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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.

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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.

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