Ask Medicaid Florida

Rural Preventive Care Funding

The federal government announced more than $193 million through the CMS Press Release to expand preventive care and rural specialty healthcare access across Florida.

6 days ago | [YT] | 0

Ask Medicaid Florida

Immigrant Coverage Changes

Under recent federal policy adjustments taking effect October 1, 2026, most lawfully present immigrants face tighter eligibility restrictions, impacting notices sent to roughly 177,000 enrollees across Florida who must submit updated verification documents.

6 days ago | [YT] | 0

Ask Medicaid Florida

SMMC 3.0 Transition: Pharmacy Continuity of Care

The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. The Agency recently entered into new contracts with health and dental plans effective February 1, 2025. Under the new Statewide Medicaid Managed Care (SMMC) contracts, plans are still required to ensure continuity of care (COC) during the transition period for Medicaid recipients enrolled in the SMMC program.

Learn more www.askmedicaidflorida.com/post/smmc-3-0-transitio…


To ensure a smooth transition of enrollees from the fee-for-service (FFS) delivery system or a health plan to another health plan, the Agency fiscal agent pharmacy system will support point of sale messaging to all pharmacies attempting to process claims during the transition period. To ensure no disruption in current services, health plans will allow enrollees to continue to receive their prescriptions through their current provider, for a minimum of 90 days, until their prescriptions can be transferred to a provider in the plan’s network.

1 week ago | [YT] | 2

Ask Medicaid Florida

Statewide Medicaid Managed Care Open Enrollment Begins October 1, 2026

The Statewide Medicaid Managed Care annual open enrollment (OE) season begins October 1, 2026 and ends November 30, 2026, for all enrollees in all regions. During open enrollment, enrollees may choose a different managed care plan or remain with their current plan.

Enrollees can change plans using one of the following methods:

Text ENROLL to FLSMMC (357662). Enrollees will need the Medicaid ID number of each member and the account PIN number.

Go online at www.flmedicaidmanagedcare.com/ to create a Member Portal account or chat with our Enrollment Virtual Assistant.

Call 1-877-711-3662 to speak with a Choice Counselor.

4 weeks ago | [YT] | 0

Ask Medicaid Florida

REMINDER: Effective October 1, 2026, the operation of the Children’s Medical Services (CMS) Plan will move from Sunshine State Health Plan, Inc. to Molina Healthcare of Florida, Inc.

The Agency previously announced (Medicaid Health Alert) that effective October 1, 2026, the operation of the Children’s Medical Services (CMS) Plan will move from Sunshine State Health Plan, Inc. (Sunshine) to Molina Healthcare of Florida, Inc. (Molina).

To ensure no disruption in current services and to support continuity of care (CoC), Molina will have a CoC period of up to 240 days (8 months). The CoC period covers services authorized by Sunshine Health and documented courses of treatment that are in effect and being delivered as of 10/1/2026 until the authorization, course of treatment, or CoC period ends, or until a new care plan is finalized and new services are authorized, whichever occurs first.

Regardless of contracting status, enrollees may continue seeing their current providers until May 31, 2027, or until their new care plan is finalized and ongoing services are authorized, whichever occurs first. Molina is required to reimburse non-participating providers at the rate they received for services rendered to enrollees prior to the transition for up to eight months, unless there is an agreement to an alternative rate.

For member questions regarding this transition, contact Molina Member Services at 1-800-262-0750. For provider questions regarding this transition, contact Molina Provider Services at 1-855-322-4076.

1 month ago | [YT] | 0

Ask Medicaid Florida

Summary Description of the Waiver Amendment Request

The Familial Dysautonomia Waiver provides home and community-based services to eligible recipients to promote, maintain and optimize the health of individuals in order to delay or prevent institutionalization.

Changes to the approved waiver in the amendment application include:

Updating waiver service rates and rate-setting methodology
Clarifying provision of transportation within the scope of service for Non-Residential Support Services
To review the full waiver document, please visit the Agency’s website “Familial Dysautonomia Waiver” at: ahca.myflorida.com/medicaid/home-and-community-bas…

1 month ago | [YT] | 0

Ask Medicaid Florida

DeSantis Administration Accused of Misusing $10 Million in Florida Medicaid Settlement: What the Grand Jury Found www.askmedicaidflorida.com/post/desantis-administr…

Why the grand jury called it "misappropriated"

The grand jury concluded that the $10 million in taxpayer-related funds had been misused for political purposes and described the transactions as part of what it called a sophisticated scheme to fund political activities.

Importantly, however, the grand jury did not find sufficient evidence to bring criminal charges. The report reportedly said investigators could not establish who specifically ordered the original $10 million payment to Hope Florida.

That distinction is important:

Grand jury finding: The money was misused/misappropriated.

Criminal prosecution: The grand jury did not find sufficient evidence to indict the individuals involved.

2 months ago | [YT] | 0

Ask Medicaid Florida

No Medicaid Expansion:

Florida continues to reject broader low-income adult Medicaid expansion under the Affordable Care Act, leaving a coverage gap for non-disabled childless adults earning under the federal poverty line

2 months ago | [YT] | 0

Ask Medicaid Florida

Why Florida Medicaid Stopped Covering Gender Affirming Surgeries

2 months ago | [YT] | 0

Ask Medicaid Florida

Florida Medicaid and Gender-Affirming Care for Minors
www.askmedicaidflorida.com/post/gender-affirming-s…

Florida Medicaid has taken a firm position against using Medicaid funds to pay for gender-affirming medical treatment for minors. The policy excludes puberty blockers, hormone therapy and sex-reassignment surgeries when they are provided to treat gender dysphoria.


The decision has become one of the most controversial healthcare policies in Florida, involving questions about medical evidence, parental rights, government authority, Medicaid coverage and the appropriate treatment of transgender children and adolescents.


For Florida families who rely on Medicaid, understanding what changed—and why—is important.

2 months ago | [YT] | 1