Eligibility Criteria

Eligibility to enroll in an approved Health Flex Plan is limited to residents of the state of Florida who:

1. As of May 2011 there are no age restrictions for HealthFlex.

2. Have a family income equal to or less than 300 percent of the federal poverty level.
Please refer to the table below:

3. Are not covered by a private insurance policy and are not eligible for coverage through a public health insurance program, such as Medicare or Medicaid, or another public health care program, such as Kidcare, and have not been covered at any time during the past 6 months, except that:

a. A person who was covered under an individual health maintenance contract issued by a health maintenance organization licensed under part I of chapter 641 which was also an approved health flex plan on October 1, 2008, may apply for coverage in the same health maintenance organization’s health flex plan without a lapse in coverage if all other eligibility requirements are met; or
b. A person who was covered under Medicaid or Kidcare and
lost eligibility for the Medicaid or Kidcare subsidy due to income restrictions within 90 days prior to applying for health
care coverage through an approved health flex plan may apply for coverage in a health flex plan without a lapse in coverage if all other eligibility requirements are met; and

4. Have applied for health care coverage as an individual through an approved Health Flex plan and have agreed to make any payments required for participation, including periodic payments or payments due at the time health care services are provided; or
Are part of an employer group of which at least 75 percent of the employees have a family income equal to or less than 300 percent of the federal poverty level and the employer group is not covered by a private health insurance policy and has not been covered at any time during the past 6 months. If the health flex plan entity is a health insurer, health plan, or health maintenance organization licensed under Florida law, only 50 percent of the employees must meet the income requirements for the purpose of this paragraph.

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