Florida’s
MEDICA ID
REDETERMINATION PLAN
BACKGROUND
Medicaid is health coverage option for low-income individuals and families. Due to the federal Public Health
Emergency, the Department of Children and Families (Department), as required by the federal government,
implemented processes to maintain Medicaid coverage for individuals, regardless of their nancial eligibility.
This resulted in the number of Medicaid recipients growing from 3.8 million to 5.5 million. In Florida, the Department
determines eligibility for Medicaid,
while the Agency for Health Care Administration administers the
Medicaid program.
PLAN OBJECTIVES
Ensure continuity of Medicaid coverage for eligible individuals while promoting the
availability of alternative health insurance providers.
Prioritize exceptional customer service through strong communication and
community collaboration.
Leverage technology and operational eciencies while being compliant with federal guidance.
FLORIDA
’
S PLAN SUMMARY
• Increase eciency by aligning public benet cases over a 12-month period.
• Enhance customer service by reducing paperwork.
• Meet federal regulatory requirements while prioritizing Florida’s families.
• Maximize technology and automation to enhance processes and communication to recipients.
• Automatic review for recipients to determine Medicaid eligibility. If Medicaid cannot be automatically
renewed, recipients will receive a notice 45 days prior to their renewal date with instructions on
how to complete the renewal process.
FLORIDA WINS
• Technology enhancements and automation implemented to help process cases faster.
•
Utilization of technology to communicate to
recipients
via email, text messaging and mail.
• More than 92% of our recipients enroll online.
• Automatic partner referrals to organizations like Florida Healthy Kids and other subsidized programs.
• Clear and robust communication to recipients, partners and stakeholders.
For more information, visit myfamilies.com, or to check on the status of your benets go to your MyACCESS Account.
Once the continuous coverage requirement ends,
the Department will return to the standard Medicaid review process,
which ensures eligible recipients will continue to remain enrolled.
FLORIDA'S MEDICAID
REDETERMINATION PLAN
Florida’s Plan to Return to Standard Medicaid Eligibility Processing
TABLE OF CONTENTS
Florida's Medicaid Redetermination Plan......................................................................................1
Executive Summary ..................................................................................................................3
Florida’s Medicaid Redetermination Plan .....................................................................................5
Impact of the Public Health Emergency on Floridians enrolled in Medicaid ....................................... 5
Florida’s Medicaid Redetermination Plan Objectives ......................................................................... 5
Current State – Processing Medicaid Applications in Florida ....................................................6
Medicaid Eligibility in Florida ............................................................................................................. 6
Getting Back to Normal – When CONTINUOUS COVERAGE ENDS .......................................8
Federal Requirements & Guidance ................................................................................................... 9
Florida’s Operation Plan for Redeterminations and Eligibility Updates ............................................ 10
Actions to Promote Continuity of Coverage ............................................................................ 12
Redetermination at SNAP Recertification ........................................................................................ 12
Ex Parte Review ............................................................................................................................. 13
Technology Enhancements ............................................................................................................. 13
Partner Referrals ............................................................................................................................ 14
Workforce ....................................................................................................................................... 14
Fair Hearings .................................................................................................................................. 15
Communication and Community Outreach ............................................................................. 15
Outreach Goals and Strategies ....................................................................................................... 15
Key Messaging ............................................................................................................................... 16
Community Partners and Stakeholders ........................................................................................... 19
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EXECUTIVE SUMMARY
In Florida, the Department of Children and Families (Department) determines eligibility for
Medicaid while the Agency for Health Care Administration (AHCA) administers the Medicaid
program. Medicaid is health insurance coverage for low-income individuals and families. As
required by the Families First Coronavirus Response Act, in March 2020 the Department
implemented processes to maintain Medicaid eligibility for individuals no longer eligible during
the Public Health Emergency (PHE). Medicaid beneficiaries who failed to recertify during the
PHE also continued to be eligible. This resulted in the number of Medicaid recipients growing
from 3.8 million in March 2020 to 5.5 million in November 2022. Under the Families First
Coronavirus Response Act, Florida is currently receiving a 6.2 percent increase in the Federal
Medical Assistance Percentage (FMAP) through the end of March 2023. In return for the
increased FMAP rate, the State of Florida was not able to reduce eligibility or make it harder
for eligible families to enroll in Medicaid. Additionally, the State of Florida was required to
provide “continuous coverage” and not able to disenroll any individuals, with limited
exceptions, even if they become ineligible for Medicaid.
In December 2022, Congress passed the Federal Consolidated Appropriations Act for 2023,
which ends the continuous coverage provision on March 31, 2023, and is no longer linked to
the end of the PHE. In addition, the Enhanced FMAP rate will begin to decrease incrementally
each quarter until the end of 2023.
Florida’s economy has rebounded quickly and continues to outperform the nation in economic
and labor market metrics. With our robust economic environment, many families have had an
increase in income and the ability to obtain insurance through employment. This is welcomed
news for many families, and the Department will work with them to ensure a smooth transition.
Over the post-continuous coverage transition period, the Department will work to notify and
communicate to all current Medicaid individuals their redetermination timeframes and next
steps.
4
After March 31, 2023, the Department will follow federal guidance to redetermine Medicaid
eligibility while working to ensure eligible individuals remain enrolled. The Centers for Medicare
and Medicaid Services (CMS) allows state agencies up to 12 months to initiate Medicaid
reviews once continuous coverage has ended. Florida will schedule and conduct
redeterminations in a manner compliant with federal regulatory requirements over a 12-month
period. To reduce the impact on families and to create efficiencies for the Department’s
workforce, the Department will align where possible and appropriate, family reviews for both
Medicaid and Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance
to Needy Families (TANF). CMS has also instituted a Medicare Special Enrollment Period
(SEP) for Medicaid recipients who may qualify for Medicare after their continuous enrollment
ends.
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FLORIDA’S MEDICAID
REDETERMINATION PLAN
Impact of the Public Health Emergency on Floridians enrolled in
Medicaid
In Florida, the Department determines eligibility for Medicaid while AHCA administers the
Medicaid program. Medicaid is health insurance coverage for low-income individuals and
families. As required by the Families First Coronavirus Response Act, in March 2020 the
Department implemented processes to preserve Medicaid eligibility for individuals no longer
eligible during the PHE. The number of Floridians receiving Medicaid increased dramatically
during the PHE from 3.8 million in March 2020 to 5.5 million in November 2022. Of the 5.5
million individuals, the Department determines eligibility for approximately 4.9 million, with the
remainder addressed by other state and federal agencies.
Florida’s Medicaid Redetermination Plan Objectives
• Ensure continuity of Medicaid coverage for eligible individuals while promoting the
availability of alternate health insurance options for those who are no longer eligible.
• Prioritize exceptional customer service through strong communication and community
collaboration.
• Leverage technology and operational efficiencies while being compliant with federal
guidance.
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CURRENT STATE – PROCESSING MEDICAID
APPLICATIONS IN FLORIDA
Medicaid Eligibility in Florida
The Department of Children and Families determines Medicaid eligibility for:
• Parents and caretaker relatives of minor children
• Children (up to age 21)
• Pregnant women
• Certain individuals formerly in foster care (up to age 26)
• Aged, blind, or disabled individuals not receiving Supplemental Security Income
Florida has an integrated application that allows individuals to apply for Medicaid, SNAP (food
assistance), and/or Temporary Assistance for Needy Families (TANF cash assistance)
through a single application. Ninety-two percent of the Department’s Medicaid applications
and redeterminations are filed through the state’s online Self-Service Portal, which is available
24 hours a day. Individuals may file a paper application via fax, mail, or in person at the
Department’s customer service centers or through community partner sites around the state.
Medicaid eligibility is determined by many factors including family circumstances, assets, and
income. These factors are inter-related: for example, children and pregnant women are eligible
with a higher family income than other adults. In normal circumstances, if a Medicaid
individual’s circumstances change, such as an increase in income or a change in household
composition, they must report changes that may affect their eligibility.
Where possible, the Department processes Medicaid redeterminations without additional
outreach to the recipient. The state approves Medicaid eligibility if it can make the
determination based on the information provided by the individual and verifications provided
through electronic data. Income is generally verified through the State Wage and Income
Collection Agency (SWICA) and the state’s Timesaving Innovation Process (TIP) automates
case processing where possible. In cases where information cannot be automatically verified,
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the Department will request additional documentation or information from individuals before
making the determination. Most redeterminations occur without recipient involvement or in
conjunction with a SNAP or TANF redetermination. During the continuous coverage period,
Florida continued processing applications and redeterminations to keep individuals informed
of their potential eligibility for Medicaid.
Under Governor DeSantis’ leadership, Florida reopened quickly and continues to outperform
the nation in key economic metrics. As of November 2022, Florida has experienced 31
consecutive months of job growth. With these economic successes in mind, we encourage all
Floridians to contact their employer to see if health coverage options are available to them
through their work benefits.
Processing Applications
When individuals are determined ineligible for Medicaid, their application is automatically
transferred to Florida KidCare or the subsidized federal programs for review for eligibility for
low-cost or subsidized insurance through those programs. In State Fiscal Year 2021, the
Department completed an average of 119,217 Medicaid reviews each month and an average
of 14 days to process Medicaid applications with 98 percent completed timely. For disability
related cases, the average days to process applications is 20, of which 98 percent were
completed timely.
By the Numbers
During the PHE, Florida saw an increase in the number of individuals and families seeking
Medicaid assistance, from 3.8 million enrolled in March 2020 to 5.5 million in November 2022.
Individuals who are determined eligible by the Social Security Administration (SSA) for
Supplemental Security Income (SSI) are also enrolled in Medicaid. All others must apply
through the Department. On average, the Department processes 220,658 Medicaid
applications, redeterminations, or requests for additional assistance each month.
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GETTING BACK TO NORMAL – WHEN
CONTINUOUS COVERAGE ENDS
During the PHE, the Families First Coronavirus Response Act provided additional matching
funds and required that states continue eligibility for Medicaid for individuals who were covered
as of March 2020 or who subsequently became eligible. Individuals receiving Medicaid during
this period were removed only if they moved from Florida, requested to be removed from
Medicaid, or were deceased.
Federal regulations require that eligibility for Medicaid must be determined “promptly and
without undue delay
1
.” Eligibility determinations may not exceed 90 days for individuals
applying for Medicaid based on a disability or 45 days for all other applicants.
1
42 CFR §§ 435.912
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Federal Requirements & Guidance
Federal guidance requires states to conduct a full Medicaid redetermination after the
continuous coverage period ends, even for individuals who were determined to be ineligible at
their last review. States must initiate redeterminations for the total caseload by the last month
of the 12-month unwinding period. Simply stated, the state must review all Medicaid cases for
eligibility once continuous coverage has ended.
Since the Department continued to complete redeterminations during most of the PHE, the
state can identify some approximate numbers of Medicaid households that include one or
more individuals that are no longer eligible. During the PHE, an individual that became
ineligible remained on Medicaid through continuous coverage, even if the family’s income
increased above the threshold, the family composition no longer qualified them for eligibility,
or the individual or family no longer met another required eligibility factor. These cases were
flagged with an indicator identifying that they were ineligible at last review. Because family
circumstances may have changed since that determination, the Department will complete
another review after continuous coverage ends before determining ineligibility for Medicaid
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coverage. The Department estimates that, as of December 2022, there are more than 900,000
Medicaid cases in which one or more individuals in the case are no longer eligible.
In addition to those previously identified as ineligible, there are approximately 850,000 cases
wherein Medicaid recipients have not responded to requests from the Department for updated
information as a part of their regularly scheduled annual redetermination. In some instances,
individuals may have not had their eligibility evaluated for up to three years but have continued
to receive continuous coverage. Some individuals may have obtained other coverage or no
longer need Medicaid, others may have moved without updating their address and did not
receive notification of their redetermination.
Federal guidance allows states to schedule redeterminations at any time for individuals who
were ineligible at their last review and those who have not completed a redetermination in the
last 12 months. Additionally, federal guidance recommends that states prioritize workload in a
manner that “considers the need to prevent inappropriate terminations” and achieves “an
evenly-distributed renewal workload that is sustainable in future years.”
2
Florida’s Operation Plan for Redeterminations and Eligibility
Updates
Based on data available in December 2022, at least 16% of Medicaid households completing
their redeterminations included at least one ineligible individual. Some may lose eligibility over
the next 12 months, as in any year, due to changes in circumstances, including changes in
income, or moving out of state. These individuals generally have a redetermination date
already scheduled. Due to external factors, applications and redeterminations have historical
peaks in certain months, including November, December, and January. The Department
anticipates scheduling redeterminations in a manner that will come closer to equalizing
2
SHO# 22-001
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workload throughout the 12-month period, creating a caseload that aligns more appropriately
to staffing, and achieves a greater level of service to individuals.
The Department’s plan to conduct redeterminations is designed to return to normal business
operations to meet federal regulatory requirements while ensuring eligible individuals continue
to receive coverage and ineligible individuals are transitioned to other coverage where
possible. The plan also reduces the impact on families and creates efficiencies for the
workforce by reducing the number of interactions with recipients by aligning family reviews for
both Medicaid and SNAP/TANF. In short, Florida will thoughtfully align benefit review and
eligibility processes back to pre-PHE standards in a manner that will provide greater customer
service for individuals.
Redetermination Prioritization
Florida has focused on continuity of coverage for eligible households while promoting
alternative coverage for those who are no longer eligible. The state has developed a common-
sense approach that seeks to prioritize reviews for those that may no longer wish to maintain
Medicaid coverage or no longer meet eligibility requirements.
The state has prioritized for first review the group which is anticipated to experience the least
negative impact: individuals who have been identified both as ineligible during the most recent
redetermination review and have not used Medicaid benefits for at least 12 consecutive
months. Individuals who were previously identified as ineligible will constitute the second
priority. In addition, SSI recipients who are determined ineligible by SSA and are referred to
the Department for an ex parte review will be processed in compliance with federal guidelines.
The Department also recognizes that families who receive multiple benefits, such as SNAP
and TANF, may have multiple requirements to complete scheduled, periodic redeterminations.
While these requirements are necessary to meet varying certification periods, each presents
a risk that failure to complete the process will result in a loss of benefits. Where possible within
the monthly processing capacity and existing prioritization, the Department will align Medicaid
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redetermination dates to existing SNAP or TANF dates while maintaining any period of
Medicaid eligibility that remains. For example, an individual with a Medicaid redetermination
date in June and a SNAP recertification in August may, for example, have the Medicaid
redetermination occur concurrently in August with the SNAP recertification.
Some Medicaid individuals have not completed a redetermination and will be assigned a
redetermination date based on the time since the last redetermination. Similarly, certain
Medicaid recipients who do not have an open case in our system, such as Family Planning
services recipients determined eligible by the Department of Health, will receive a
redetermination as capacity allows and in compliance with federal guidelines.
Finally, the Department coordinated with AHCA to identify Medicaid recipients under the age
of 21 diagnosed with a medically complex condition. Similarly, the Department will delay
redeterminations for certain other vulnerable groups, including SSI-related institutional care
and hospice care with limited income sources. Redeterminations for these group will be
postponed until the end of the redetermination period.
ACTIONS TO PROMOTE CONTINUITY OF
COVERAGE
Redetermination at SNAP Recertification
Florida provides an integrated application process, allowing individuals to apply for SNAP,
Medicaid, and TANF, as well as certain other benefits, on the same application. The integrated
application process simplifies the receipt of benefits for Florida’s families.
Because Florida is an integrated eligibility state, the state is able to leverage information from
the SNAP and TANF program to support Medicaid eligibility determinations. Approximately 42
percent of Medicaid cases also receive SNAP and those recipients are required to recertify
every four or six months. When a SNAP recertification is conducted and eligibility factors
continue to be met for Medicaid, Medicaid can be extended for 12 months. For example, if an
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individual receives both Medicaid and SNAP beginning in January, recertification for SNAP
would be due in June to continue receipt of SNAP for July through December. The Medicaid
recertification is scheduled for the following January. At the July SNAP review, if eligibility
requirements are met, Medicaid can be extended for 12 months. If Medicaid eligibility cannot
be established in July, the original 12-month Medicaid eligibility period remains, and a
redetermination will occur in January.
Ex Parte Review
Florida’s existing processes complete ex parte reviews for Medicaid eligibility for a significant
number of cases. At the beginning of the month prior to each redetermination date, the system
conducts data matching to evaluate Medicaid recipients for redetermination without contacting
individuals. If the data matching does not provide sufficient information to renew Medicaid
benefits, a notice is sent to the individual requesting they complete a redetermination.
Technology Enhancements
During the continuous coverage period, the Department implemented new technologies to
provide enhanced service to individuals and streamline eligibility processes. Florida has long
been a leader in the automation of applications and redeterminations, with more than 92
percent of applications and recertifications submitted electronically.
Enhancements already implemented include:
• Assisted address changes in the Self-Service Portal to facilitate the maintenance of up-
to-date addresses.
• Created “How To” videos to assist individuals in updating addresses or making changes
to their account.
• Extension of twelve months of continuous Medicaid coverage for postpartum women.
• Automated processes to allow Family Related Medicaid cases to close only after a
review has occurred after the end of the continuous coverage period. Existing
automation will prevent closure until the review.
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• Enhanced returned mail processing that will identify Medicaid redetermination notices
that will be referred for special handling/follow-up and to create automatic email or text
notifications to individuals.
Additional technology enhancements that we are implementing:
• Changes to Ex Parte processes to increase the number of cases that will allow renewal
based on data matching.
• Increased use of email and text messaging to alert customers when redeterminations
are due.
Partner Referrals
Some Medicaid recipients who have experienced a change in circumstances that make them
ineligible, such as increased income or a change in family composition, may be eligible for
coverage through other subsidized state and federal programs. The Department automatically
refers certain individuals who are no longer eligible for Medicaid coverage electronically to
Florida Healthy Kids, the Medically Needy Program, and other subsidized federal programs.
Workforce
The Department has implemented strategies to maintain its workforce to support the increase
in Medicaid redeterminations when the continuous coverage period ends. State strategies
include:
• Streamline hiring practices to reduce time to fill positions.
• Provide overtime during the PHE to promote timely case processing.
• Enhance call center performance by:
o Onboarding additional call center agents to provide support for individuals.
o Hiring vendor staff to assist with overflow call volume.
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o Both Department and vendor staff encourage callers to opt in to receiving case
notifications via electronic delivery, ensuring we have accurate electronic contact
information.
o Department and vendor staff are actively confirming mailing addresses to ensure
the most accurate customer contact information is available to the Department.
• Review for consideration all flexibilities under federal regulations to gain operational
capacity and efficiencies.
Fair Hearings
The Department’s Office of Appeal Hearings affords due process to individuals who believe
actions on their eligibility for benefits were made in error. The Office of Appeal Hearings is
poised and ready to process appeal requests that may result from a denial in coverage under
this process. However, if the Office of Appeal Hearings identifies that the number of hearing
requests exceeds the capacity to respond in a timely manner, the Department may request,
through AHCA, authority under section 1902 (e)(14)(A) to temporarily extend the timeframe to
take final administrative action on fair hearing requests.
COMMUNICATION AND COMMUNITY OUTREACH
Outreach Goals and Strategies
Medicaid Redetermination Communication Objectives:
• Communicate clearly to recipients, the public, community partners, and stakeholders
regarding the ending of continuous coverage and how this may impact their Medicaid
enrollment.
• Educate individuals regarding the Department’s Medicaid Redetermination Plan and health
insurance options to ensure families are prepared and enrolled in health care coverage
that meets their individual needs.
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In 2022, the Department initiated efforts to ensure Medicaid recipients are aware of upcoming
changes. The messaging highlights the urgency for individuals to provide updated contact
information. Other key components of the messaging focus on ensuring individuals know it is
important to look for and respond to future notices from the Department and understand their
coverage options.
Outreach materials will be provided to AHCA for Medicaid health plans to use in assisting
individuals in changing their address. Additionally, the Department is encouraging partner
organizations, advocacy groups, and other state agencies to remind recipients to update their
contact information with the Department. These organizations will have access to a partner
packet to assist them in communicating with individuals.
The Department has worked to identify households that have moved and will contact them
directly to alert them to change their address. Individuals that have identified a different
address with a medical provider, a Medicaid health plan, or the Department’s Electronic
Benefit Transfer (EBT) provider are sent notifications to all available addresses indicating that
they should update their address to ensure they can continue medical coverage.
The Department will leverage various communication channels to provide clear and engaging
reminders for individuals to update their address and/or renew their benefits. The
Department’s Medicaid Redetermination outreach will occur through both direct and indirect
messaging. Individuals will receive direct messaging through text messages, email, and
mailed notices. Indirect messaging will occur through website, social media platforms, and
Interactive Voice Response (IVR).
The Department is exploring additional outreach and customer support avenues that will be
implemented before and after the end of continuous coverage.
Key Messaging
For messaging to be effective, it takes repetition. The Department’s outreach and
communication will focus on providing accurate and clear information to recipients on a
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continuous basis through various communication channels. Individual-focused messaging will
be available in English, Spanish, and Haitian Creole. Public outreach prior to the end of
continuous coverage focuses on education and awareness, while reinforcing the importance
of updated contact information and timeliness in responding to redetermination notices. Once
continuous coverage ends, messaging will focus on education and awareness, leveraging
many of the same communication channels previously engaged.
The Department will roll out direct messaging to Medicaid recipients who must complete the
redetermination process which may include postcard mailers, letter notices, text messages,
and emails. Redetermination notifications will also be provided to recipients in their Self-
Service Portal account. Reminders will align with the recipient’s planned redetermination
schedule.
Postcard mailer: Individuals who have identified a different address with a medical provider,
a Medicaid health plan, or the Department’s Electronic Benefit Transfer (EBT) provider will be
sent a postcard mailer to all available addresses indicating that they should update their
address to ensure they can continue medical coverage. The postcard mailer will have an eye-
catching graphic of a moving van encouraging individuals to take action to update their
address.
Yellow Stripe Envelope: Medicaid redetermination notices will be identified with a special
yellow stripe envelope and a communications campaign will be initiated to encourage
individuals to watch for and respond to their notice.
Text Messaging: Redetermination notifications will be sent to Medicaid recipients through a
text message campaign. Individuals with returned mail will receive an additional text message
notifying them that they were sent a notice from the Department about their Medicaid, but it
was returned undeliverable. All Medicaid recipients will receive a text message at the end of
the continuous coverage period to let them know they will not lose coverage at this time and
to look out for the redetermination notice.
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Email Messaging: Individuals who have opted to receive email notifications for updates from
their MyAccess account will receive a renewal email sent 45 days before they need to renew.
The standard notice will inform individuals to visit their MyAccess account within the next 30
days to renew their benefits. Individuals will also be reminded again to ensure their address
and phone number are up to date.
The Department will provide indirect outreach messaging through broad channels including
the Department’s webpage, social media, Medicaid Health Plans, stakeholders, and
community partners. Messaging through indirect communication channels will occur on a
continuous basis both before and after the end of continuous coverage.
Website: The Department will establish a webpage to educate and inform Medicaid individuals
of what to expect, how to update contact information, and other available health insurance
options. Individuals can browse a bank of frequently asked questions about Medicaid
Redetermination as well as frequently asked questions about using their MyAccess portal for
their renewal. A preview of the Department’s notice will be displayed to assist individuals with
knowing what to look out for and what they need to do when it is received. This webpage will
serve as the state’s centralized reference point for up-to-date information regarding Florida’s
Medicaid redetermination process and next steps. Additional messaging on the Department’s
webpage will include a continuous scrolling message on the MyAccess homepage and
interactive messaging with the Department’s virtual assistant.
Social Media: A social media campaign across multiple platforms will amplify the
Department’s public outreach. Eye-catching phrases and graphics will encourage individuals
to update their address and take action to renew their benefits. A link to the MyAccess page
and “DCF Virtual Assistant” will be shared in applicable posts to create a seamless path for
individuals to update their address or renew their benefits. Short, animated videos will be made
available for individuals who need additional assistance with logging into their MyAccess portal
or understanding their health coverage options.
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Community Partners and Stakeholders
Community partners and key stakeholders are included in the Department’s public outreach
efforts and will receive electronic fliers for display and distribution to connect individuals to
more information on our website in English, Spanish, and Haitian Creole. Many of the
Department’s community partners support individuals with applying for public benefits or
renewing their benefits. The Department sees community partners as a significant resource
for message delivery to individuals. Communications to community partners occurs prior to
and after the end of continuous coverage.
Partnering with Medicaid Health Plans
The Department will engage in a multi-faceted approach to work with AHCA and the Medicaid
health plans to facilitate the maintenance of health coverage.
In anticipation of the end of continuous coverage, the Department provided AHCA with training
materials for Medicaid health plans to use in assisting individuals in changing their address
through the Department’s Self-Service Portal or Call Center. The Department encourages all
entities that interact with individuals to ensure individual contact information is current. After
the redetermination dates are re-aligned, the Department will provide AHCA current
redetermination date information, which will then be shared with the health plans to support
individuals in completing their redeterminations.
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GLOSSARY
Term/Acronym
Definition
AHCA
Agency for Healthcare Administration, the Florida agency
that administers the Medicaid program (DCF determines
eligibility for Medicaid).
CMS
Centers for Medicare and Medicaid Services, a federal
partner guiding the state’s Medicaid Redetermination.
Department of Children
and Families’ Medically
Needy Program
A Medicaid program that allows Medicaid coverage after
a monthly “share of cost” is met. The share of cost is
determined by household size and family income.
Individuals who are not eligible for “full” Medicaid because
their income or assets are over the Medicaid program
limits may qualify for this program.
Ex Parte Review
Where the Department reviews and renews the
customer’s Medicaid case automatically.
Federal Marketplace
Also known as the Health Insurance Marketplace, a
shopping and enrollment service for medical insurance
created by the Affordable Care Act of 2010.
Federally Qualified
Health Center
Community-based health care providers that receive
funds from the HRSA Health Center Program to provide
primary care services in underserved areas.
Florida KidCare
Florida Kidcare is the umbrella brand for the four
government-sponsored health insurance programs –
Medicaid, MediKids, Florida Healthy Kids (CHIP), and
Children’s Medical Services Health Plan, that provide
health and dental coverage from birth to age 18.
Healthcare Navigator
Healthcare Navigators are individuals that can help
consumers understand new coverage options and find
the most affordable coverage that meets their health care
needs. In Florida, these individuals must be trained and
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register with the Florida Department of Financial
Services.
MAGI
Modified adjusted gross income refers to family-related
Medicaid.
Medicaid health plans
Medicaid health plans are a managed care organizations
that contract with the Agency for Healthcare
Administration to provide healthcare coverage through
the Medicaid Program
PHE
Public Health Emergency, declared through the U.S.
Department of Health and Human Services, when a
disease or disorder presents a public health emergency
or that a PHE otherwise exists due to the significant
outbreaks of infectious disease. PHE’s can last up to 90
days and can be extended at any time by the U.S.
Department of Health and Human Services.
SNAP
Supplemental Nutrition Assistance Program (SNAP)
provides nutritional support for low-income seniors,
people with disabilities living on fixed incomes, and other
individuals and families with low incomes.
SSA
Social Security Administration, Federal agency
determining aged related and disability benefits.
SSI-Related Medicaid
Individuals who are either aged 65 or older or disabled
may be eligible for SSI – Related Medicaid.
TANF
Temporary Assistance for Needy Families, also known as
Cash Assistance
TIP
Timesaving Innovation Process is the state’s automated
case processing program that verifies income with the
State Wage and Income Collection Agency.
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Medicaid Redetermination Communications Plan
Objective: Communicate clearly to recipients, the public, community partners, and stakeholders regarding the ending of the continuous coverage
period and how this may impact the enrollment to the state’s Medicaid program. The plan will educate recipients regarding the Department’s
Medicaid Redetermination Plan and health insurance options, to ensure families are prepared and enrolled in health care coverage that meets
their individual needs.
Indirect Outreach
The Department will have an initial campaign of information through broad channels including our website, social media, Medicaid health
plans, community partners, and other stakeholders about the continuous coverage period ending and what recipients need to do now.
Direct Messaging
The Department will roll out direct messaging to Medicaid recipients who need to go through the redetermination process. Reminders
will align with the recipient’s planned redetermination schedule. Medicaid recipients can redetermine benefits within two months of their
predetermined redetermination date. Recipients who have an email address and a phone number in their MyACCESS account will receive
additional reminders through email and text messaging.
Stakeholders:
• Current Medicaid Recipients
• Medicaid health plans
• Florida KidCare
• Agency for Health Care Administration
• Media
• General Public
• Advocacy Groups
• Community Partners
• Medical Providers
• Legislative Members
• Pharmacies
• DCF Employees & Leadership
• Healthcare Navigators
• Other social service executive agencies
Modes of Communication:
• Department’s Website
o Scrolling messages on MyAccess homepage (continuous)
o Medicaid redetermination specific page on myflfamilies.com
o FAQs
o Virtual Assistant
o Repackaged ‘How To’ videos
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• Interactive Voice Response – Call Center Message & script
• Social Media
o Reminders to Medicaid recipients to update information (corresponding graphics)
o Videos and graphics on what to expect as a current Medicaid recipient
• Direct Messages to Medicaid Recipients
o Email
o Text Messages
o Notices
• Partner Packets
o Plan summary with QR code to community partners and stakeholders
▪ Timeline
▪ What to expect
▪ How to help our recipients
o Correspondence to MCOs
▪ Letter communicating expectations to share resources outside of the current MCOs’ health insurance plans
• Internal Employees
o ESS training “Tip of the Week”
o Policy Memos
o Statewide ESS Operations Call (OCM)
o Medicaid Redetermination Project Management Meetings
Content
• Florida’s Medicaid Redetermination Plan
• Website Content
o FAQs
o Timeline (post ending of the continuous coverage period)
o Chatbot messaging
o ‘How To’ videos (repackaged)
o Sample of the Department’s Redetermination Notice
o Resource flyer
• Social Media Messaging & Graphics
o Reminder to update contact information
3
o Tips for keeping individual’s MyAccess account current
o Medicaid recipient journeys
• Interactive Voice Response Message – Call Center recording
• Talking Points
o Call Center / Hope Navigator scripts
o PowerPoint for external meetings/ events
o External talking points/ statements
• Medicaid Recipient Content
o Notices – paper and email
o Text messages
o Post card regarding duplicate addresses
o Count down reminders
o Resource flyer
o Recipient pathway / next steps
4
Content Language:
Website Content:
Florida’s Medicaid Redetermination Plan
Since the beginning of the Public Health Emergency (PHE), as a requirement to receive additional funding from the federal government, Florida
has provided continuous Medicaid coverage and has not disenrolled ineligible recipients. As a result of this policy, Florida saw a significant increase
in the number of individuals and families seeking Medicaid assistance, from 3.8 million enrolled in March 2020 to 5.5 million in November 2022.
Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI
recipients) while the Agency for Health Care Administration (AHCA) administers the Medicaid Program. Each month the Department processes,
on average, 220,658 Medicaid applications, redeterminations, or requests for additional assistance.
As a result of legislative changes in the Consolidated Appropriations Act, 2023, the continuous coverage provision will end on March 31, 2023, and
is untied from the end of the PHE. The Department will follow federal guidance to restore Medicaid eligibility through normal processing while
working to ensure eligible recipients remain enrolled. The Centers for Medicare and Medicaid Services (CMS) allows state agencies up to 12 months
to complete Medicaid reviews once the continuous coverage period ends. Florida will undertake this task by scheduling and conducting
redeterminations in a manner that will meet federal regulatory requirements while minimizing the impact on families.
Florida’s economy has rebounded quickly and continues to outperform the nation in economic and labor market metrics. With our robust
economic environment, many families have had an increase in income and the ability to obtain insurance through employment. This is welcome
news for many families, and the Department will work with them to ensure a smooth transition. Over the next 12 months, the Department will
work to notify and communicate to all current Medicaid recipients their redetermination timeframes and next steps.
LINK FLORIDA’S MEDICAID REDETERMINATION PLAN (post after the ending of the continuous coverage period is announced)
The Florida Medicaid Redetermination Plan Objectives:
• Ensure continuity of Medicaid coverage for eligible individuals while promoting access to alternative health coverage providers.
• Prioritize exceptional customer service through strong communication and community collaboration.
• Leverage technology solutions to enhance operational efficiencies while being compliant with federal guidelines.
LINK FREQUENTLY ASKED QUESTIONS
Don’t miss information about your Medicaid coverage – update your contact information here
MOVING GRAPHIC WITH LINK TO Self-Service Portal (SSP)
5
SSP Posted Scrolling Message: Have you moved recently or changed your email address? Be sure to update your address with the DCF Virtual
Assistant so you can stay up to date on your benefit information.
FAQs:
What is a federal Public Health Emergency (PHE)?
A PHE is when the United States Department of Health and Human Services (HHS), a federal agency, declares that a disease or disorder presents
a public health emergency or that a PHE otherwise exists due to the significant outbreaks of infectious disease. PHEs can last up 90 days and can
be extended at any time by U.S. Department of Health and Human Services (HHS). For the COVID-19 pandemic, the federal government declared
a PHE on January 31, 2020.
How does the federal PHE affect eligibility for Florida Medicaid?
The Families First Coronavirus Response Act requires that states maintain continuous Medicaid coverage for enrollees during the PHE. Florida has
allowed individuals to remain on Medicaid throughout the PHE even though their household situation may have changed. As a result of federal
legislative changes in the Consolidated Appropriations Act, 2023, the continuous coverage provision will end on March 31, 2023. Once the
continuous coverage ends, some Medicaid recipients may no longer be enrolled in Medicaid.
When will the continuous coverage end for Medicaid?
The continuous coverage provision will end on March 31, 2023.
What will happen when the continuous coverage ends?
Over the course of 12 months the Department will review all Medicaid cases to ensure recipients are eligible for benefits. Many individuals will be
the beneficiary of an automatic review and approval to continue Medicaid eligibility (also called passive renewal or ex parte renewal). In this case,
individuals will receive a notice that their Medicaid case has been approved and their Medicaid coverage will continue.
If the Department cannot automatically review an individual's Medicaid coverage because additional information is required, the Department will
send a notice 45 days prior to the renewal date with instructions on how to complete the renewal process. Individuals will have the opportunity
to provide updated information to Department staff who will evaluate their eligibility for Medicaid. Upon receipt of this notice, it is important that
individuals act timely to provide requested information to ensure they do not experience a disruption in Medicaid coverage.
For more information on how to sign up for e-mail notifications visit this link: Going Paperless: Email Notifications and Online Notices
(myflfamilies.com)
If recipients have questions regarding their MyACCESS Account or about updating their contact information, please check out the ‘How To’ videos
here: Access Florida - Florida Department of Children and Families (myflorida.com).
6
What should I do when the continuous coverage ends?
You should make sure your address on file is updated by logging in to your MyAccess account. Additionally, be on the lookout for a mailed or
emailed notice from the Department to complete your renewal. Upon receipt of that notice, you should renew as quickly as possible by going to
https://www.myflorida.com/accessflorida/ to update your Medicaid information. The Department may ask for additional information from you
while your case is being reviewed.
What should I do if I am no longer eligible for Medicaid when the continuous coverage ends?
If you are no longer eligible for Medicaid coverage, the Department will send you a notification through your MyACCESS account, and by sending
a letter or an email to you. To ensure continuing coverage, applications for individuals not determined eligible for Medicaid, but eligible for a
different healthcare coverage program, will automatically be referred to Florida KidCare, the Medically Needy Program, and other subsidized
federal healthcare programs. You can check your MyACCESS account to see if your application has been forwarded to one of these agencies.
Florida KidCare provides low-cost health coverage for children based on family income. You can learn more about this program at the following
link: www.floridakidcare.org. The Medically Needy Program allows Medicaid coverage after a monthly “share of cost” is met, determined by
household size and family income. You can learn more about the Medically Needy program at the following link: Medically Needy Brochure
(myflfamilies.com).
If your application is transferred to the Federal Marketplace, you will receive a letter from the United States Department of Health and Human
Services with instruction on how to complete an application for healthcare insurance. You can learn more about the Federal Marketplace at the
following link: www.healthcare.gov.
What additional information or documentation may the Department need to complete my Medicaid redetermination?
Current Medicaid recipients have already provided verification of some eligibility factors, such as identity, Florida residence, citizenship or eligible
immigration status. Example of additional information that may need to be provided includes but is not limited to, information about the members
of your household, income and, for certain coverage, asset information.
How long will it take for the Department to review my Medicaid redetermination?
Once all the information needed to make a determination is available, the Department will make a decision on eligibility within 45 days. The
Department will review your application to determine if you are eligible for Medicaid and the level of Medicaid coverage you are eligible to receive.
If it is determined that you are not eligible for Medicaid, your application will be automatically referred electronically to Florida KidCare, the
7
Medically Needy Program, and other subsidized federal health programs. You can check your MyACCESS account to see if your application has
been forwarded to one of these agencies.
Other Medical Help for Those Not Eligible for Medicaid
Individuals who are not eligible for Medicaid may get help with healthcare in their area through:
• Federally Qualified Health Centers
Individuals who are not eligible for Medicaid may get help with the cost of prescription drugs through:
• Florida Discount Drug Card Program, or
• FloridaRXCard.com
NOTE: These programs are not administered by the Department of Children and Families and are being provided as a potential healthcare resource
for you and your family. The Department and its partners, including the Medicaid Health Plans, stand ready to help families secure other options
to receive health care coverage including referrals to the Federally Qualified Health Centers, who provide primary care services on a sliding fee
scale to individuals without health insurance.
To speak with a Healthcare Navigator for guidance on navigating the healthcare system, visit My Florida CFO for a contact list of Florida-registered
and federally-certified Navigators. A guide on Health Insurance and HMO Overview is also available at My Florida CFO.
What if I think the determination that I am ineligible is wrong?
If the Department determines that you are not eligible for Medicaid and you think the determination is wrong, you have a right to appeal and
should do so within 10 days of the date on the denial letter. You can initiate an appeal by making a request to the Office of Inspector General
(OIG). While your appeal is in process, you have the choice to retain your Medicaid coverage.
8
Talking Points:
• The Department continues to work diligently for Floridians to ensure that Medicaid coverage remains intact for current enrollees during
and throughout the continuous coverage period.
• The Centers for Medicare and Medicaid Services (CMS) allows state agencies up to 12 months to complete Medicaid reviews once the
continuous coverage period has ended.
• The Department will follow federal guidance relating to Medicaid eligibility to ensure eligible recipients continue to remain enrolled.
• The Department has already begun outreach to current Medicaid enrollees to communicate the importance of providing updated contact
information to ensure that they receive redetermination notices. Due to the duration of the PHE, some current Medicaid enrollees will
need to submit additional information or update their information on file to continue their Medicaid coverage.
• The Department has deployed several technology solutions and supports to ensure we will be successful throughout this process.
• Florida’s budget this year has funding to expand and supplement our existing call center to provide additional support for recipients.
Beginning in March 2021, the Department started working to onboard more than 137 additional call center agents to provide support for
recipients who need to update their eligibility information.
• In November 2021, the Department deployed automation and robotics to auto-index returned mail to sort, process and respond quickly
to recipients whose notices are not delivered. We are working to deploy an additional bot this spring that will send an automated text
message to recipients when a notice returned to the Department.
• These efforts and the extensive work we have done with our partners and key stakeholders across the state are to ensure Florida is poised
and ready for the task at hand.
• The Department maintains constant communication with our federal partners, sister state agencies including the Agency for Health Care
Administration (AHCA), and stakeholders to work together to ensure Floridians are able to plan for the future.
• Florida has many safety net options for families. In fact, recipients who are determined ineligible for Medicaid based on a change in
circumstances are referred automatically to alternatives, including the Florida KidCare, the Medically Needy Program, and other subsidized
federal health programs.
• For children in particular, Florida’s KidCare program will often provide a low-cost option for medical coverage.
• The Department and its partners, including the Medicaid health plans, stand ready to help families secure other options to receive health
care coverage including referrals to the Federally Qualified Health Centers who provide primary care services on a sliding fee scale to
individuals without health insurance.
9
Call Center Script:
If a customer has questions about their Medicaid coverage use these talking points to guide the conversation:
• It is important to keep your contact information up to date in your MyACCESS account so you will receive notices about your Medicaid
coverage.
• Once the continuous coverage period ends, the Department will work over the course of 12 months to review all Medicaid cases to ensure
recipients are eligible for benefits. Many Medicaid recipients will be automatically redetermined while others may have to provide
additional information before the Department can determine their eligibility. If this is the case, the Department will reach out to those
recipients with a notice in the mail 45 days prior to their renewal date, as well through email and or text messaging.
• Applications for individuals determined ineligible for Medicaid will be automatically referred electronically to Florida KidCare, the Medically
Needy Program, and the Federal Marketplace.
• You can also log-in to your MyACCESS account and renew online.
• For more information about Medicaid or to locate additional resources for you or your family, you can visit the Medicaid Redetermination
Frequently Asked Questions page at myflfamilies.com/Medicaid.
• Press Release Announcing Restart of
Redeterminations and Important Recipient
Information
• Scrolling Web Messages
• Continue Social Media Campaign
• Begin mail, email, and text to April
redetermination recipients
April
• Launch Social Media
Campaign
• Continue to collect updated
contact info with postcard
campaign
February
• Press Release Announcing end of Continuous
Coverage & Next Steps for Recipients
• Text & email to all Medicaid recipients
• Additional Call Center Agents
• Post How-to Videos
March
Continue Mail, Email, and Text to Redetermination Clients during
their Redetermination Month, and Continue Social Media Campaign
through February 2024
Feb
2023
Mar
2023
Apr
2023
May
2023
Jun
2023
Jul
2023
Aug
2023
Sep
2023
Florida’s Medicaid Redetermination Communications
• Press Release on Florida’s
Redetermination Process
• Continue Social Media Campaign
• Mail, email, and text to May
redetermination recipients
May
• Press Release, an update on
Florida’s Redetermination
Process
July
Jan
2023
January
• Distribute Partner Packet
• Send out postcard to clients
with multiple addresses on
file
• Webpage & FAQ
10
Florida’s Response to Common Concerns About the Medicaid Redetermination Process
Item/ Accusation
DCF’s Response
Medicaid to Separate CHIP Program
Recipients who are determined to no longer be eligible for Medicaid due to changes in circumstances are
referred automatically to alternatives, including Florida KidCare, the Medically Needy program or other
subsidized federal health programs.
CHIP Premiums Are a Barrier
For children in particular, Florida’s KidCare program will often provide a low-cost option for medical coverage.
The Department and its partners, including the Medicaid Health Plans, stand ready to help families secure other
options to receive health care coverage including referrals to the Federally Qualified Health Centers who
provide primary care services on a sliding fee scale to individuals without health insurance.
Medicaid to Federally Facilitated
Marketplace (Federal Marketplace)
Individuals who are determined to no longer be eligible for Medicaid due to changed circumstances are referred
automatically to alternatives, including the Florida KidCare, the Medically Needy program, or other subsidized
federal health programs.
The Department and its partners, including the Medicaid Health Plans, stand ready to help families secure other
options to receive health care coverage including referrals to the Federally Qualified Health Centers who
provide primary care services on a sliding fee scale to individuals without health insurance.
Notices Frequency, Return Mail &
Communication
For more than a year, the Department has been communicating with recipients regarding the importance of
updating contact information to ensure we have the most up to date information. Florida’s Medicaid
Redetermination Plan includes extensive outreach to recipients through multiple communication modes to
alert individuals throughout their redetermination period.
The Department has shared resources and information with health care and other non-profit stakeholders
statewide to provide additional supports to recipients throughout the redetermination process.
In November of 2021, the Department deployed automation and robotics to auto-index returned mail to help
sort, process and respond quickly to recipients whose notices are not delivered. We have also implemented
additional enhancements to facilitate sending automated text messages to recipients when a notice is returned
to the Department and when their renewal is due.
11
Automatic Renewal Rates (using
existing data sources)
The Department leverages existing data to automatically renew or redetermine recipients without contacting
them when possible. This year, 67 percent of the adult/disabled Medicaid population were renewed without
contact.
The Department leverages the review process for SNAP and TANF to extend Medicaid where possible and
automatically renews recipients when information is received automatically from a variety of data sources
integrated within the Department.
12 Months Continual Coverage for
Kids
In Florida, children covered by Medicaid under the age of 5 receive 12-month of continuous eligibility while
children ages 5 and older receive six months of continuous eligibility.
Boosting Call Center Workforce
To support the needs of our recipients, Governor DeSantis and the Florida Legislature increased funding by
more than $22 million to expand our existing call center. We are working now to onboard more additional
contracted agents to provide support for recipients who need to update their eligibility information.
Community Based Outreach
The Department has an extensive list of community partners throughout the State. Florida’s Medicaid
Redetermination Plan includes providing partner packets with information, timelines, and graphics to assist
recipients throughout their redetermination process.
Additionally, the Department will provide extensive outreach to recipients through multiple communication
modes to update recipients throughout their redetermination period.
Application Assistance
The Department has an extensive list of community partners and stakeholders who stand ready to assist
recipients in filling out an application for Medicaid or help answer questions regarding their benefits. To locate
a community partner in your area, please visit: https://access-web.dcf.state.fl.us/CPSLookup/search.aspx
Redetermination Timeline
The Department will take advantage of the full 12-month timeline.
Improper Determinations
A federal review of the Medicaid eligibility process from 2021 determined that Florida’s Medicaid eligibility
process has an error rate of only 1.99%. The Department’s Office of Appeal Hearings affords due process to
individuals who believe actions on their eligibility for benefits were made in error. Within 10 days of receipt of
the case action letter from the Department, appeals should be initiated by the recipient through making a
request to the Office of Inspector General (OIG).
12
Press Statement(s):
In coordination with the Agency for Healthcare Administration, the Department has already begun an outreach campaign to current Medicaid
enrollees to communicate the importance of providing updated contact information so recipients can receive critical information and notices
regarding their Medicaid coverage.
Recipients who are no longer eligible for Medicaid, but are receiving Medicaid coverage due to the continuous coverage period will need to seek
additional options for health insurance once their coverage ends. To assist qualifying families in obtaining health care coverage, the Department
provides a seamless “account transfer” to other health coverage options. These account transfers allow recipients to be referred to Florida KidCare
or other subsidized federal health programs that they may qualify for.
Under Governor DeSantis’ leadership Florida reopened quickly, and Florida continues to outperform the nation in key economic metrics. Florida
has experienced 31 consecutive months of job growth and its private sector job growth rate has exceeded the nation’s for 20 consecutive months.
With these economic successes in mind, many recipients have been able to pursue opportunities in Florida and may no longer be eligible for
Medicaid.
Statement Operations Back to Normal:
Florida has worked with its partners to develop a robust operational and communication plan to provide information to Medicaid recipients, the
public, and key stakeholders. We have developed a strategy to thoughtfully align benefit reviews and eligibility processes in a manner that will
provide greater customer service to our recipients.
As Medicaid returns to standard processing, Florida’s families should expect an annual review. Some families may see changes in dates as the
Department aligns public benefit case reviews where possible, reducing the frequency in which families are required to interact with the
Department. We encourage all recipients to contact their employers to see if options for health coverage are available to them through their work
benefits.
Florida’s plan streamlines processes and reviews, prioritizing recipients first over an annual timeline. Florida families will have their Medicaid case
reviewed annually by the Department, which is the normal benefit review and eligibility business processes pre-PHE.
13
Messaging
IVR Call Center Message:
Have you moved recently or changed your email address? Be sure to let your agent know if you have a change in your contact information so we
have the most up to date information on file.
Draft Social Media Messages:
Message 1: Have you moved within the last 3 years? Make sure your health coverage moves with you. Log in to your MyACCESS account to update
your contact information. (Moving Truck Graphic)
Message 2: We want to get in touch with you! Medicaid recipients may receive text message reminders from DCF to update your address or renew
your benefits application. You can also check for notices from DCF by logging in to your MyACCESS account. (Mailbox Graphic)
Message 3: A short, animated video on how to update your contact information through MyACCESS account.
Text Message: (Must be under 160 characters)
Message 1: This is a reminder from DCF to update your address so we can reach you about changes to your Medicaid coverage. To update, log in
to your MyACCESS account or chat with the DCF Virtual Assistant.
Message 2: This is a reminder from DCF to renew your Medicaid benefits application within 30 days. To renew, log in to your MyACCESS account
and click the “Renew My Benefits” button.
Message 3: This is a reminder from DCF to renew your Medicaid benefits application within 14 days. To renew, log in to your MyACCESS account
and click the “Renew My Benefits” button.
Message 4: Returned Mail Recipients Only. DCF has sent you a notice on regarding your Medicaid benefits to your address on file, but the notice
was returned undeliverable. Please log in to your MyACCESS account to update or chat with the DCF Virtual Assistant.
14
Email:
Message 1: Standard MyACCESS account notices (first notice sent 45 days before customer needs to renew)
Message 2: Additional reminder
It’s time to renew your Medicaid benefits application! Visit your MyACCESS account to renew your benefits application within the next 30 days with
the Florida Department of Children and Families. Your renewal will be processed to determine if you are still eligible for Medicaid coverage. DCF
may ask for additional information while your case information is being reviewed. Please make sure your mailing address and phone number are
up to date.
Once we receive your renewal information, DCF will send you a notice to let you know if you are still eligible for Medicaid coverage.
For more information about Medicaid, including other options for health coverage, please visit …INSERT Medicaid RESOURCE LINK
Postcard Mailer
Message 1:
Front: Moving Van Graphic: Have you moved? Make sure your health coverage moves with you.
Back: You are receiving this because the Florida Department of Children and Families (DCF) has multiple addresses on file for you. Please update
your mailing address, email address, and phone number with the Department of Children and Families. To update quickly, scan the QR code on
the front of this care, or visit: myflorida.com/accessflorida
Make sure your
HEALTH COVERAGE
moves with you!
SCAN FOR
MORE INFO
ACCESS CENTRAL MAIL CENTER
P.O. BOX 1770
Ocala, FL 34478
You are receiving this because Department
of Children and Families (DCF) has multiple
addresses on le for you. Please update your
mailing address, email address, and phone
number with DCF. To update quickly, scan the
QR code on the front of this card, or visit:
myorida.com/accessorida
2415 North Monroe Street, Suite 400, Tallahassee, Florida 32303-4190
Mission: Work in Partnership with Local Communities to Protect the Vulnerable, Promote Strong and
Economically Self-Sufficient Families, and Advance Personal and Family Recovery and Resiliency
Ron DeSantis
Governor
Shevaun L. Harris
Secretary
State of Florida
Department of Children and Families
To: Medicaid Health Plans
Re: Florida’s Medicaid Redetermination Plan – Recipient Communication
Thank you for your continued partnership in ensuring Floridians have had access to quality
healthcare throughout the Public Health Emergency (PHE). I have had discussions with many of
you who are interested in supporting the Department as we undergo the Medicaid redetermination
process in partnership with the Agency for Health Care Administration (AHCA).
As many of you are aware, under the Families First Coronavirus Response Act, in order to qualify
for the enhanced 6.2% FMAP, States were required to provide continuous coverage for Medicaid
recipients and to not disenroll any recipients, with limited exceptions, even if they became
ineligible for Medicaid. In December 2022, Congress passed the Consolidated Appropriations Act,
2023, which ends the continuous coverage provision on March 31, 2023.
In preparation, and to assist us in this process, we are asking for your support in encouraging
your enrollees to update their contact information and report any changes in their circumstance
(such as change of mailing or living address, family composition or income) to the Department.
As a reminder, recipients can update their information at any time through the virtual
assistant/chatbot feature on our website (myflfamilies.com) or through their MyACCESS account.
Our number one priority is to ensure continued coverage for those who remain eligible for
Medicaid and to assist those who are no longer eligible with alternative options. When an
individual is determined ineligible for Medicaid, the Department will automatically forward their
information to agencies such as Florida KidCare, the Medically Needy Program, and other
subsidized health coverage options.
We will provide you with the scheduled redetermination dates for your enrollees and the earliest
date with which you should begin sending reminders, it is imperative that this schedule be followed
to avoid unnecessary confusion and to prevent recipients from submitting documentation too
early.
The Department has created a Medicaid Redetermination Partner Packet to assist you in
communicating with recipients about their Medicaid coverage. The materials and templates
provided in this toolkit include graphics and key messaging. The Medicaid Redetermination
Partner Packet is available on our website, myflfamilies.com/Medicaid.
Thank you, again, for your partnership and dedication to serve Florida’s families.
Best,
Shevaun L. Harris
Secretary
Florida’s
M E DI CAID ELIGIBILITY
REDETERMINATION PROCESS
INELIGIBLE
FOR MEDICAID
AUTOMATIC
REFERRAL
SUBSIDIZED
FEDERAL
HEALTH
PROGRAMS
CLIENT
SELECTS
A PLAN
AND PAYS
PREMIUM
DCF
CASE REVIEW
AND
NOTICE SENT
DCF reviews
client eligibility.
ELIGIBLE FOR
OTHER HEALTH
COVERAGE!
INELIGIBLE
FAMILY
WITH
CHILDREN
UNDER
18
Florida
Healthy
Kids
HEALTHCARE
OPTION
PROVIDED
CLIENT
SELECTS PLAN
AND
PAYS PREMIUM
Florida
Healthy Kids
CONTACTS CLIENT
2-3 days:
NOTICE (U.S. Mail)
10 days:
PHONE CALL
INELIGIBLE
FOR MEDICAID
AUTOMATIC
REFERRAL
ELIGIBLE FOR
Florida
Healthy Kids!
NOTICE
If additional information
is needed, DCF will send
a notice 45 days before
Medicaid ends, asking
client to complete
a renewal application.
DCF REVIEWS
AND MAKES A
DETERMINATION
DCF
CASE REVIEW
DCF automatically
reviews client eligibility
based on available data.
Parent
provides
info
U.S. MAIL &
EMAIL
ELIGIBLE
FAMILY
WITH
CHILDREN
UNDER
18
ELIGIBLE FOR
MEDICAID!
ELIGIBLE FOR
MEDICAID!
DCF
CASE REVIEW
DCF automatically
reviews client eligibility
based on available data.
Medicaid is available
for expecting mothers
and is provided up to
12 months for baby
and mom
PREGNANT
OR
NEW MOM
1
2
3
4
Log in to your
MyACCESS Account
Click the “Report My Changes”
button
Check the box for Address, Email,
or Phone Number changes
Enter your updated information and
follow prompts to nish and submit
To receive important notices about
your HEALTH COVERAGE
UPDATE
YOUR
CONTACT
INFO
UPDATE
YOUR
CONTACT
INFO
If you are no longer eligible
for Medicaid...
FLORIDA
KidCare
If you do not quality for
Medicaid, and you have
children under the age of 18,
you may be able to purchase
low-cost insurance for your
children here.
FEDERALLY
QUALIFIED
HEALTH CENTERS
A healthcare provider who
provides medical care for clients
with limited or no health insurance.
Services are offered on a sliding
scale based on income.
COMMERCIAL
COVERAGE
Provide health care
coverage (including employer
sponsored or private) for a
monthly fee, and coordinate care
for clients through a dened
network of physicians
and hospitals.
To review
your healthcare
options, visit:
fqhc.org
healthcare.gov
oridakidcare.org
medicaidmanagedcare.com
*Depending on the needs of your family, you may be eligible to
benet from two (or more) healthcare options simultaneously.
FEDERALLY
SUBSIDIZED
HEALTH PROGRAMS
A national website
where you can purchase
health insurance, including
low-cost income
based plans.
MEDICALLY
NEEDY
PROGRAM
A program that allows
Medicaid coverage after a monthly
“share of cost” is met. Those who are
not
eligible for “full” Medicaid
because of income or asset
limits,
may qualify.
