Jeffrey Wade
If you're looking to change your Florida Medicaid insurance provider, there are a few things to keep in mind. Firstly, you have the option to change your plan during the first 90 to 120 days of your enrollment. This is known as the trial period, and you can switch for any reason. After this initial period, you will only be able to change your plan during the yearly Open Enrollment Period, which typically lasts 60 days. During this time, you can change plans without state approval. Additionally, certain events or state-approved reasons may allow you to change providers outside of the enrollment period. Maintaining relationships with your preferred physicians is important, and some providers will work with you to continue receiving their services even if they are not in-network. To initiate a change, you can contact Florida's enrollment broker or a Choice Counselor for guidance.
| Characteristics | Values |
|---|---|
| Time period to change the plan after enrollment | First 90 days or 120 days of enrollment |
| Time period to change the plan after the initial period | 60-day annual open enrollment period |
| Time period to change the plan after the open enrollment period | Next open enrollment period or with a State-approved reason |
| Who to contact to change the plan | Medicaid Choice Counselor at 1-877-711-3662 (TTY/TDD 1-866-467-4970) |
| Online platform to change the plan | Member Portal Account |
| Other ways to change the plan | Contact the Helpline to speak with a Choice Counselor |
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What You'll Learn
Changing your plan within the first 120 days of enrollment
If you have been approved for Medicaid in Florida, you may change your plan during the first 120 days of your enrollment. This is known as the 'no change period'. During this time, you can switch to a new plan for any reason, and you will not need state approval to do so.
To change your plan, you can create a member portal account or message a virtual enrollment assistant. You can also call the helpline to speak with a Choice Counselor. Before enrolling in a new Medicaid plan, you must first apply for Medicaid benefits through the ACCESS online portal, where you can create a MyACCESS account.
If you are switching to a new plan, it is important to notify your provider immediately, especially if you are receiving services that you will need to continue. This is because one of the most common obstacles to switching Medicaid plans is maintaining your relationship with your current physicians. However, some providers will work with you and your doctors to help you continue receiving the services you need, even if the doctor is not in their network.
After the initial 120-day period, you will only be able to change your plan during the yearly Open Enrollment period or with a State-approved 'For Cause' reason. The Open Enrollment period is a 60-day period each year when you can change plans without state approval.
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Switching to Humana Healthy Horizons in Florida
If you're looking to switch to Humana Healthy Horizons in Florida, there are a few things you should know. Firstly, Humana Healthy Horizons is a Medicaid product of Humana Medical Plan, Inc., and it is available to eligible Florida residents through Managed Medical Assistance (MMA) plans. This means that you will need to enrol in an MMA plan to switch to Humana Healthy Horizons.
When can you change your Florida Medicaid insurance provider? If you have been approved for Medicaid, you may change your plan during the first 120 days of your enrollment. After these initial 120 days, you will only be able to change your plan during the annual 60-day Open Enrollment period or with a State-approved reason. This Open Enrollment period is when you can change plans without state approval. Remember that if your address changes, you may need to select a different plan if your region has changed.
To enrol in Humana Healthy Horizons, you can contact Florida's enrollment broker at 877-711-3662 (TTY: 711). They can assist you with enrolment, disenrolment, and any questions you may have about the plan.
With Humana Healthy Horizons, you can expect to receive Medicaid benefits, rewards, and support to make your life easier. They aim to provide you with the care you need to feel your best and go beyond that by offering additional services that you may not even realise you needed. This approach is what they call "human care".
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Changing your primary care provider
If you have been approved for Medicaid, you may change your plan during the first 120 days of your enrollment. During this period, you can switch for any reason to a new plan. After 120 days, you will only be able to change your plan during the yearly Open Enrollment period or with a State-approved reason. The yearly Open Enrollment period is a 60-day period each year when you can change plans without state approval.
If you want to change your primary care provider, you can do so by creating an online account on the Sunshine Health website. You can also find a provider using their online search tool or by looking in their online provider directory.
If you switch to Humana Healthy Horizons in Florida, you can create a Member Portal Account or chat with a virtual enrollment assistant. You can also call the Helpline to speak with a Choice Counselor at 877-711-3662.
If you are unsure whether you can change plans, you can call an enrollment broker at 877-711-3662 (TTY: 711) or a Medicaid Choice Counselor at the same number.
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Maintaining relationships with physicians
In Florida, Medicaid recipients may change their plans during the first 90 or 120 days of their enrollment. After this period, they will only be able to change their plan during the yearly Open Enrollment period or with a State-approved reason. This can be challenging as one of the most common obstacles to switching Medicaid plans is maintaining your relationship with your physicians.
To maintain relationships with physicians when changing Medicaid plans in Florida, it is important to take proactive steps. Firstly, communicate with your current physicians about your intention to switch plans. They might be able to provide guidance on how to continue receiving their services or facilitate a smooth transition to a new provider. It is important to be transparent about your healthcare needs and services you wish to continue, so your physicians can provide the necessary information and assistance.
Additionally, when choosing a new plan, consider providers that are part of the same network as your current physicians. This increases the likelihood that you can continue your relationship with them. Review the provider directories and networks of your prospective plans to identify potential overlaps. You can also contact the new plan's member support or customer service to inquire about specific physicians or request assistance in finding new doctors with similar expertise and experience.
In some cases, your current physicians may be able to provide referrals to colleagues within the network of your new plan. These referrals can help ensure continuity of care and facilitate a warm handoff to new treating physicians. It is also beneficial to review the policies and procedures of your new plan regarding continuity of care. Many plans have established protocols to assist members in maintaining relationships with their current physicians or finding suitable alternatives.
Lastly, stay informed about any changes in your physicians' affiliations and accreditations. Sometimes, physicians may gain inclusion in new networks or participate in different plans over time. By staying up to date with their credentials, you can identify opportunities to re-establish your relationship with them, even if it was not possible initially when you switched plans. Remember that open communication, proactive planning, and leveraging available resources will help you maintain valuable physician relationships or find suitable alternatives when changing Medicaid plans in Florida.
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Open Enrollment periods
If you have been approved for Florida Medicaid, you may change your plan during the first 90 or 120 days of your enrollment. After this period, you will only be able to change your plan during the yearly Open Enrollment period or with a State-approved reason. The Open Enrollment period is a 60-day window each year when you can change plans without state approval.
During the Open Enrollment period, you can switch to a new Medicaid plan, such as Humana Healthy Horizons in Florida, which provides extra services and perks. To switch to a new plan, you can create a Member Portal Account or chat with a virtual enrollment assistant. You can also call the Helpline to speak with a Choice Counselor.
If you are unsure whether you can change plans, you can call Florida's enrollment broker to ask questions. You can also call the Medicaid Choice Counselor to find out if you can change plans.
It is important to note that if you change plans during the Open Enrollment period or at any other time, you will be locked into that plan for 12 months. If you wish to change plans after this period, you must have a State-approved reason.
In addition to the Open Enrollment period, you may be able to change your Medicaid provider if your address changes and your region has changed. This is a State-approved reason to change plans.
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Frequently asked questions
You can change your Florida Medicaid insurance provider during the first 120 days of your enrollment. After the 120 days, you will only be able to change your plan during your yearly 60-day open enrollment period or with a State-approved reason.
You can change your provider in your private online account or by calling an enrollment broker at 1-877-711-3662 (TTY: 711).
Yes, you can continue receiving services from your current doctors even if they are not in your new provider's network.
