Florida's Medicaid managed care system was rebuilt on February 1, 2025. The number of regions dropped from 11 to 9, the contracts run through 2030, AmeriHealth Caritas exited, Molina won a new statewide children's contract, and the plan footprint of every other player was reshuffled. If you read a "Florida Medicaid plans" guide written before 2025, much of it is wrong. This guide isn't. We walk through every active SMMC 3.0 plan in 2026, the regions each one serves, the phone numbers you'll actually need, and the choice rules that determine whether you can switch plans this year.
How SMMC works (in 60 seconds)
Florida's Statewide Medicaid Managed Care (SMMC) program is the master architecture through which essentially all Florida Medicaid services are delivered. Three components:
- Managed Medical Assistance (MMA), acute and primary care for the general Medicaid population (children, parents, MAGI adults, MEDS-AD, dual-eligibles)
- Long-Term Care (LTC), home and community-based long-term services and supports for elderly and disabled members who meet nursing facility level of care
- Statewide Prepaid Dental, separate dental coverage statewide via DentaQuest and Liberty Dental
Three agencies make it run:
- Agency for Health Care Administration (AHCA), single state Medicaid agency; runs SMMC, contracts with the plans, sets the rules
- Department of Children and Families (DCF), financial eligibility through ACCESS Florida
- Department of Elder Affairs (DOEA), functional eligibility for LTC through CARES
If you need help getting eligibility approved before plan choice, see /medicaid/florida/how-to-apply. This guide picks up after eligibility, when you know you're enrolled and need to choose a plan.
The 9 lettered regions (effective 2/1/2025)
| Region | Geographic area | Major counties |
|---|---|---|
| A | Western Panhandle | Escambia, Santa Rosa, Okaloosa, Walton, Bay, Leon, Wakulla, Jefferson, Madison + 9 others |
| B | Northeast Florida | Duval, St. Johns, Clay, Nassau, Alachua, Volusia, Marion, Lake, Sumter + 14 others |
| C | North-Central Florida | (subset including parts of pre-2025 Region 3, overlap with B in the post-2025 map) |
| D | Tampa Bay | Hillsborough, Pinellas, Pasco, Manatee, Sarasota |
| E | Polk / Highlands / Hardee | Polk, Highlands, Hardee |
| F | Southwest Florida | Lee, Collier, Charlotte, DeSoto, Glades, Hendry |
| G | Central Florida / Orlando | Orange, Osceola, Seminole, Brevard |
| H | Treasure Coast / Palm Beach | Palm Beach, Martin, St. Lucie, Indian River, Okeechobee |
| I | South Florida | Miami-Dade, Broward, Monroe |
The exact county-to-region mapping for every Florida zip code is published at flmedicaidmanagedcare.com. When in doubt, search your zip code there.
The plans, region by region
The most-asked question in Florida managed care isn't "what plans exist", it's "what plans serve me." Here's the matrix.
| Region | LTC plans available | MMA plans available |
|---|---|---|
| A Western Panhandle | Humana, FCC | Humana, Sunshine Health, Simply Healthcare, FCC |
| B NE Florida | Humana, FCC, UnitedHealthcare | Humana, Sunshine Health, Simply Healthcare, FCC, UnitedHealthcare |
| C N-Central | Humana, FCC | Humana, Sunshine Health, Simply Healthcare, FCC |
| D Tampa Bay | Humana, FCC, Aetna, UnitedHealthcare | Humana, Sunshine Health, Simply Healthcare, FCC, Aetna, UnitedHealthcare |
| E Polk/Highlands/Hardee | Humana, FCC, UnitedHealthcare | Humana, Sunshine Health, Simply Healthcare, FCC, Community Care Plan, UnitedHealthcare |
| F SW Florida | Humana, FCC | Humana, Sunshine Health, Simply Healthcare, FCC, Community Care Plan |
| G Central FL/Orlando | Humana, FCC, Aetna | Humana, Sunshine Health, Simply Healthcare, FCC, Aetna, Community Care Plan |
| H Treasure Coast/Palm Beach | Humana, FCC | Humana, Sunshine Health, Simply Healthcare, FCC, Community Care Plan |
| I Miami-Dade/Broward/Monroe | Humana, FCC, Aetna, UnitedHealthcare | Humana, Sunshine Health, Simply Healthcare, FCC, Aetna, Molina, UnitedHealthcare, Community Care Plan |
Note: regions C and B overlap in the post-2025 AHCA map; AHCA's plan-finder is authoritative for any specific zip code.
The plans themselves
Every active SMMC 3.0 plan, what it does, where it does it, and the phone numbers you'll need:
Humana Healthy Horizons in Florida
- Member services (MMA): 1-800-477-6931
- LTC member services: 1-888-998-7732
- Web: humana.com/medicaid/florida-medicaid
Humana is the largest commercial Medicaid LTC plan in Florida by enrollment and one of two plans with a presence in every region. Strong network for LTC providers, particularly in southeast and central Florida. Uses GT Independence for the Participant-Directed Option (PDO), so members who hire family caregivers go through GT's payroll, EVV, and onboarding system.
Sunshine State Health Plan (Sunshine Health)
- Member services: 1-866-796-0530
- LTC PDO: 1-877-659-4500
- Web: sunshinehealth.com
Sunshine Health is the largest Florida MMA plan by enrollment, partly because the four statewide specialty contracts route many high-need members through Sunshine. The Comprehensive LTC Plus designation is a higher-need population than standard LTC, typically dual-eligible members with significant comorbidity. Sunshine's specialty footprint is one of the strongest in the country at the state level.
Simply Healthcare Plans
- Member services: 1-844-406-2396
- Web: simplyhealthcareplans.com
Simply is one of three plans with statewide MMA presence (alongside Humana and Sunshine) and one of the larger Elevance Health Medicaid books in the country. PDO members on Simply use Public Partnerships LLC (PPL) as their F/EA, a different vendor from the GT Independence used by Humana/Sunshine/Aetna. PPL's worker portal and EVV app are different in feel; if your family already knows GT, this is a real consideration when picking between Simply and a GT-aligned plan.
Florida Community Care (FCC)
- Member services: 1-833-322-7526 (1-833-FCC-PLAN)
- Web: fcchealthplan.com
FCC is the largest LTC-focused plan in Florida and one of the two plans every Florida senior on LTC has access to regardless of region. Particularly strong in the southwest, northeast, and panhandle markets where commercial competitors have thinner LTC networks. Uses PPL for PDO.
Aetna Better Health of Florida
- MMA member services: 1-800-441-5501
- LTC member services: 1-844-645-7371
- Web: aetnabetterhealth.com/florida
Aetna concentrates its Florida footprint in three high-population regions. If you're outside Tampa Bay, the Orlando metro, or Miami-Dade/Broward/Monroe, Aetna isn't an option. If you're in those regions, Aetna's national CVS Health network can be a draw, CVS pharmacies, MinuteClinics, and HealthHUB locations are integrated into the plan in ways that other Florida plans don't replicate.
UnitedHealthcare Community Plan
- Member services: 1-888-716-8787
- Web: uhc.com/communityplan/florida
UnitedHealthcare was a 2024 procurement initial loser that was awarded a follow-on contract to satisfy Florida's two-plan-per-region floor. The footprint covers the Jacksonville/Gainesville cluster (Region B), Tampa Bay (Region D), and Miami-Dade/Broward/Monroe (Region I). UHC's national provider network is among the largest in U.S. healthcare; for a senior with regular travel between Florida and another state, that can matter. F/EA assignment is not published in member handbooks, call 1-888-716-8787 for current PDO vendor.
Community Care Plan (CCP)
- Member services: 1-866-899-4828
- Web: ccpcares.org
CCP is Florida's hospital-system-owned plan, Broward Health and Memorial Healthcare in south Florida launched it specifically to keep coordinated care inside their two networks. The plan is small but locally trusted, particularly for seniors already attached to Broward Health or Memorial providers. Regions covered cluster across central and south Florida.
Molina Healthcare of Florida
- Member services: 1-866-472-4585
- Web: molinahealthcare.com/members/fl
Molina entered Florida SMMC at scale with the November 2025 CMS specialty plan award, the first major mid-cycle plan change of SMMC 3.0. The transition runs through 2026, with current CMS Plan members (previously administered by Sunshine Health) moving to Molina on staggered effective dates. For senior Medicaid families this matters less directly, Molina does not currently hold an LTC or comprehensive contract, but is the most active news in the Florida managed care landscape and worth tracking.
Statewide Prepaid Dental
Two plans serve all 9 regions:
- DentaQuest: 1-888-468-5509 / dentaquest.com
- Liberty Dental Plan: 1-833-276-0850 / libertydentalplan.com
Florida Medicaid adult dental coverage is limited (emergency extractions, preventive cleanings, certain restorative services) under both plans. Children's dental coverage is more comprehensive under EPSDT. See /medicaid/florida/dental-coverage for the full breakdown.
How plan choice actually works
When you become Medicaid-eligible in Florida, you choose your MMA plan (and, if eligible, your LTC plan). The mechanics:
FAQ
After eligibility is approved, AHCA mails a notice listing the plans available in your region and a deadline to choose. The pre-enrollment notice period is typically 30 to 60 days, depending on whether you're a new applicant, a renewal, or a mid-year switch.
If you affirmatively pick a plan within the notice period, you're enrolled in your chosen plan. If you don't choose, AHCA auto-assigns you using an algorithm that considers prior plan history, family member assignments, geographic accessibility, and plan capacity. Both paths produce the same starting point.
From the date of enrollment, you have 120 days to switch plans without justification. Use it. If your assigned doctor is out of network, your preferred ALF doesn't take the plan, you don't like the formulary, the plan's portal is hard to use, any reason works.
Once the 120-day window closes, you're locked in to the chosen plan until your annual 60-day open enrollment period, which runs around the anniversary of your enrollment. During open enrollment you can switch freely. Outside of open enrollment, you can switch only for a "good cause" exception under Florida Administrative Code Rule 59G-8.600: provider not in network, quality concerns, plan termination, member relocates outside region, etc.
Whichever path you take, the new plan starts the first day of the calendar month after the change is processed. There is no mid-month switch.
How to actually pick a plan
Most third-party "best Florida Medicaid plan" rankings are useless, they treat plans as products and miss that the right answer depends on your specific situation. The four questions that actually matter:
- Are my doctors in the plan's network? This is the single biggest practical factor. Check the plan's provider directory or call member services with your doctors' names. If your primary care doctor, specialist, or preferred hospital isn't in network, the plan is wrong for you regardless of national reputation.
- Is my preferred LTC setting in the plan's network? If your loved one is moving into a specific Assisted Living Facility, Adult Family Care Home, or nursing facility, ask the facility which plans they currently take. Most ALFs in Florida contract with FCC and Humana; Aetna/UHC vary by region.
- What F/EA does the plan use for PDO? If you plan to hire a family caregiver under the Participant-Directed Option, Humana/Sunshine/Aetna use GT Independence and Simply/FCC use Public Partnerships LLC (PPL). Each has its own onboarding, EVV app, and pay calendar.
- Does the plan have a stable case manager? LTC plans assign a case manager who develops your Plan of Care and authorizes services. Plans with high case-manager turnover create disrupted care. There's no public scorecard for this, call the plan and ask about case load and tenure, or ask current members in your area.
Free, neutral help is available through Florida's enrollment broker. Call 1-877-711-3662 or visit flmedicaidmanagedcare.com. The broker is contracted by AHCA, not by the plans, and walks you through plan options with no incentive to push any particular plan.
How quality is measured (and where to find it)
AHCA publishes a Medicaid Health Plan Report Card at ahca.myflorida.com that grades plans on dimensions including:
- Children's preventive care
- Adult preventive care
- Care for chronic conditions
- Behavioral health
- Member experience
- Access to care
The most recent published cycle as of this guide's last verification (6/2/2026) was based on calendar-year 2022 measures. AHCA had not yet published an updated 2025 or 2026 scorecard. Check the live AHCA Report Card page before making any plan recommendation that hinges on quality scores, the field changes every cycle.
For dual-eligible seniors (Medicare + Medicaid), the Medicare Star Ratings for each plan's Medicare counterpart can also be useful. Humana, UHC, Aetna, and Molina have Medicare Advantage products in Florida that are generally rated by CMS at medicare.gov/plan-compare.
What changed in February 2025 (and what stayed the same)
Changed:
- 11 numbered regions → 9 lettered regions A-I
- AmeriHealth Caritas Florida exited the program
- Plan footprints reshuffled across regions
- Contracts renewed for 5 years (Feb 2025 – Dec 2030)
- Aetna and UHC won new follow-on contracts to satisfy two-plan-per-region floor
- Community Care Plan retained specialty Comp LTC Plus + SMI in Regions E-I
- Molina's CMS specialty plan was awarded November 2025 (transitioning through 2026)
Stayed the same:
- AHCA, DCF, DOEA three-agency structure
- Comprehensive vs. specialty plan distinction
- 120-day plan-change window + annual open enrollment
- Choice counseling at 1-877-711-3662
- F/EA vendor split for PDO (GT Independence + PPL)
- Statewide prepaid dental (DentaQuest + Liberty Dental)
- The fundamental Medicaid eligibility math (see /medicaid/florida/eligibility-income-limits)
Frequently asked questions
Search your zip code at flmedicaidmanagedcare.com. The site returns the region letter and the plans available to you.
Only if the new plan has the doctor in its network. Before switching, check the new plan's provider directory or call member services with your doctor's name. Most large Florida primary care groups (HCA, AdventHealth, Memorial, Cleveland Clinic Florida, Baptist Health) contract with multiple plans, but specialists and ancillary providers vary more.
MMA is acute and primary care, doctors, hospitals, prescriptions, behavioral health. LTC is long-term services, home health, ALF placement, nursing home care, adult day care, home-delivered meals, PERS. A senior on Medicaid LTC enrolls in BOTH an MMA plan and an LTC plan; sometimes they're the same company (e.g., Humana for both), sometimes different.
Yes, that's the norm for LTC seniors. You enroll in one MMA plan (for medical) and one LTC plan (for long-term care). The two plans coordinate with each other on overlapping issues (e.g., a hospital admission triggers both). The MMA and LTC plans don't have to be the same company.
FCC is a Medicaid-only plan operated by Independent Living Systems specifically for Florida's LTC population. It doesn't compete in commercial insurance, its sole product is Medicaid managed care. That focus makes it the highest-LTC-volume plan in Florida and the option with the most LTC-specific care management infrastructure.
It's rare but it does happen, see AmeriHealth Caritas's exit on 2/1/2025. AHCA transitions members to remaining plans in their region. You receive a notice 60-90 days before the change; the transition includes a 90-day continuity-of-care period during which the new plan honors your existing prior authorizations and provider relationships.
Plan exits are uncommon mid-cycle but possible. The 5-year SMMC 3.0 contracts run through December 2030; the next major procurement cycle will start in 2029-2030. Mid-cycle plan changes (like Molina's CMS specialty award) are more common than exits.
No. Florida is a near-fully-mandatory managed care state, almost all Medicaid services flow through SMMC plans. The exceptions are narrow (some American Indian beneficiaries, certain dual-eligible carve-outs, services rendered before plan enrollment). For practical purposes, every Medicaid recipient is in a managed care plan.
Then you're a dual-eligible beneficiary. Medicare is your primary payer for most medical services; Medicaid is secondary and covers what Medicare doesn't (long-term care, premiums, copays, certain services Medicare excludes). For LTC, your SMMC LTC plan still organizes your home and community-based services, but the medical side runs through Medicare. Many duals also enroll in a Medicare Special Needs Plan (D-SNP) operated by their Medicaid plan's parent company, Humana, UnitedHealthcare, Aetna, and Sunshine all offer D-SNPs aligned with their Florida Medicaid LTC plans.
You have a few options: (a) negotiate single-case agreements through the plan's case management; (b) request a "good cause" plan change if eligible (see Rule 59G-8.600); (c) appeal the network adequacy decision through DCF's Office of Appeal Hearings. The first option is by far the most common path forward.
If you don't have a plan yet, call 1-877-711-3662 (the enrollment broker, free and neutral) or visit flmedicaidmanagedcare.com. If you do have a plan and want to switch, call the same number, they'll walk you through the change-for-any-reason or good-cause process.
Bottom line
Florida's Medicaid managed care landscape is more concentrated than it looks. Despite eight active plans, only two, Humana and FCC, serve LTC across all 9 regions. The rest of the field competes on regional density, network depth, F/EA choice, and ancillary perks like CVS integration (Aetna), national provider networks (UHC), or hospital-system alignment (CCP).
For most Florida seniors, the right plan choice comes down to three questions: are my doctors in the network, is my preferred LTC setting in the network, and what F/EA does the plan use for PDO if I'm hiring a family caregiver. Get those right, use your 120-day change window if you're not satisfied, and the rest sorts itself out.
When in doubt, call 1-877-711-3662, the enrollment broker is free, contracted by AHCA, and not selling you anything.
Learn More
- Florida Medicaid Programs Overview
- Florida Medicaid Eligibility & Income Limits
- How to Apply for Florida Medicaid
- Florida Long-Term Care Waiver
- What Florida Medicaid Covers
- Florida Medicare vs. Medicaid
Find personalized help choosing a Florida Medicaid plan at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.