files in other files types, such as .doc, .docx, .xls, .xlsx, .ppt, or .pptx, need to be converted into an approved file type or .rtf. 
• Zip files are not accepted. 
• Files cannot be password-protected, secure, encrypted, or corrupted. If they are, we can’t open them.  
• Files should be related to the application or renewal process. Florida KidCare does not process medical bills, claims or any other types of bills. 
• Do not include any protected health information.  

You can also email documents to contactus@floridakidcare.org or submit a document by chatting online with a live agent during business hours. 

If you forget your Parent Portal account password, follow these steps: 

1. Click Forgot your username or password? 
2. Enter your username, email, or your family account number found on letters or emails from Florida KidCare. 
3. Click Send code. You will receive an email at the address associated with your Parent Portal account. The email will have a 6-digit code that expires in one hour. 
4. Click Continue. 
5. Enter the 6-digit code from the email. 
6. Enter your username, email, or family account number. 
7. Create a password and re-enter it to confirm. 

• Minimum length of 10 characters 
• At least one number 
• At least one special character 
• At least one uppercase letter 
• At least one lowercase letter 
• Click Reset and log in. 

If you cannot reset your password using these steps or have problems logging in, you can chat with a live agent or call 1-888-540-KIDS (5437) Monday – Friday, 7:30 a.m. – 7:30 p.m., Eastern Time, except holidays.