Eligibility Criteria

No age restrictions

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

Family income at or below 300% of the federal poverty level

Have a family income equal to or less than 300 percent of the federal poverty level. Contact us for the current FPL chart that applies to your household size.

No other health insurance in the past 6 months

Not covered by a private insurance policy and not eligible for coverage through a public health insurance program such as Medicare, Medicaid, or another public health care program such as KidCare, and not covered at any time during the past 6 months — except that:

• A person who was covered under an individual health maintenance contract issued by a Florida-licensed HMO that was also an approved Health Flex plan on October 1, 2008, may apply for coverage in the same HMO's Health Flex plan without a lapse in coverage if all other eligibility requirements are met; or
• 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 an approved Health Flex plan may apply without a lapse in coverage if all other eligibility requirements are met.

Application as individual or employer group

Have applied for health care coverage as an individual through an approved Health Flex plan and have agreed to make any required payments — periodic payments or payments due at the time services are provided.

OR — be part of an employer group of which at least 75 percent of 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 employees must meet the income requirements.