Medicaid Enrollment, Homeless Services, Utility and Housing Assistance: A Practical Guide for Florida Seniors, Families, and Caregivers

If you’re juggling health care, rent, and utility bills, you’re not alone—and there are programs designed to help. This guide pulls together what’s new and what works, with concrete steps to enroll in Medicaid, connect with homeless services, and lower your home energy costs. It focuses on practical actions for Florida residents, while highlighting national policy changes that may affect what benefits are available.

Why this matters now

  • Homelessness remains a growing challenge. The U.S. Department of Housing and Urban Development’s latest one‑night snapshot counted more than 770,000 people experiencing homelessness in January 2024—an 18% increase from 2023, per HUD’s 2024 Point‑in‑Time report (HUD).
  • Many eligible people are still not enrolled in Medicaid. Research cited by the American Medical Association’s Journal of Ethics found that in a study of 725 adults experiencing chronic homelessness in 11 cities, almost 75% of Medicaid‑eligible individuals were not enrolled (AMA Journal of Ethics).
  • Medicaid is evolving to address health‑related social needs. CMS has been approving state demonstration waivers that integrate primary care, behavioral health, and social supports, including housing‑related services (CMS approval of New York’s 1115 amendment). Some states are even testing time‑limited rent help under Medicaid waivers (California Healthline).

Part 1: Medicaid—How to Enroll and Keep Coverage

Who may qualify

Medicaid provides no‑ or low‑cost coverage to low‑income adults, seniors, children, pregnant people, and people with disabilities. Eligibility and benefits vary by state, but for people experiencing homelessness, Medicaid can be a critical lifeline for primary care, behavioral health, substance use treatment, medications, and transportation. The AMA Journal of Ethics also notes that Medicaid funds, under certain waivers, can support services that help people prepare for, transition to, and maintain housing, plus behavioral health and some transportation supports (AMA Journal of Ethics).

Step‑by‑step enrollment

  • Gather information you have.
  • Personal details: full name, date of birth, and, if you have it, Social Security number.
  • Income: recent paystubs or a statement of no income.
  • Proof of Florida residence: if you don’t have a traditional address, be prepared to provide a reliable mailing location (for example, a trusted service provider’s address where you can receive mail). Clinicians and community organizations often help people experiencing homelessness complete Medicaid enrollment, according to the AMA Journal of Ethics (AMA Journal of Ethics).
  • Apply the way that works for you.
  • Online or by phone through the state’s Medicaid agency.
  • In person with a community assister. Healing Tampa Bay’s team can help you prepare documents, complete applications, and follow up on your case.
  • Respond quickly to requests. If Medicaid asks for verification (income, identity), submit it as soon as possible to avoid delays.
  • If you’re denied, appeal. Many denials are fixed with more documentation or a short hearing. Bring any medical or financial updates to your appeal appointment.

Keeping your Medicaid active

  • Watch for renewal mail. Renewals are back nationwide, and failing to complete them can end coverage even if you’re still eligible. CMS has emphasized oversight and integrity in eligibility processes (CMS fact sheet on Section 1115 review process).
  • Update your contact information. If you move or change mailing locations, update Medicaid immediately so you don’t miss renewal notices.
  • Ask for help with “good cause” or reinstatement. If you missed a renewal for reasons beyond your control, community assisters can help you request reinstatement.
  • Avoid duplicate coverage issues. CMS recently flagged potential duplicate enrollment across Medicaid and ACA exchange plans, which can cause billing confusion. If you receive notices about overlapping plans, contact an assister to resolve it (CMS press release on duplicate enrollment).

What Medicaid can do for people facing housing instability

  • Housing‑related services via waivers. According to the AMA Journal of Ethics, Medicaid funds can be used (under specific waiver authorities) to help people prepare for and transition to housing, identify housing options, and provide services that support tenancy; Medicaid can also fund behavioral health and some transportation (AMA Journal of Ethics).
  • Integrated care models. CMS approved New York’s demonstration to connect primary care, behavioral health, and community‑based organizations to address health‑related social needs—an example of the direction some state Medicaid programs are taking (CMS on New York 1115).
  • Limited rent support in some states. According to California Healthline’s reporting, Arizona received approval to provide rent payments for up to six months and transitional housing supports under its initiative. These policies vary by state and are time‑limited and targeted (California Healthline).

Bottom line: In Florida, eligibility and benefits are state‑specific, but you should still ask your Medicaid managed care plan and your assister whether you have access to housing‑related case management, behavioral health, transportation, or other supports that can stabilize your health and housing.

Part 2: Homeless Services and Housing Assistance—What to Know and Ask For

The scale of need and why health systems are involved

HUD’s most recent Point‑in‑Time assessment underscores the scale of homelessness nationally (HUD 2024 PIT). At the same time, health systems and Medicaid are increasingly recognizing housing as foundational to health. The AMA Journal of Ethics highlights that supportive housing linked with health care can improve outcomes and reduce costs, and urges closer collaboration between Medicaid and housing providers (AMA Journal of Ethics).

Practical actions you can take

  • Ask about coordinated entry. Communities typically use a “coordinated entry” process to match people to shelters, transitional programs, or permanent supportive housing. If you’re working with a clinic, hospital, or case manager, ask them to refer you and document your health needs, which can affect prioritization.
  • Request housing‑related services from your care team. Even when direct rent isn’t covered, Medicaid plans may offer case management, behavioral health treatment, substance use services, or transportation that can stabilize your situation while you seek housing support (AMA Journal of Ethics).
  • Keep all medical and shelter documentation. Discharge papers, letters from providers, and proof of chronic health conditions can support eligibility for certain housing programs.
  • Stay reachable. If you lack a reliable mailing address, ask a trusted service provider about receiving mail there, and check in weekly for time‑sensitive notices.

Part 3: Utilities Assistance—Lowering Energy and Water Costs with LIHEAP/LIHWAP

If your household is behind on utility bills or facing shutoff, the Low Income Home Energy Assistance Program (LIHEAP) and related programs can be lifesavers.

What LIHEAP does

  • Helps with home energy bills and crises. LIHEAP can assist with heating or cooling costs, and states report on how many households had services restored or loss of service prevented—underscoring LIHEAP’s role in avoiding shutoffs (Administration for Children and Families—LIHEAP).
  • State‑set income limits and benefits. Each state sets maximum income cutoffs (for example, for a four‑person household) and determines benefit levels. The ACF guidance outlines that states must report average benefits and maximum income cutoffs by assistance type each year (ACF LIHEAP guidance).

How to apply effectively

  • Apply early if you can. Funding is limited and often first‑come, first‑served.
  • Bring what’s requested. Be ready with identification, proof of income, your latest utility bill, and any shutoff notice.
  • Ask about crisis assistance. States track prevention of loss and restoration of energy service—if you have a shutoff notice, make that clear (ACF LIHEAP guidance).
  • Reapply when needed. Assistance is generally not automatic from year to year.

Water and wastewater help

  • Some communities offer Low Income Household Water Assistance (LIHWAP) or local water‑bill relief. While program availability and funding vary, ask your local utility or community assistance organization about current options. The ACF site lists LIHWAP among related programs (ACF LIHEAP/LIHWAP overview).

Part 4: What’s Changing in Medicaid Policy—and What It Means for You

  • States are testing new approaches via Section 1115 demonstrations. CMS describes an improved process for reviewing/approving these projects, which let states pilot services that address health‑related social needs (HRSN) and integrate care (CMS 1115 process fact sheet).
  • New York’s 1115 amendment shows how Medicaid can link primary care and community supports, including behavioral health—approaches that can benefit people with unstable housing (CMS on New York 1115).
  • Some states are piloting limited rent support. California Healthline reports that Arizona’s approved initiative can pay rent for up to six months and offer transitional housing for targeted populations—policies that may emerge in other states in tailored ways (California Healthline).
  • CMS is emphasizing eligibility integrity and avoiding duplicate coverage. If you receive confusing notices about your coverage or plan overlap, seek assistance to correct your record and avoid gaps or unexpected bills (CMS newsroom highlights).

Action checklist for Florida residents

  • Medicaid enrollment
  • Start your application and get help with documentation. Healing Tampa Bay can help you apply, upload verifications, and track your case.
  • If experiencing homelessness, ask a clinic, hospital, or community organization to help you complete enrollment and serve as a mailing contact if needed, consistent with the AMA Journal of Ethics’ recommendations for clinician involvement (AMA Journal of Ethics).
  • After approval, note your managed care plan’s member services number and ask what non‑medical supports (case management, behavioral health, transportation) are available.
  • Medicaid renewals
  • Keep your contact information updated.
  • Open all mail right away and respond to renewal requests before the deadline.
  • If you lose coverage but think you’re still eligible, request a reconsideration or appeal.
  • Utilities assistance
  • Apply for LIHEAP as soon as funds open. Bring your utility bill and any shutoff notice. Emphasize crisis status if applicable—states track prevention/restoration as key LIHEAP outcomes (ACF LIHEAP).
  • Ask your utility company about payment plans or medical hardship protections while your LIHEAP application is pending.
  • Homeless services and housing support
  • Ask a health care provider or case manager to help you access the community’s coordinated entry system for shelter or housing programs.
  • Keep medical documentation handy—it can affect prioritization and help you qualify for supportive services.
  • If enrolled in Medicaid, ask your plan about housing‑related case management, behavioral health, and transportation supports that can stabilize your situation while you seek housing resources, in line with what states are increasingly pursuing under CMS guidance and waivers ([AMA Journal of Ethics](https://journalofethics.ama-assn.org/article/how-medicaid-and-states-could-better-meet-health-needs-persons-experiencing-homelessness/2021-11