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State Medicaid waiver funding explainer

Florida Medicaid waiver funding, explained

This page explains one funding baseline. It also explains what that baseline cannot prove.

Sources checked:

The federal government and Florida both help fund Florida Medicaid.

For Federal fiscal year 2026 (October 1, 2025 through September 30, 2026), the regular Federal Medical Assistance Percentage (FMAP) for Florida is 57.22% (Federal fiscal year 2026). The corresponding state share is 42.78% (Federal fiscal year 2026).

These are baseline matching percentages for qualifying medical-assistance spending subject to the regular rate. They are not a verified funding split for every waiver, service, payment, or person.

1

What this program is

Florida Medicaid is Florida's Medicaid program. It is administered by the Florida Agency for Health Care Administration.

Florida lists section 1115, section 1915(b), concurrent section 1915(b) and 1915(c), and section 1915(c) home- and community-based services waivers. The state explains that section 1915(c) programs can provide approved services in home or community settings for people who would otherwise require institutional care.

A waiver is an approval that lets a state operate specified parts of Medicaid differently from ordinary program rules. Each waiver has its own authority, terms, eligible groups, services, and limits.

2

Who helps pay for it

Medicaid is jointly funded. The federal government pays an approved federal share. Florida supplies the applicable state share.

The Centers for Medicare & Medicaid Services (CMS) uses the Federal Medical Assistance Percentage (FMAP) as one matching-rate method. The regular FMAP is a baseline. Other federal matching rules can apply.

3

What the funding numbers mean

Applicable period: Federal fiscal year 2026, October 1, 2025 through September 30, 2026

Regular federal FMAP
57.22%

Federal fiscal year 2026

Calculated state share
42.78%

Federal fiscal year 2026

Calculation

100.00% (Federal fiscal year 2026) − 57.22% (Federal fiscal year 2026) = 42.78% (Federal fiscal year 2026).

The federal rate comes from the official U.S. Department of Health and Human Services notice. The state share shown here is the arithmetic remainder.

Read the official federal matching-rate notice

4

What the numbers do not prove

  • The regular FMAP does not establish the exact federal share for a particular waiver or service.
  • It does not replace an approved waiver's terms, budget rules, or special matching provisions.
  • Different rules can apply to the Children's Health Insurance Program (CHIP), some eligibility groups, administrative costs, enhanced service categories, and supplemental payments.
  • It does not prove that either government paid a particular claim.
  • It does not establish concealment, diversion, a legal violation, or any person's eligibility.

No exact waiver-specific allocation is stated here because the controlling sources do not establish one common allocation for every Florida waiver.

5

Where to ask for help

Start with the state agency for applications, eligibility, coverage, claims, replacement cards, and provider questions. CMS directs these questions to the state Medicaid agency.

If a written notice denies, reduces, suspends, or ends Medicaid, read that notice promptly. It should explain how to request the state's fair-hearing process and the applicable deadline.

Open the official CMS state-help directory

6

Where to raise a federal concern

General federal Medicaid contact

CMS lists 877-267-2323 and 410-786-3000. The toll-free teletypewriter (TTY) number is 800-877-8339.

CMS describes this channel as general policy guidance and technical assistance. It does not replace the state agency or a state fair hearing.

Read the CMS contact boundary

Federal civil-rights concern

If you believe a covered health or social-service program discriminated because of disability or another protected characteristic, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) provides a complaint process.

Filing does not guarantee jurisdiction, investigation, enforcement, response time, or an outcome.

Read the official HHS OCR complaint instructions

This page gives general public information. It does not provide individualized legal advice.

Official sources

Use the official pages for current program terms and contact information.

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