Florida KidCare is not one program. It is the name for four children's coverage programs, and they do not all cover ABA the same way. If your autistic child is on KidCare, or you are about to apply, the part of KidCare your child lands in can decide whether ABA is covered at all. This guide compares the four parts and gives you a checklist for what to ask.
What are the four parts of Florida KidCare?
The Florida KidCare website describes KidCare as "the brand name for the four income-based health insurance programs, Medicaid, MediKids, Florida Healthy Kids and the Children's Medical Services (CMS) Health Plan." KidCare says it matches each child to one of the four based on the child's age, household size and family income. You apply once, and KidCare places the child.
- Medicaid for children, with eligibility determined by the Department of Children and Families (DCF). KidCare lists it for children from birth until the 19th birthday. (The Medicaid behavior analysis benefit itself runs to age 21 for anyone enrolled in Medicaid.)
- MediKids, administered by AHCA, for children from age 1 until the 5th birthday.
- Florida Healthy Kids, administered by Florida Healthy Kids Corporation, for children from age 5 until the 19th birthday.
- CMS Health Plan, for children with special health care needs, with a Medicaid option and a subsidized CHIP option.
MediKids, Healthy Kids and the CHIP side of the CMS Health Plan make up Florida's Children's Health Insurance Program (CHIP, federal Title XXI). Medicaid is Title XIX. That federal split matters, because the Medicaid rules for children (including the EPSDT benefit) do not automatically apply to CHIP programs.
Which KidCare programs cover ABA?
| Program | Ages (per KidCare) | ABA coverage | Where that comes from |
|---|---|---|---|
| Medicaid | Birth to 19th birthday (Medicaid BA benefit runs under 21) | Yes, when medically necessary, with a physician's order, a Comprehensive Diagnostic Evaluation and prior authorization. No copay. | Rule 59G-4.125 and the BA coverage policy |
| MediKids | Age 1 to 5th birthday | State law says MediKids benefits are the same as children's Medicaid benefits under ss. 409.905 and 409.906. The BA coverage policy lists s. 409.906 as its legal authority, so BA falls within those benefits. Confirm with the plan. | Fla. Stat. 409.8132(5) |
| Florida Healthy Kids | Age 5 to 19th birthday | No. KidCare's benefits page says Healthy Kids "does not cover applied behavioral analysis (ABA) therapy services." | floridakidcare.org benefits page |
| CMS Health Plan | Medicaid: birth through 20; CHIP: 1 through 18 (per AHCA contract) | The Medicaid side follows Medicaid benefits. The contract applies its general managed care service terms to CHIP members too, unless it says otherwise, but we could not confirm from it whether BA is covered for CHIP members. Ask the plan. | AHCA contract Exhibit II-C (July 2026) |
The biggest surprise for families is Healthy Kids. A child who turns 5, or whose family income rises, can move from Medicaid or MediKids into Healthy Kids, and ABA coverage stops at that point, even though the child's needs have not changed. State law for Healthy Kids (s. 409.815) sets a benefit benchmark that includes outpatient mental health visits but does not name ABA.
How does MediKids handle ABA?
Florida Statute 409.8132(5) is short: "Benefits provided under the Medikids program component shall be the same benefits provided to children as specified in ss. 409.905 and 409.906." Behavior analysis services are authorized under s. 409.906, according to section 1.3 of the BA coverage policy. So a MediKids child generally has the same path to ABA as a Medicaid child: a physician's order, a CDE, an assessment by a BA provider in the plan's network, and prior authorization.
MediKids is for ages 1 to 5, so families should plan for the 5th birthday early. When your child ages out of MediKids, KidCare will place your child in whichever program fits. If that is Healthy Kids, ABA coverage would end. Ask KidCare in advance which program your child is likely to move to.
What is the CMS Health Plan, and who runs it now?
The CMS Health Plan is a specialty plan for children and youth with special health care needs. AHCA's July 2026 contract exhibit for the plan explains that, because of 2025 legislation, the contract that the Department of Health had procured was transferred to AHCA. The same exhibit requires the plan to state in marketing materials: "The CMS Health Plan is operated by Molina, a Managed Care Plan with a Florida Medicaid contract." Some state web pages still describe the older arrangement, so the contract exhibit is the most current source we found.
Per that exhibit, the plan serves children from birth through 20 as a Medicaid plan, and children 1 through 18 as a KidCare (CHIP) plan, if they have a qualifying condition. AHCA's Recipient Support page says a treating physician can attest to a child's clinical eligibility for the CMS plan using a Department of Health attestation form, which includes the list of qualifying chronic and serious conditions. Whether your child's diagnosis qualifies is a question for your child's doctor and the plan.
Florida's Medicaid enrollment site lists the CMS plan's member line as 1-800-262-0750.
What does KidCare cost?
KidCare says coverage is income-based and that "many families pay just $15 or $20 a month to cover all qualifying children in the household." Its benefits page says many services are free, no copay is more than $10, and there is no deductible. MediKids and Healthy Kids also offer a full-pay option for families above the subsidy level. Children's Medicaid has no premium, and Medicaid BA services have no copay. Use KidCare's own cost calculator for your family's numbers.
Decision checklist: is your child in the right place for ABA?
- Find out which KidCare program your child is in. The card or your KidCare account will show it. If you are unsure, call KidCare at 1-888-540-5437.
- If it is Medicaid or MediKids, ABA is a covered benefit when the plan finds it medically necessary. Your next step is a provider in your plan's network. See finding a Medicaid ABA provider.
- If it is Healthy Kids, ABA is not covered. Ask:
- Could your child qualify for the CMS Health Plan? Talk with your child's doctor about the clinical eligibility attestation.
- Has your household's situation changed so your child might qualify for Medicaid instead? DCF decides Medicaid eligibility.
- Does a parent have employer coverage? Florida's autism insurance law requires ABA coverage in many large, fully insured group plans. See Florida's autism insurance law explained.
- Is your child eligible for the FES-UA scholarship, which can pay for ABA from approved providers? See FES-UA for families leaving Medicaid ABA.
- If it is the CMS Health Plan, ask the plan's member services to confirm BA coverage and its network for your child's age and coverage type (Medicaid or CHIP).
- Before a birthday or an income change, ask KidCare which program your child would move to, and ask your ABA provider what records to keep ready (the treatment plan, the latest assessment and progress data).
How KidCare compares with a parent's employer plan
If a parent has access to a job-based plan, compare it with KidCare carefully. Medicaid and MediKids ABA has no copay. An employer plan may have a deductible and coinsurance, but Florida's mandate requires many large fully insured plans to cover ABA for autism and Down syndrome, and self-funded plans set their own terms. Our guide comparing Medicaid and private insurance for ABA goes through the trade-offs line by line.
How Hope Center can help
Hope Center for Behavior Change works with Blue Cross Blue Shield (Florida Blue), Aetna (employer plans), Cigna (Evernorth), UMR, Personify Health and TRICARE East, with a sliding scale for your share after insurance. A child who has Medicaid cannot be seen self-pay at Hope Center (center policy). If your child's KidCare program does not cover ABA and your family has or can get one of those plans, we can run a free benefits check and explain your likely costs before anything starts. Costs depend on your plan. See insurance at Hope Center, contact us, or call 561-337-8865.