CMS Network Eligibility
Children's Medical Services (CMS) Network provides health insurance coverage for children with special needs who have no insurance or who are under insured for their condition. CMS Network eligibility is based on the child's age, clinical condition, and the family's income.
The CMS Network is one of four Florida KidCare Program options.
Families who meet the eligibility requirements for Title XIX Medicaid or Title XXI KidCare and whose child has a special health care need qualify for the CMS Network
health benefits package.
Financial Eligibility
- Title XIX Medicaid - Financial eligibility is based on the most current year's Federal Poverty Level Guidelines for your family size
- Title XXI KidCare - Financial eligibility is based on the most current year's Federal Poverty Level Guidelines for your family size
(upper limit is 200% of the
federal poverty level)
- There is not a separate full
pay coverage option for the CMS Network. Depending on the
child’s age, children with special health care needs whose
family income is above 200 percent of the federal poverty level
may enroll in full pay MediKids or Healthy Kids through the
Florida KidCare program
- CMS Network Safety Net - Children whose families are over-income for TXIX or TXXI,
may be eligible for limited
services, subject to the availability of funds, if the
cost of their child's care spends the family down to the Federal
Poverty Level Guidelines for their family size
Clinical Eligibility
- Your child's clinical eligibility is determined using a clinical screening tool that is administered by Children's Medical Services nurses.
Early Steps, Florida's early intervention system for infants and toddlers, has different financial eligibility requirements; these requirements can be found in the Early Steps area of this website.
If your child has a medical, behavioral, or developmental condition that you think might qualify him or her for Children's Medical Services, you should apply now by completing a Florida KidCare application. Florida KidCare applications are available on-line or from your local CMS Area Office.
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