Starting this Thursday, Florida's annual open enrollment period for the Statewide Medicaid Managed Care (SMMC) begins. This 60-day window allows current Medicaid Managed Care beneficiaries to evaluate their coverage options and switch plans without needing to provide justification to the state, as reported by the Agency for Health Care Administration (AHCA).
The enrollment period runs from October 1 to November 30, 2026, with any plan changes taking effect on December 1.
Understanding Open Enrollment
It's crucial to note what this open enrollment period is—and isn't. This isn't the time for first-time Medicaid applications, nor does it involve Medicare, the Health Insurance Marketplace, or the Affordable Care Act. It specifically concerns those already enrolled in Florida's Medicaid Managed Care who wish to switch their managed care plans.
When Can You Change Your Plan?
The official program website in Spanish outlines three scenarios in which a beneficiary can change their plan: within the first 120 days after initial enrollment, during the annual open enrollment period, or any time with a state-approved justified reason.
Outside these instances, there is what the program refers to as a "no-change season," during which plan modifications aren't allowed unless justified by an approved reason.
"If you have been approved for Medicaid, you can change your plan within the first 120 days of enrollment. After 120 days, you can only change your plan during your open enrollment period or with a state-approved justified reason," states the official portal.
How to Manage Plan Changes
The program provides several official methods for changing plans:
- Online Portal: Through the FL Medicaid Beneficiary Portal, where you can access account information and manage plan changes.
- Phone: Call 1-877-711-3662. To use the automated system, you'll need the PIN from the state's letter, the Florida Medicaid number or Gold Card number, and the birth year of each enrolee.
- Phone Advisors: Available at 1-877-711-3662. TDD users can call 1-866-467-4970.
- Text Message: During open enrollment, start the process by texting ENROLL to 357662.
If beneficiaries lack their Medicaid number or PIN, they can contact the Florida Department of Children and Families for the necessary information.
Special Considerations for CMS Plan Beneficiaries
October 1 also marks the transition for the Children's Medical Services (CMS) Plan: beneficiaries previously covered by the Sunshine State Health Plan are automatically moved to Molina Healthcare of Florida, requiring no additional action.
Those in this situation have continuity of care protections for up to 240 days, until May 31, 2027, or until a new care plan is completed and services authorized, whichever comes first.
For Cubans receiving Medicaid and adjusting their status under the Cuban Adjustment Act, this coverage does not impact their immigration adjustment due to public charge reasons. Those pursuing residency through other immigration routes should be aware of the new public charge rules effective from September.
"Once a year, beneficiaries will have the opportunity to change plans during open enrollment. Beneficiaries will receive a reminder letter before this period," the official program portal reminds.
Florida Medicaid Enrollment FAQs
Who is eligible to change their Medicaid plan during open enrollment?
Current beneficiaries of Florida's Medicaid Managed Care are eligible to change their plans during the open enrollment period.
What happens if I miss the open enrollment period?
If you miss the open enrollment period, you can only change your plan if you have a state-approved justified reason or during the next enrollment period.
How can I change my Medicaid plan?
You can change your Medicaid plan through the online portal, by phone, or via text message during the open enrollment period.